Prevalence of Low Level of Vitamin D Among COVID-19 Patients and Associated Risk Factors in India – A Hospital-Based Study

Singh, Shruti; Nimavat, Nirav; Singh, Amarjeet; Ahmad, Shamshad; Sinha, Nishi

doi:10.2147/ijgm.s309003

Cited by 16 publications

(18 citation statements)

References 49 publications

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“…However, it is important to note that the combined effect of all variants that tend to lower 25D levels is only about 5% [ 121 ]. Further, a hospital-based cross-sectional investigation in India observed a prevalence of 59% and 89% of vitamin D deficiency and insufficiency, respectively, among 156 COVID-19 hospitalized patients [ 122 ].…”

Section: Recent Clinical Data Assessing An Association Between Vitamin D and Covid-19 Infection And Course Of Diseasementioning

confidence: 99%

Vitamin D, infections and immunity

Ismailova

White

2021

Rev Endocr Metab Disord

153

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Vitamin D, best known for its role in skeletal health, has emerged as a key regulator of innate immune responses to microbial threat. In immune cells such as macrophages, expression of CYP27B1, the 25-hydroxyvitamin D 1α-hydroxylase, is induced by immune-specific inputs, leading to local production of hormonal 1,25-dihydroxyvitamin D (1,25D) at sites of infection, which in turn directly induces the expression of genes encoding antimicrobial peptides. Vitamin D signaling is active upstream and downstream of pattern recognition receptors, which promote front-line innate immune responses. Moreover, 1,25D stimulates autophagy, which has emerged as a mechanism critical for control of intracellular pathogens such as M. tuberculosis. Strong laboratory and epidemiological evidence links vitamin D deficiency to increased rates of conditions such as dental caries, as well as inflammatory bowel diseases arising from dysregulation of innate immune handling intestinal flora. 1,25D is also active in signaling cascades that promote antiviral innate immunity; 1,25D-induced expression of the antimicrobial peptide CAMP/LL37, originally characterized for its antibacterial properties, is a key component of antiviral responses. Poor vitamin D status is associated with greater susceptibility to viral infections, including those of the respiratory tract. Although the severity of the COVID-19 pandemic has been alleviated in some areas by the arrival of vaccines, it remains important to identify therapeutic interventions that reduce disease severity and mortality, and accelerate recovery. This review outlines of our current knowledge of the mechanisms of action of vitamin D signaling in the innate immune system. It also provides an assessment of the therapeutic potential of vitamin D supplementation in infectious diseases, including an up-to-date analysis of the putative benefits of vitamin D supplementation in the ongoing COVID-19 crisis.

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Section: Recent Clinical Data Assessing An Association Between Vitamin D and Covid-19 Infection And Course Of Diseasementioning

confidence: 99%

Vitamin D, infections and immunity

Ismailova

White

2021

Rev Endocr Metab Disord

153

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“…Data from other studies show a consistent relationship between older age and more severe disease. 16 , 20 , 22 , 24 , 25 , 26 Our data showed a median age of 52 years in the symptomatic group versus 39 years in the asymptomatic group. Higher BMI has been identified as a risk factor for severe disease or poor outcomes such as the need for invasive ventilation or death.…”

Section: Discussionmentioning

confidence: 50%

“…Using the same definition of vitamin D deficiency and insufficiency as our study, a study performed in India found similar results to our study with a combined prevalence of vitamin D deficiency (< 20 ng/mL) and insufficiency (20 ng/mL – 30 ng/mL) at 89.1%. 16 This comprised 58.9% of vitamin D deficient patients and 30.2% with vitamin D insufficiency. Likewise, an Algerian study found a prevalence of vitamin D insufficiency (20 ng/mL – 30 ng/mL) and deficiency (< 20 ng/mL) of 75.1%.…”

Section: Discussionmentioning

confidence: 99%

“…Higher BMI has been identified as a risk factor for severe disease or poor outcomes such as the need for invasive ventilation or death. 16 , 20 , 22 , 25 , 26 Hypocalcaemia is a significant finding in severe COVID-19 disease; 17 , 27 however, the underlying relationship with vitamin D needs further investigation. Being a negative acute phase reactant, it was not surprising that albumin was found to be lower in patients with more severe COVID-19 disease.…”

Section: Discussionmentioning

confidence: 99%

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Vitamin D status and COVID-19 severity

Kalichuran

Blydenstein

Venter

et al. 2022

Southern African Journal of Infectious Diseases

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Background: Age, body mass index (BMI) and pre-existing comorbidities are known risk factors of severe coronavirus disease 2019 (COVID-19). In this study we explore the relationship between vitamin D status and COVID-19 severity.Methods: We conducted a prospective, cross-sectional descriptive study. We enrolled 100 COVID-19 positive patients admitted to a tertiary level hospital in Johannesburg, South Africa. Fifty had symptomatic disease (COVID-19 pneumonia) and 50 who were asymptomatic (incidental diagnosis). Following written informed consent, patients were interviewed regarding age, gender and sunlight exposure during the past week, disease severity, BMI, calcium, albumin, magnesium and alkaline phosphatase levels. Finally, blood was collected for vitamin D measurement.Results: We found an 82% prevalence rate of vitamin D deficiency or insufficiency among COVID-19 patients. Vitamin D levels were lower in the symptomatic group (18.1 ng/mL ± 8.1 ng/mL) than the asymptomatic group (25.9 ng/mL ± 7.1 ng/mL) with a p-value of 0.000. The relative risk of symptomatic COVID-19 was 2.5-fold higher among vitamin D deficient patients than vitamin D non-deficient patients (confidence interval [CI]: 1.14–3.26). Additional predictors of symptomatic disease were older age, hypocalcaemia and hypoalbuminaemia. Using multiple regression, the only independent predictors of COVID-19 severity were age and vitamin D levels. The patients exposed to less sunlight had a 2.39-fold increased risk for symptomatic disease compared to those with more sunlight exposure (CI: 1.32–4.33).Conclusion: We found a high prevalence of vitamin D deficiency and insufficiency among patients admitted to hospital with COVID-19 and an increased risk for symptomatic disease in vitamin D deficient patients.

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“…This point has incited studies to investigate the effect of an imperfect or lower level of Vitamin D, linking it with many other severe health conditions like autoimmune disorders, cardiovascular disease (CVD), hypertension (HTN), and other diseases. Similarly, various studies have been conducted on the positive benefits of Vitamin D on the early recovery and prevention of COVID-19 [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Vitamin D Levels and Severity in Illness in COVID-19 Patients: A Cross-Sectional Study

Nimavat¹,

Singh²,

Patel³

et al. 2022

Cureus

Self Cite

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic hit the world badly with high mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increased the COVID-19 burden among developed and developing countries due to the unavailability of proven treatment options. Vitamin D has many important anti-inflammatory, immunomodulator, and anti-viral functions. The present study was conducted to evaluate the relationship between Vitamin D in COVID-19.Methods: A cross-sectional study was conducted at a tertiary care hospital in Patna, India. All the patients were enrolled during the period of 3.5 months. A chemiluminescence-based immunoassay analyzer was used to quantify Vitamin D among COVID-19 patients. The study compared Vitamin D deficiency and insufficiency among different groups, i.e., age, sex, BMI, comorbidity, etc. Diabetes and hypertension were evaluated as risk factors for mortality.Results: A total of 225 patients were investigated. Of these, 13.6% had Vitamin D deficiency and 38.9% had insufficiency. Vitamin D level was statistically significant among different age groups, sex, and smokers. Patients aged >60 years were 23 times more likely to have a severe illness (adjusted OR (aOR) 23.53, 95%CI 4.67-118.61), whereas those aged 40 to 60 years were 11 times more likely to have a severe illness (aOR 10.86,. Patients with many comorbidities, on the other hand, had a tenfold greater chance of severe . A deficiency of vitamin D increased the chance of a serious illness by nearly five times (aOR 4.72, 95%CI 1.31-17.03).Conclusion: Vitamin D level was associated with severity of illness; it can be used to estimate the prognosis of COIVD-19 patients and aid in the modification of treatment protocols.

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Prevalence of Low Level of Vitamin D Among COVID-19 Patients and Associated Risk Factors in India – A Hospital-Based Study

Cited by 16 publications

References 49 publications

Vitamin D, infections and immunity

Vitamin D, infections and immunity

Vitamin D status and COVID-19 severity

The Relationship Between Vitamin D Levels and Severity in Illness in COVID-19 Patients: A Cross-Sectional Study

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