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
Zhila Maghbooli, Mohammad Ali Sahraian, Mehdi Ebrahimi, Marzieh Pazoki, Samira Kafan, Hedieh Moradi Tabriz, Azar Hadadi, Mahnaz Montazeri, Mehrad Nasiri, Arash Shirvani, Michael F Holick
PLOS ONE, doi:10.1371/journal.pone.0239799
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.
Supporting information
S1 Video. (MP4) support. The authors are grateful to the members of the COVID-19 Crisis Committee of the Sina Hospital for their help and consult.
Author Contributions Conceptualization: Zhila Maghbooli, Arash Shirvani, Michael F. Holick. Data curation: Zhila Maghbooli, Hedieh Moradi Tabriz, Mehrad Nasiri, Arash Shirvani. Formal analysis: Zhila Maghbooli, Arash Shirvani, Michael F. Holick. Investigation: Zhila Maghbooli, Mehdi Ebrahimi, Marzieh Pazoki, Samira Kafan, Azar Hadadi, Mahnaz Montazeri, Arash Shirvani. Methodology: Zhila Maghbooli, Mohammad Ali Sahraian, Michael F. Holick. Project administration: Zhila Maghbooli, Mohammad Ali Sahraian. Validation: Arash Shirvani. Writing -original draft: Zhila Maghbooli. Writing -review & editing: Mohammad Ali Sahraian, Mehdi Ebrahimi, Marzieh Pazoki, Samira Kafan, Hedieh Moradi Tabriz, Azar Hadadi, Mahnaz Montazeri, Mehrad Nasiri, Arash Shirvani, Michael F. Holick.
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