The Relationship Between Vitamin D Levels, Inflammatory Parameters and Disease Severity of COVID-19 Infection

The Relationship Between Vitamin D Levels, Inflammatory Parameters and Disease Severity of COVID-19 Infection: A Retrospective Study

Vitamin D deficiency increases the susceptibility to respiratory virus infections and the severity of infections. Inflammation plays a key role in pathogenesis in COVID19 while identifying clinical course and prognosis COVID19.The aim of this study was to determine the relationship between 25OH vitamin D levels, inflammatory laboratory parameters of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), C-reactive protein (CRP) levels and disease severity of COVID19 infection.

Study Overview

• Status: Completed
• Conditions: Covid19; Vitamin D Deficiency
• Intervention / Treatment: Diagnostic test: Inflammatory Parameters; Other: 25 OH Vitamin D Level

Detailed Description

In this retrospective study 300 patients diagnosed with COVID19 were included. According to clinical classification of cases with COVID19 the patients were divided into three groups; mild (Group1), moderate (Group2) and severe/critical (Group3). The 25OH vitamin D values below 20 ng/ml were defined as deficiency, 21-29 ng/ml were defined as insufficiency, and 30 ng/ml and above were defined as normal. Patients' age, gender, comorbid diseases and laboratory values were recorded

• Study Type: Observational
• Enrollment (Actual): 300

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34752
    • Gulcan Ozturk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 97 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

COVID19 infection positive patients whose polymerase chain reaction (PCR) test positive patients and whose 25-OH vitamin D levels were measured in the last 6 months

Description

Inclusion Criteria:

• The study included 300 polymerase chain reaction (PCR) test positive patients and whose 25-OH vitamin D levels were measured in the last 6 months

Exclusion Criteria:

• Patients with COVID-19 whose 25-OH vitamin D levels were not measured in the last 6 months before the COVID-19 diagnosis were excluded from the study

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Experimental: Mild Clinical Group; patients showing mild clinical symptoms without pneumonia.	Diagnostic test: Inflammatory Parameters; Laboratory measurement of patient's inflammatory status in unit of % and mg/dl; Other: 25 OH Vitamin D Level; Laboratory measurement of patient's 25 OH vitamin D level in unit of ng/dl
Experimental: Moderate Clinical Group; patients with fever, other respiratory symptoms, and pneumonia findings based on radiological imaging	Diagnostic test: Inflammatory Parameters; Laboratory measurement of patient's inflammatory status in unit of % and mg/dl; Other: 25 OH Vitamin D Level; Laboratory measurement of patient's 25 OH vitamin D level in unit of ng/dl
Experimental: severe/critical clinical group; severe one of these as follows; patients with hypoxia (≤93% oxygen saturation), respiratory distress (RR >30 times per minute), partial pressure of arterial blood oxygen (PaO 2 )/the fraction of inspired oxygen (FiO 2 ) ≤ 300 mmHg, patients whose chest imaging shows that lung damage develops significantly within 24 to 48 hours, or critical one of these as follows; respiratory failure requiring mechanical ventilation, signs of septic shock with multiple organ failure requiring intensive care unit admission.	Diagnostic test: Inflammatory Parameters; Laboratory measurement of patient's inflammatory status in unit of % and mg/dl; Other: 25 OH Vitamin D Level; Laboratory measurement of patient's 25 OH vitamin D level in unit of ng/dl

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
25-OH vitamin D	laboratory measurement in unit of ng/ml	1 day
White blood cell count	laboratory measurement in unit of x103/uL	1 day
neutrophil count	laboratory measurement in unit of x103/uL	1 day
neutrophil ratio	laboratory measurement in unit of %	1 day
lymphocyte count	x103/uL	1 day
lymphocyte ratio	laboratory measurement in unit of %	1 day
platelet count	laboratory measurement in unit of x103/uL	1 day
hemoglobin count	laboratory measurement in unit of g/dl	1 day
C-reactive protein levels	laboratory measurement in unit of mg/dL	1 day
neutrophil to lymphocyte ratio	laboratory measurement in unit of %	1 day
platelet to lymphocyte ratio	laboratory measurement in unit of %	1 day

Collaborators and Investigators

• Sponsor: Fatih Sultan Mehmet Training and Research Hospital

Publications and helpful links

General Publications

• Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020 Oct;13(10):1373-1380. doi: 10.1016/j.jiph.2020.06.021. Epub 2020 Jun 20.
• Ali N. Elevated level of C-reactive protein may be an early marker to predict risk for severity of COVID-19. J Med Virol. 2020 Nov;92(11):2409-2411. doi: 10.1002/jmv.26097. Epub 2020 Jun 9. No abstract available.
• Khemka A, Suri A, Singh NK, Bansal SK. Role of Vitamin D Supplementation in Prevention and Treatment of COVID-19. Indian J Clin Biochem. 2020 Oct;35(4):502-503. doi: 10.1007/s12291-020-00908-3. Epub 2020 Jul 30. No abstract available.

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2020
• Primary Completion (Actual): August 1, 2020
• Study Completion (Actual): August 1, 2020

Study Registration Dates

• First Submitted: June 6, 2021
• First Submitted That Met QC Criteria: June 28, 2021
• First Posted (Actual): June 30, 2021

Study Record Updates

• Last Update Posted (Actual): June 30, 2021
• Last Update Submitted That Met QC Criteria: June 28, 2021
• Last Verified: June 1, 2021

More Information

Terms related to this study

• Keywords: Vitamin D; COVID-19; Inflammatory markers; Disease severity
• Additional Relevant MeSH Terms: Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; Nutrition Disorders; Avitaminosis; Deficiency Diseases; Malnutrition; COVID-19; Vitamin D Deficiency; Physiological Effects of Drugs; Micronutrients; Vitamins; Bone Density Conservation Agents; Vitamin D
• Other Study ID Numbers: Gulcanozturk

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No