Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection

PLoS One. 2020 Sep 25;15(9):e0239799. doi: 10.1371/journal.pone.0239799. eCollection 2020.

Abstract

Background: To investigate the association between serum 25-hydroxyvitamin D levels and its effect on adverse clinical outcomes, and parameters of immune function and mortality due to a SARS-CoV-2 infection.

Study design: The hospital data of 235 patients infected with COVID-19 were analyzed.

Results: Based on CDC criteria, among our study patients, 74% had severe COVID-19 infection and 32.8% were vitamin D sufficient. After adjusting for confounding factors, there was a significant association between vitamin D sufficiency and reduction in clinical severity, inpatient mortality serum levels of C-reactive protein (CRP) and an increase in lymphocyte percentage. Only 9.7% of patients older than 40 years who were vitamin D sufficient succumbed to the infection compared to 20% who had a circulating level of 25(OH)D< 30 ng/ml. The significant reduction in serum CRP, an inflammatory marker, along with increased lymphocytes percentage suggest that vitamin D sufficiency also may help modulate the immune response possibly by reducing risk for cytokine storm in response to this viral infection.

Conclusion: Therefore, it is recommended that improving vitamin D status in the general population and in particular hospitalized patients has a potential benefit in reducing the severity of morbidities and mortality associated with acquiring COVID-19.

MeSH terms

  • Adult
  • Adverse Outcome Pathways
  • Aged
  • Aged, 80 and over
  • Betacoronavirus
  • C-Reactive Protein / metabolism
  • COVID-19
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / prevention & control
  • Cross-Sectional Studies
  • Female
  • Humans
  • Immunity / drug effects
  • Iran
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Pandemics / prevention & control
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / prevention & control
  • Prognosis
  • SARS-CoV-2
  • Treatment Outcome
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D / pharmacology
  • Vitamin D / standards

Substances

  • Vitamin D
  • C-Reactive Protein
  • 25-hydroxyvitamin D

Grants and funding

The author(s) received no specific funding for this work.