Vitamin D Levels among Hospitalized and Non-Hospitalized COVID-19 Patients in Dr. M. Djamil General Hospital Padang
##plugins.themes.bootstrap3.article.main##
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.
Downloads
References
-
Ali N. Role of vitamin D in preventing of COVID-19 infection, progression, and severity. Journal of Infection and Public Health. 2020; 13(10): 1373–1380.
DOI | Google Scholar
1
-
Turrubiates‑Hernández FJ, Sánchez‑Zuno GA, González‑Estevez G, Hernández‑Bello J, Macedo‑Ojeda G, Muñoz‑Valle JF. Potential immunomodulatory effects of vitamin D in the prevention of severe coronavirus disease 2019: An ally for Latin America (Review). International Journal of Molecular Medicine. 2021; 47(4): 32.
DOI | Google Scholar
2
-
Cutolo M, Paolino S, Smith V. Evidence for a protective role of vitamin D in COVID-19. RMD Open. 2020; 6: e001454.
DOI | Google Scholar
3
-
Pusparini. Defisiensi vitamin D terhadap penyakit. Indonesian Journal of Clinical Pathology and Medical Laboratory. 2014; 21(1): 90–95. Indonesian.
DOI | Google Scholar
4
-
Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Berisha AT, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. European Journal of Clinical Nutrition. 2020; 74: 1498–1513.
DOI | Google Scholar
5
-
Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: a helpful immuno-modulator. Immunology. 2011; 134(2): 123–139.
DOI | Google Scholar
6
-
Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in Autoimmunity: Molecular Mechanisms and Therapeutic Potential. Frontiers in Immunology. 2017; 7: 697.
DOI | Google Scholar
7
-
Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients. 2020; 12(4): 988.
DOI | Google Scholar
8
-
Annweiler G, Corvaisier M, Gautier J, Dubée V, Legrand E, Sacco G, et al. Vitamin D supplementation associated to better survival in hospitalized frail elderly COVID-19 patients: the GERIA-COVID quasi-experimental study. Nutrients. 2020; 12(11): 3377.
DOI | Google Scholar
9
-
Ling SF, Broad E, Murphy R, Pappachan JM, Pardesi-Newton S, Kong MF, et al. High-dose cholecalciferol booster therapy is associated with a reduced risk of mortality in patients with COVID-19: a cross-sectional multi-centre observational study. Nutrients. 2020; 12(12): 3799.
DOI | Google Scholar
10
-
Raharusuna P, Priambada S, Budiarti C, Agung E, Budi C. Patterns of COVID-19 mortality and vitamin D: an indonesian study. SSRN Electronic Journal. 2020: 1-14.
DOI | Google Scholar
11
-
Macaya F, Espejo C, Valls A, Ortiz AF, Castillo JG, Martin J, et al. Interaction between age and vitamin D deficiency in severe COVID-19 infection. Nutricion Hospitalaria. 2020; 37(5): 1039–1042.
DOI | Google Scholar
12
-
Kementerian Kesehatan Republik Indonesia. Pedoman pencegahan dan pengendalian coronavirus disease (COVID-19) revisi Ke-5. Kementerian Kesehatan Republik Indonesia. Jakarta. 2020; 1–214. Indonesian.
Google Scholar
13
-
Edis Z, Bloukh SH. Vitamin D deficiency: main factors affecting the serum 25-hydroxyvitamin d ([25(OH)D]) status and treatment options. International Journal of Research. 2016; 3(1): 197–210.
Google Scholar
14
-
Abbott Laboratories. Architect 25-OH Vitamin D, B5P020 25-OH Vitamin D 5P02 G5-6832/R03e, Lake Forest, Illinois, USA. 2020:1–8.
Google Scholar
15
-
Merzon E, Tworowski D, Gorohovski A, Vinker S, Golan Cohen A, Green I, et al. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study. FEBS J. 2020; 287(17): 3693–3702.
DOI | Google Scholar
16
-
Pinzon RT, Angela, Pradana AW. Vitamin D deficiency among patients with COVID-19: case series and recent literature review. Troical Medical Health. 2020; 48: 102.
DOI | Google Scholar
17
-
Hastie CE, Pell JP, Sattar N. Vitamin D and COVID-19 infection and mortality in UK Biobank. European Journal of Nutrition. 2021; 60(1): 545–548.
DOI | Google Scholar
18
-
Hernández JL, Nan D, Fernandez-Ayala M, García-Unzueta M, Hernández-Hernández MA, López-Hoyos M, et al. Vitamin D status in hospitalized patients with SARS-CoV-2 infection. Journal of Clinical Endocrinology & Metabolism. 2021; 106(3): e1343-e1353.
DOI | Google Scholar
19
-
Radujkovic A, Hippchen T, Tiwari-Heckler S, Dreher S, Boxberger M, Merle U. Vitamin D deficiency and outcome of COVID-19 patients. Nutrients. 2020; 12(9): 2757.
DOI | Google Scholar
20
-
Wang MX, Gwee SXW, Pang J. Micronutrients deficiency, supplementation and novel coronavirus infections-a systematic review and meta-analysis. Nutrients. 2021; 13(5): 1589.
DOI | Google Scholar
21
-
Bourgonje AR, Abdulle AE, Timens W, Hillebrands JL, Navis GJ, Gordijn SJ, et al. Angiotensin-converting enzyme 2 (ACE2), SARS-CoV-2 and the pathophysiology of coronavirus disease 2019 (COVID-19). Journal of Pathology. 2020; 251(3): 228–248.
DOI | Google Scholar
22
-
Efrida, Yaswir R, Rofinda ZD. Hubungan vitamin D dengan kadar adiponektin, Hs-CRP, dan profil lipid pada subjek berat badan berlebih di RSUP Dr. M. Djamil Padang. Jurnal Kesehatan Andalas. 2018. Indonesian.
Google Scholar
23