Background: This study was aimed to explore the association of vitamin D in the risk of coagulopathy in coronavirus disease-19 (COVID-19).
Methods: Clinical and laboratory findings were obtained from 50 confirmed COVID-19 patients hospitalized in Saiful Anwar General Hospital, Malang, Indonesia, from September to November 2020. Thrombotic events during hospitalization were recorded, and the ISTH disseminated intravascular coagulation (DIC) score was used to classify overt DIC. Hypovitaminosis D was defined by serum vitamin D level <49.92 nmol/L.
Results: Among 50 patients, 42 (84%) had hypovitaminosis D, and 6 (12%) developed thrombotic events. Vitamin D levels were lower in patients with thrombotic events (p=0.015), D-dimer >2 mg/L (p=0.006), ISTH DIC score 5 (p=0.020), admitted on ICU (p=0.002), and non-survivor groups (p=0.007). Multivariate analysis for the risk in increased D-dimer levels showed low vitamin D as the only significant risk factor with OR 1.8 (1.2-4.4), p=0.034. Low vitamin D also increased the risk for developing overt DIC with OR. 5.4 (1.0-30.2), p=0.039. Vitamin D level had negative correlations with ferritin (R=-0.316, p=0.044) and CRP (R=-0.530, p=0.000).
Conclusions: In conclusion, a low level of vitamin D was found in most hospitalized COVID-19 patients and might be associated with the development of coagulopathy.
Uvod: Cilj ove studije je bio da istraži povezanost vitamina D sa rizikom od koagulopatije kod koronavirusne bolesti 2019 (COVID-19).
Metode: Klinički i laboratorijski nalazi dobijeni su od 50 potvrđenih pacijenata sa COVID-19 hospitalizovanih u opštoj bolnici Saiful Anvar u Malangu u Indoneziji, od septembra do novembra 2020. Zabeleženi su trombotični događaji tokom hospitalizacije, a rezultati ISTH diseminovane intravaskularne koagulacije (DIC) korišćeni su za klasifikaciju očigledne DIC. Hipovitaminoza D je definisana nivoom vitamina D u serumu <49,92 nmol/L.
Rezultati: Od 50 pacijenata, 42 (84%) je imalo hipovitaminozu D, a 6 (12%) je razvilo trombotičke događaje. Nivoi vitamina D su bili niži kod pacijenata sa trombotičkim događajima (p=0,015), D-dimerom >2 mg/L (p=0,006), ISTH DIC rezultatima 5 (p=0,020), primljenih na intenzivnu negu (p=0,002), i grupa koje nisu preživele (p=0,007). Multivarijantna analiza rizika za povećane nivoe D-dimera pokazala je nizak nivo vitamina D kao jedini značajni faktor rizika sa OR 1,8 (1,2-4,4), p=0,034. Nizak nivo vitamina D je takođe povećao rizik od razvoja očiglednog DIC-a sa OR 5,4 (1,0-30,2), p=0,039. Nivo vitamina D je imao negativne korelacije sa feritinom (R=-0,316, p=0,044) i CRP-om (R=-0,530, p=0,000).
Zaključak: Na kraju, kod većine hospitalizovanih pacijenata sa COVID-19 utvrđen je nizak nivo vitamina D koji bi mogao biti povezan sa razvojem koagulopatije.
Keywords: COVID-19; coagulopathy; vitamin D.
2021 Hani Susianti, Cesarius Singgih Wahono, Perdana Aditya Rahman, Mirza Zaka Pratama, Indah Adhita Wulanda, Khoirunisah Dwi Hartanti, Elvira Sari Dewi, Kusworini Handono, published by CEON/CEES.