Vitamin D deficiency as a factor for immunity stimulation and lower risk of acute respiratory infections and COVID-19

[SARS-CoV-2 morbidity depending on vitamin D status]

BACKGROUND

The association between vitamin D deficiency and the severity of COVID-19 is currently being actively discussed around the world.

AIM

The aim of this study was to assess the prevalence of vitamin D insufficiency and deficiency and compare it with the incidence rates of SARS-CoV-2 in eight Federal Districts of the Russian Federation.

MATERIALS AND METHODS

We included 304,564 patients (234,716 women; 77,1%) with serum 25(OH)D levels results performed September 2019 through October 2020.

RESULTS

Only 112,877 people (37.1%) had a normal serum 25(OH)D level, others had a deficiency. Vitamin D insufficiency and deficiency was presented with the same frequency in women and men, and no differences were found depending on the geographical location and age in subjects from 18 to 74 years old. However, subjects over 75 years more often had vitamin D deficiency, while subjects under 18 years had normal levels in over 50% cases. In addition, 21,506 patients were tested for SARS-CoV-2 by PCR with further comparison of results with serum 25(OH)D level. The SARS-CoV-2 positivity rate was detected in 3,193 subjects, negative in 18,313. There were no differences in the morbidity in a vitamin D deficiency and a normal level. Thus, 14.8% subjects had positive PCR rates among vitamin D deficiency patients (4,978 tests), 14.9% when 25(OD)D level was from 20 to 30 ng/ml (7,542 tests), 15.0% among those who had 25(OH)D 30- 50 ng/ml (6,622 tests), and 13.9% when vitamin D was more than 50 ng/ml (4,612 tests).

CONCLUSION

There was no association between the COVID-19 incidence and vitamin D status in different regions of Russia. Although the nutrient deficiency persists in all regions and is most often diagnosed in people over 75 years old.

Low 25(OH)D Level Is Associated with Severe Course and Poor Prognosis in COVID-19

We evaluated associations between serum 25-hydroxyvitamin D [25(OH)D] level and severity of new coronavirus infection (COVID-19) in hospitalized patients. We assessed serum 25(OH)D level in 133 patients aged 21-93 years. Twenty-five (19%) patients had severe disease, 108 patients (81%) had moderate disease, and 18 (14%) patients died. 25(OH)D level ranged from 3.0 to 97.0 ng/mL (median, 13.5 [25%; 75%, 9.6; 23.3] ng/mL). Vitamin D deficiency was diagnosed in 90 patients, including 37 with severe deficiency. In patients with severe course of disease, 25(OH)D level was lower (median, 9.7 [25%; 75%, 6.0; 14.9] ng/mL), and vitamin D deficiency was more common than in patients with moderate course (median, 14.6 [25%; 75%, 10.6; 24.4] ng/mL, p = 0.003). In patients who died, 25(OH)D was 9.6 [25%; 75%, 6.0; 11.5] ng/mL, compared with 14.8 [25%; 75%, 10.1; 24.3] ng/mL in discharged patients (p = 0.001). Severe vitamin D deficiency was associated with increased risk of COVID-19 severity and fatal outcome. The threshold for 25(OH)D level associated with increased risk of severe course was 11.7 ng/mL. Approximately the same 25(OH)D level, 10.9 ng/mL, was associated with increased risk of mortality. Thus, most COVID-19 patients have vitamin D deficiency; severe vitamin D deficiency is associated with increased risk of COVID-19 severity and fatal outcome.

serum 25(oH)D level in patients with CoVID-19

Recently, vitamin D deficiency is considered as a risk factor for the incidence and severity of new coronavirus infection.The aimof this work was to evaluate the vitamin D level of patients with COVID-19 hospitalized with communityacquired pneumonia and compare the value of 25(OH)D in blood serum with the clinical manifestations of the disease.Results.Included are 80 patients aged 18 to 94 years (mean age 53,2 ± 15,7 years), 43 (53,8%) men; with severe course – in 25 (31,3%) patients (12 males), and moderate – in 55 people (68,7%) (31 males). Half of the severely ill patients were obese, and among the deceased patients, the number of obese people was 61,5%, which was significantly higher than the discharged ones – 14,9% (p<0,001). Diabetes mellitus and cardiovascular diseases occurred with the same frequency, regardless of the severity of the disease. Analysis of the outcomes of coronavirus infection in these patients showed mortality in 52,0% of cases in severe patients. Serum 25(OH)D level ranged from 3,0 to 88,8 ng / ml (16,7 ± 12,7 ng / ml). It was found that in patients with severe course, the level of 25(OH)D blood was significantly lower (11.9 ± 6.4 ng / ml) and vitamin D deficiency was more common than in patients with moderate to severe course of the disease (18,5 ± 14,0 ng / ml, p = 0,027). The same pattern was revealed in patients with a fatal outcome, where the level of 25(OH)D was 10,8 ± 6,1 ng / ml, compared with this indicator in patients discharged from the hospital (17,8 ± 13,4 ng / ml) (p = 0,02).Conclusions.Vitamin D deficiency and obesity have been found to increase the risk of severe course and death of coronavirus infection.