Vitamin D Deficiency is Associated with Increased COVID-19 Severity: Prospective Screening of At-Risk Groups is Medically Indicated

Abstract Non-classical actions of Vitamin D are involved in regulation of the immune system including a role in mitigation of excessive inflammation. We hypothesized that vitamin D deficiency existing prior to SARS-CoV-2 infection could contribute to patients developing severe pulmonary compromise as a result of dysfunctional hyperinflammation. Serum vitamin D concentrations of patients experiencing such severe COVID-19 manifestations that they required ICU care at any point of their hospitalization were compared to serum vitamin D concentrations of patients achieving discharge without the need for any ICU care. Having serum vitamin D < 20 ng/mL was significantly associated with increased COVID-19 severity, p=0.001. It is conjectured that population groups know to have low serum vitamin D should be prospectively screened for deficiency and if found emergently treated. Such action could both decrease the maximum severity suffered by infected individuals and lessen the strain on medical resources by decreasing the percentage of COVID-19 hospital admissions requiring ICU care.

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Vitamin D Levels among Hospitalized and Non-Hospitalized COVID-19 Patients in Dr. M. Djamil General Hospital Padang

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2021.3.6.1131 ◽

2021 ◽

Vol 3 (6) ◽

pp. 78-81

Author(s):

Harika Putra ◽

Efrida ◽

Rismawati Yaswir

Keyword(s):

Vitamin D ◽

Immune System ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Study Groups ◽

P Value ◽

Chi Square ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Chemiluminescent Microparticle Immunoassay

Coronavirus Disease 2019 (COVID-19) causes immune system dysregulation and an exaggerated systemic inflammatory response. Vitamin D acts as an immunomodulator that enhances the immunity defense. Low levels of vitamin D affect the severity of COVID-19 infection. This study aims to determine vitamin D levels in hospitalized and non-hospitalized COVID-19 patients. A case-control study was conducted involving 62 COVID-19 patients, equally divided into hospitalized and non-hospitalized groups at RSUP dr. M. Djamil, Padang from February to September 2020. Serum vitamin D levels were measured using the Chemiluminescent Microparticle Immunoassay. Vitamin D deficiency was defined as a level less than 20 ng/mL. The hospitalized group consisted of moderate to critical COVID-19 patients, whereas the non-hospitalized group consisted of the asymptomatic and mild COVID-19 patients according to the Indonesian Ministry of Health Guidelines. All data were analyzed using a T-test and Chi-square with a significant p-value of 0.05. The results showed that most subjects were women between 21–60 years. The mean level of vitamin D (ng/mL) in the hospitalized group was lower than in the non-hospitalized group (15.5 ± 7.72 vs. 19.2 ± 14.30; 95% CI -9.509–2.167; p=0.213). Vitamin D deficiency affected hospitalized group more than the non-hospitalized group, but not statistically significant (71% vs. 64.5%, p=0.566). It indicated the role of vitamin D in preventing immune system hyperactivation causing COVID-19 cytokine storm. This study concluded no difference in vitamin D levels among the study groups. Nevertheless, further research on vitamin D is needed to determine its role and benefits against COVID-19 infection.

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SERUM 25-HYDROXY VITAMIN D;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.03.1549 ◽

2017 ◽

Vol 24 (03) ◽

pp. 375-380

Author(s):

Shazia Memon ◽

Farzana Shiakh ◽

Asadullah Makhdoom ◽

S. M. Tahir

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Bone Mineral ◽

Serum Vitamin ◽

Mineral Density ◽

Cross Sectional ◽

Serum Vitamin D ◽

Low Serum

Deficiency of vitamin D is an emerging issue in children worldwide. It has beenobserved that all patients with vitamin D deficiency does not manifest clinical features or hyperparathyroidresponse. In this study we have evaluated the interaction of serum vitamin D level,parathyroid hormone (PTH) level and bone mineral density (BMD) in children. Objectives: Ourobjectives were to determine the frequency of Vitamin D deficiency in children and association oflow serum D level with serum parathyroid level and bone mineral density (BMD). Study Design:Descriptive cross sectional study. Period: June 2012 to May 2014. Setting: Pediatric and Orthopediatricout-patient departments. Material & Methods: A total of 500 children up to 15 yearswith low serum vitamin D level were enrolled to analyze the interaction of Serum vitamin D, PTHand BMD. Patients were divided in groups on the basis of serum PTH. We have categorize thedeficiency of Vitamin D on the basis of level of 25OHD. It was defined as severe (25OHD ≤ 5ng/ml), moderate (25OHD≤ 10 ng/ml) and mild (25OHD ≤ 20 ng/ml) and hyperparathyroidism(SHPT) was valued if level >65 pg/ml. All children with 25OH ≤ 20 ng/ml were included andassociation with SHPT and BMD were measured. Results: It has been observed that 30–40%of patients with moderate and severe deficiency of vitamin D respectively had shown increasedlevel of PTH. Bone mineral density has demonstrated decline pattern from PTH Quartile 1toQuartile 4 at all sites in children, with only minimal difference (decreasing trend) in serum25OHD levels between these quartiles. The critical level of parathyroid hormone beyond whichBMD going to decline is 35 pg/ml. No demonstrable difference has been observed in BMDwithin each PTH quartile according to categorization of Vitamin D Deficiency. Conclusions:Around 40% of the patients having low serum vitamin D level demonstrated SHPT. Regardingthe BMD levels, it begins to decreases at PTH levels currently well thought-out to be normal.So there is a need to re-define SHPT among different age groups considering the relationshiplinking PTH and BMD. This may also affect guidelines regarding vitamin d supplementation inpatients with vitamin D deficiency.

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SERUM VITAMIN D STATUS AMONG CRITICALLY ILL CHILDREN WITH RESPIRATORY INFECTIONS

10.36106/ijar/0401461 ◽

2020 ◽

pp. 1-3

Author(s):

SS Kalyanshettar ◽

Sanjeevani Umarani ◽

M M Patil ◽

SV Patil

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Critically Ill ◽

Serum Vitamin ◽

Respiratory Illness ◽

Respiratory Support ◽

Critically Ill Children ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Low Serum

Objective: To know whether low levels of vitamin D affects severity of respiratory illness and its clinical outcomes. Design: Hospital based prospective cross sectional observational study. Setting : Pediatric Intensive Care Unit in Teaching Hospital affiliated with Medical College with study period of one and half years Methodology The study was performed on 50 cases of critically ill children with respiratory infectious disease admitted to the paediatric intensive care unit. Assessment of severity of respiratory infection was done with Paediatric respiratory severity score (PRESS). Serum vitamin D levels were assessed. Duration of PICU stay, hospital stay, need and type of respiratory support and its duration were also recorded. Results: Severe Vitamin D deficiency (<20ng/ml) was noted in 64% of total cases admitted with respiratory illness in PICU. Among these, 62.5% (20) cases had severe respiratory illness. The severity of respiratory illness was found to be highly significant with low Serum vitamin D values (p<0.01). Low serum vitamin D levels were also significantly associated with length of PICU stay (p<0.01), length of hospital stay (p=0.014), type of respiratory support (<0.001) and duration of respiratory support (p<0.001) Conclusion: A high prevalence of Vitamin D deficiency and insufficiency was found in critically ill children admitted with Respiratory infection. A strong statistical correlation was noted with Vitamin D deficiency and strongly associated with prolonged PICU care, respiratory support and hospitalization.

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Relationships between low serum vitamin D levels and HBV “a” determinant mutations in chronic hepatitis B patients

The Journal of Infection in Developing Countries ◽

10.3855/jidc.7459 ◽

2016 ◽

Vol 10 (09) ◽

pp. 1025-1030 ◽

Cited By ~ 3

Author(s):

Huijuan Zhu ◽

Xingxiang Liu ◽

Yi Ding ◽

Hui Zhou ◽

Yiying Wang ◽

...

Keyword(s):

Vitamin D ◽

Chronic Hepatitis ◽

Hepatitis B ◽

Vitamin D Deficiency ◽

Chronic Hepatitis B ◽

Serum Vitamin ◽

Vitamin D Insufficiency ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Low Serum

Introduction: Vitamin D is significantly associated with virus replication in chronic hepatitis B virus (HBV) infection. However, the relationship between low serum vitamin D levels and HBV “a” determinant mutations remains unknown. Methodology: A total of 133 chronically HBV-infected, treatment-naive patients were randomly selected in the present study. Serum vitamin D levels were measured by using liquid chromatography-mass spectrometry. The HBV “a” determinant was amplified, sequenced, and analyzed by nested polymerase chain reaction (PCR). Results: Among 133 patients, 36, 88, and 9 patients had vitamin D deficiency (25(OH)D < 14 ng/mL), vitamin D insufficiency (25(OH)D ≥ 14 and < 30 ng/mL), and normal vitamin D serum levels ((25(OH)D ≥ 30 ng/mL), respectively. As results showed, 36 [11 genotype B HBVs (HBV/B) and 25 genotype C HBVs (HBV/C)] were isolated from the vitamin D-deficient group, 88 (48 HBV/B and 40 HBV/C) from the vitamin D-insufficient group, and 4 HBV/C strains from the normal serum-vitamin D group. Compared to the HBV/B infected patients with vitamin D insufficiency, higher rates of amino acid mutation within “a” determinant were detected in HBV/B-infected, vitamin D-deficient patients. Moreover, the change frequency of M133 was 27.27% in HBV/B infected patients with vitamin D deficiency, which was significantly higher than those in the vitamin D-insufficient group (p = 0.040). Conclusions: Vitamin D deficiency is significantly associated with genotype B HBV “a” determinant mutations.

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Clinical factors correlated with vitamin D deficiency in patients with obesity scheduled for bariatric surgery: A single center experience

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000662 ◽

2020 ◽

Vol 90 (3-4) ◽

pp. 346-352

Author(s):

Vincenzo Pilone ◽

Salvatore Tramontano ◽

Carmen Cutolo ◽

Federica Marchese ◽

Antonio Maria Pagano ◽

...

Keyword(s):

Bariatric Surgery ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Inverse Correlation ◽

Model Assessment ◽

Cross Sectional ◽

Serum Vitamin D ◽

Female Sex ◽

Vitamin D Levels

Abstract. We aim to assess the prevalence of vitamin D deficiency (VDD) in patients scheduled for bariatric surgery (BS), and to identify factors that might be associated with VDD. We conducted a cross-sectional observational study involving all consecutive patients scheduled for BS from 2017 to 2019. The exclusion criteria were missing data for vitamin D levels, intake of vitamin D supplements in the 3 months prior to serum vitamin D determination, and renal insufficiency. A total of 206 patients (mean age and body mass index [BMI] of 34.9 ± 10.7 years, and 44.3 ± 6.99 kg/m2, respectively) met the inclusion criteria and were enrolled for data analysis. VDD (<19.9 ng/mL), severe VDD (<10 ng/mL), and vitamin D insufficiency (20–29.9 ng/mL) were present in 68.8 %, 12.5 %, and 31.2 % of patients, respectively. A significant inverse correlation was found between vitamin D levels and initial BMI, parathyroid hormone, and homeostatic model assessment of insulin resistance (r = −0.280, p < 0.05; r = −0.407, p = 0.038; r = −0.445, p = 0.005), respectively. VDD was significantly more prevalent in patients with higher BMI [−0.413 ± 0.12, CI95 % (−0.659; −0.167), p = 0.006], whereas no significant association between hypertension [−1.005 ± 1.65, CI95 % (−4.338; 2.326), p = 0.001], and diabetes type 2 (T2D) [−0.44 ± 2.20, CI95 % (−4.876; 3.986), p = 0.841] was found. We observed significant association between female sex and levels of vitamin D [6.69 ± 2.31, CI95 % (2.06; 11.33), p = 0.006]. The present study shows that in patients scheduled for BS, VDD deficiency is common and was associated with higher BMI, and female sex.

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SUBLINGUAL VITAMIN D3 DRUG THERAPY IN VITAMIN D DEFICIENCY PATIENTS AT PRAVARA RURAL HOSPITAL

International Journal of Clinical and Biomedical Research ◽

10.31878/ijcbr.2019.54.05 ◽

2019 ◽

pp. 18-20

Author(s):

Sanjeeva Kumar Goud T ◽

Rahul Kunkulol

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D3 ◽

Serum Vitamin ◽

Cross Sectional ◽

Serum Vitamin D ◽

Significant Difference ◽

Before And After

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route

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Association between vitamin D deficiency and prostate cancer: Prospective case-control study

Journal of Clinical Urology ◽

10.1177/2051415821993606 ◽

2021 ◽

pp. 205141582199360

Author(s):

Ghanshyam Kumawat ◽

Vijay Chaudhary ◽

Anurag Garg ◽

Nishkarsh Mehta ◽

Gagan Talwar ◽

...

Keyword(s):

Prostate Cancer ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Case Control Study ◽

Serum Vitamin ◽

P Value ◽

Serum Vitamin D ◽

Severe Vitamin ◽

Vitamin D Levels ◽

Control Study

Objective: We aimed to find out the association of low serum vitamin D levels with the incidence of prostate cancer through a prospective case-control study. Material and methods: This study was carried out in the tertiary care hospital (India). All newly diagnosed patients of prostate cancer and age-matched controls were included. Serum vitamin D levels were measured in all of them. Vitamin D status (ng/mL) was classified as severe deficiency <10, moderate deficiency 10–<30, normal 30–100, and toxicity >100. Normality of the data was tested by the Kolmogorov–Smirnov test, statistical analysis was done with Statistical Package for the Social Sciences version 26.0, p-value of <0.05 was considered significant. Results: In our study, 320 cases and 320 controls were included. The mean vitamin D levels in cases and controls were 15.71 ± 6.5 (ng/mL) and 17.63 ± 4.54 (ng/mL), respectively, ( p-Value <0.01). Patients with severe vitamin D deficiency (73.58%) had a Gleason score ⩾8 on biopsy and 79.24% of them had a serum prostate specific antigen (PSA) level >20 ng/mL. Conclusion: We had concluded that there was no significant association between vitamin D deficiency and increased risk of prostate cancer, although patients with higher-grade prostate cancer and with higher PSA level had severe vitamin D deficiency. Level of evidence: Not applicable for this multicentre audit.

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Association of Vitamin D Deficiency in Newly Diagnosed Pulmonary Tuberculosis

10.53350/pjmhs2115102572 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2572-2573

Author(s):

Khalil Ullah ◽

Sajid Ur Rehman ◽

Ramsha Nadeem ◽

Muhammad Abubakar ◽

Qasim Raza

Keyword(s):

Vitamin D ◽

Pulmonary Tuberculosis ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Sampling Technique ◽

Hypovitaminosis D ◽

Control Group ◽

Sputum Smear ◽

Study Group ◽

Serum Vitamin D

Aim: Relationship between Vitamin D deficiency and pulmonary tuberculosis. Methodology: Study duration: November 2020 to April 2021 Sampling technique: A case-control study Setting: Hayatabad Medical Complex, Peshawar It included 30 adult newly identified sputum-quality pulmonary tuberculosis patients and 30 age and sex matched healthy cases as controls. All cases had undergone a thorough medical examination and repeated laboratory tests, including vitamin D, calcium, and sputum for AFB and X-ray chest. Results: Majority were males (88%). In the Study group, BMI decreased significantly i.e. 19.0 vs 23.5. Serum vitamin D concentrations were significantly lower in the tuberculosis group i.e. 17.9ng/dl than in the control group 24.8ng/dl. Mean of serum albumin in the control group was 3.9 ng/dl whereas 2.9 ng/dl in the study group. Conclusion: Hypovitaminosis D was associated with more severe medical symptoms, increased sputum smear positivity and large lesions on chest radiographs in patients with pulmonary tuberculosis. Keywords: Vitamin D, Pulmonary Tuberculosis, Sputum

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