International Journal of General Medicine (Nov 2022)

Clinical and Prognostic Significance of Baseline Serum Vitamin D Levels in Hospitalized Egyptian Covid-19 Patients

  • Mostafa S,
  • Mohammed SA,
  • Elshennawy SI,
  • Zakaria DM,
  • Mahmoud SAK,
  • Alsadek AM,
  • Ahmad IH,
  • Mohammed DS,
  • Mohammed MA,
  • Eltrawy HH

Journal volume & issue
Vol. Volume 15
pp. 8063 – 8070

Abstract

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Sadek Mostafa,1 Shaymaa A Mohammed,2 Salwa I Elshennawy,2 Doaa Mohammed Zakaria,1 Sammar Ahmed Kasim Mahmoud,1 Amira Mohammed Alsadek,3 Inass Hassan Ahmad,4 Doaa Sayed Mohammed,4 Marwa Abdelmonim Mohammed,1 Heba H Eltrawy3 1Internal Medicine Department, Al-Azhar University, Cairo, Egypt; 2Clinical Pathology Department, Al-Azhar University, Cairo, Egypt; 3Chest Diseases Department, Al-Azhar University, Cairo, Egypt; 4Endocrinology and Metabolism Department, Al-Azhar University, Cairo, EgyptCorrespondence: Heba H Eltrawy, Chest Diseases Department, Al-Azhar University, Cairo, Egypt, Tel +201006381297, Email [email protected] and Aim: Vitamin D is a hormone with essential roles in both cellular metabolism and immunity. It controls calcium homeostasis and modulates innate and adaptive immune system responses. Many studies suggested an association between vitamin D deficiency and clinical outcomes of covid-19 infection, while others failed to document such a relation. The present study aimed to evaluate the clinical and prognostic significance of baseline vitamin D levels in hospitalized Egyptian covid-19 patients.Patients and Methods: The present retrospective study included 300 hospitalized covid-19 patients. Patients were submitted to standard clinical, laboratory, and radiological assessment. According to vitamin D levels, patients were classified to have normal levels (≥ 30), insufficient levels (20– 29) or deficient levels (< 20).Results: According to their vitamin D levels, patients were classified into those with normal vitamin D (n=135), others with vitamin D insufficiency (n=114), and a third group with vitamin D deficiency (n=51). Patients with normal vitamin D levels and vitamin D insufficiency are significantly younger [median (IQR): 49.0 (39.0– 57.0) versus 51.0 (40.0– 61.0) and 55.0 (43.0– 62.0) years, respectively, p=0.012] and had less frequency of severe disease (24.4% versus 40.4% and 51.0%, respectively) when compared with those with vitamin D deficiency. Moreover, they had significantly lower levels of D dimer [median (IQR): 1.5 (0.9– 2.5) versus 1.8 (0.9– 3.1) and 2.0 (1.0– 3.2)], CRP [median (IQR): 58.0 (30.0– 120.0) versus 76.0 (42.5– 160.0) and 105.0 (74.0– 208.0), respectively, p< 0.001], ferritin [median (IQR): 458.0 (240.0– 759.0) versus 606.0 (433.8– 897.8) and 820.0 (552.0– 1087.0), respectively, p< 0.001], and procalcitonin [median (IQR): 290.0 (152.0– 394.0) versus 372.5 (227.0– 530.5) and 443.0 (272.0– 575.0), respectively, p< 0.001]. Only lower vitamin D levels were significant predictors of mortality in multivariate analysis [OR (95% CI): 0.88 (0.84– 0.92), p< 0.001].Conclusion: Low vitamin D levels are related to exaggerated inflammatory response, disease severity, and poor clinical outcome in hospitalized covid-19 patients.Keywords: covid-19, vitamin D, vitamin D deficiency

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