The prognostic significance of vitamin D deficiency in patients with COVID-19 pneumonia

Yıldız, Mustafa; Şenel, Makbule; Kavurgacı, Suna; ÖZTÜRK, Fatih Emin; Öztürk, Ali

doi:10.4149/bll_2021_119

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…This finding is in line with the international literature, highlighting the importance of adequate vitamin D levels for immune function, prevention of acute respiratory infections including COVID-19, and recovery [18,19,24,25].…”

Section: Discussionsupporting

confidence: 90%

Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial

Ried¹,

BinJemain²,

Sali³

2021

Cureus

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BackgroundCOVID-19 is a global pandemic. Treatment with hydroxychloroquine (HCQ), zinc, and azithromycin (AZM), also known as the Zelenko protocol, and treatment with intravenous (IV) vitamin C (IVC) have shown encouraging results in a large number of trials worldwide. In addition, vitamin D levels are an important indicator of the severity of symptoms in patients with COVID-19. ObjectivesOur multicenter, randomized, open-label study aimed to assess the effectiveness of HCQ, AZM, and zinc with or without IVC in hospitalized patients with COVID-19 in reducing symptom severity and duration and preventing death. MethodsHospitalized patients with COVID-19 in seven participating hospitals in Turkey were screened for eligibility and randomly allocated to receive either HCQ, AZM, and zinc (group 1) or HCQ, AZM, zinc plus IV vitamin C treatment (group 2) for 14 days. The patients also received nontherapeutic levels of vitamin D3.The trial is registered on the Australian and New Zealand Clinical Trial Registry ACTRN12620000557932 and has been approved by the Australian Therapeutic Goods Administration (TGA). ResultsA total of 237 hospitalized patients with COVID-19 aged 22-99 years (mean: 63.3 ± 15.7 years) were enrolled in the study. Almost all patients were vitamin D deficient (97%), 55% were severely vitamin D deficient (<25 nmol/L) and 42% were vitamin D deficient (<50 nmol/L); 3% had insufficient vitamin D levels (<75 nmol/L), and none had optimal vitamin D levels.Of the patients, 73% had comorbidities, including diabetes (35%), heart disease (36%), and lung disease (34%).All but one patient (99.6%; n = 236/237) treated with HCQ, AZM, and zinc with or without high-dose IV vitamin C (IVC) fully recovered. Additional IVC therapy contributed significantly to a quicker recovery (15 days versus 45 days until discharge; p = 0.0069).Side effects such as diarrhea, nausea, and vomiting, reported by 15%-27% of the patients, were mild to moderate and transient. No cardiac side effects were observed.Low vitamin D levels were significantly correlated with a higher probability of admission to the intensive care unit (ICU) and longer hospital stay.

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Section: Discussionsupporting

confidence: 90%

Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial

Ried¹,

BinJemain²,

Sali³

2021

Cureus

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“…In addition, vitamin D can downregulate pro-inflammatory cytokines and balance the inflammatory response, thereby avoiding the cytokine storm-induced host tissue damage during acute viral infection ( 11 , 12 ). Despite some controversy and inconsistency ( 13 , 14 ), multiple studies have suggested that vitamin D may reduce COVID-19 mortality and severity in hospitalized patients, especially in adults with vitamin D deficiency ( 15 , 16 ). Notably, a recent study revealed an association between vitamin D deficiency and clinical severity and inflammatory markers in pediatric COVID-19 cases, and recommended preventive vitamin D supplementation ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

Vitamin D levels and clinical outcomes of SARS-CoV-2 Omicron subvariant BA.2 in children: A longitudinal cohort study

et al. 2022

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ObjectiveTo investigate the picture between vitamin D levels and clinical outcomes of SARS-CoV-2 Omicron subvariant BA.2 in children.MethodsA retrospective, longitudinal cohort study was performed. All included hospitalized cases were divided into the sufficient (sVD) and insufficient vitamin D (iVD) groups according to whether their serum 25-hydroxyvitamin D [25(OH)D] concentration was ≥30 ng/mL. Dynamic changes in clinical parameters were observed for seven time periods within 28 days after admission.ResultsSerum 25(OH)D concentrations were significantly negatively correlated with age in the included cases (r = −0.6; P < 0.001). Compared with the iVD group (n = 80), the sVD group (n = 36) had higher interleukin-6 (18.4 vs. 12.9; P = 0.003) within the first day; higher procalcitonin within the first (0.15 vs. 0.1; P = 0.03), 2–3 (0.14 vs. 0.07; P = 0.03), 4–5 (0.21 vs. 0.07; P = 0.02) days; more lymphocytes within the first (1.6 vs. 1.2; P = 0.02), 2–3 (3.7 vs. 2; P = 0.001), 4–5 (3.9 vs. 2.1; P = 0.01) and 6–7 (4.9 vs. 2.7; P = 0.02) days; notably, higher cycle threshold for N gene (30.6 vs 19.8; P = 0.03) or ORF1ab gene (31.4 vs 20.1; P = 0.03) within 2 to 3 days. Pneumonia lesions were found in eleven and six cases in the iVD and sVD groups, respectively, without significant difference on computed tomography at admission. Six out of eleven and five out of six had a repeat computed tomography after 1–2 weeks. Lesion improvement was more significant in the sVD group (P = 0.04).ConclusionsChildren with vitamin D insufficiency might have poorer clinical outcomes in Omicron subvariant BA.2 infection, especially in older pediatric patients. Further studies are needed to assess effectiveness of supplements in reducing the same.

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“…In a study on COVID-19 patients who had and did not have Vit D replacements, only 1 patient (2.7%) died in the Vit D replacement group while 24 patients (14.1%) died in the non-replacement group (p=0.038). It has been reported that a single dose of 300,000 IU Vit D may be useful in the treatment of COVID-19 (20). Unlikely, another study reported that there was no link between serum Vit D concentrations and the risk of severe COVID-19 infection or death (21).…”

Section: Ilie Et Al Investigated the Relationship Of Mean Vit D Level...mentioning

confidence: 99%

Correlation of vitamin D level with the clinical-radiological severity of COVID-19 in geriatric patients

Baykal

ÜLGER

2022

Journal of Health Sciences and Medicine

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Objective: This study was planned to investigate the effect of 25-OH-Vitamin D (Vit D) deficiency on clinical and radiological findings of coronavirus disease-2019 (COVID-19) in geriatric patients hospitalized due to COVID-19. Material and Method: Seventy-five patients who were treated for COVID-19 were reviewed retrospectively, and grouped in relation with their ages [(1) 65-74, (2) 75-84, (3) >84 years] and the severity of Vit D deficiency [(1) severe deficiency: 30 ng/mL]. The complaints on admission, comorbidities, intensive care unit (ICU) need, length of hospital stay, laboratory data, and mortality of the ones who had and did not have Vit D replacement (n=18/75) were recorded. The patients were analyzed for COVID-19 severity using radiological and clinical markers. Results: Moderate Vit D deficiency (10-20 ng/mL) was frequently detected. When the disease severity and Vit D levels were analyzed, it was found that the disease was more severe (46.6%) in the Vit D 30 ng/ml group, but there was no statistically significant difference among the groups. Low or high Vit D levels did not show any significant correlations with the severity of pneumonia or the thorax CT findings. The intensive care unit (ICU) admission rate was significantly lower in those who had Vit D replacement (p

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The prognostic significance of vitamin D deficiency in patients with COVID-19 pneumonia

Cited by 5 publications

References 23 publications

Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial

Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial

Vitamin D levels and clinical outcomes of SARS-CoV-2 Omicron subvariant BA.2 in children: A longitudinal cohort study

Correlation of vitamin D level with the clinical-radiological severity of COVID-19 in geriatric patients

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