Background/Purpose: Vitamin D serum levels have been inversely associated with risk of pulmonary infections and autoimmune inflammatory disease activity and severity [1,2]. A possible role of vitamin D in patients with SARS-Cov-2 infection was also recently reported [3]. 
The aim of the study was to evaluate 25OH-vitamin D serum levels in a cohort of patients hospitalized for SARS-Cov-2 infection, looking in particular for correlations with parameters of lung involvement. 

Methods: Sixty consecutive COVID-19 patients (mean age 76±8 years, mean disease duration 13±13 days, 26 males and 34 females) and sixty sex- and age-matched healthy subjects (CNT) were evaluated. Pulmonary involvement (radiological findings), respiratory parameters (PaO₂/F_IO₂, pO₂, sO₂), clinical parameters, duration of hospitalization and global disease duration were recorded.

Results: Vitamin D serum levels were found significantly lower in COVID-19 patients than in CNT (median 7.8 vs 16.0 ng/ml, p=0.0003). Among COVID-19, vitamin D sufficiency ( >30 ng/ml), insufficiency (between 20 and 30 ng/ml) deficiency (between 10 and 20 ng/ml) and severe deficiency (< 10 ng/ml) were observed respectively in 11, 12, 20 and 57 % of patients. In CNT, the same vitamin D distribution occurred in 21, 22, 34 and 23 % of subjects respectively.

A statistically significant positive correlation was observed between vitamin D serum levels and PaO₂/F_IO₂ (p=0.02), pO₂ (p=0.04), sO₂ (p=0.05), while a statistically significant negative correlation was found between vitamin D serum levels and percentage of O₂ in Venturi Mask (p=0.04). Vitamin D serum levels negatively correlated also with C-reactive protein (p=0.04), D-dimer (p=0.04), and parathyroid hormone (p=0.05).

A negative correlation was also found between vitamin D levels and severity of radiographic pulmonary involvement, but this did not reach the statistical significance (median vitamin D levels in patients with Mild, Moderate and Severe lung involvement were respectively 10.9, 7.7 and 5.5 ng/dl; p=0.11). However, vitamin D serum levels were found significantly lower in COVID-19 patients with either multiple lung consolidations or severe interstitial lung involvement than in those with either normal or mild interstitial lung involvement (p=0.02).

Finally, lower vitamin D serum levels were found associated with longer global disease duration (p=0.05).

Conclusion: Deficiency of 25OH-vitamin D serum levels seem associated with more severe lung involvement and longer disease duration in COVID-19 patients.

References. 1. Zittermann A et al. Eur J Med Res (2016) 21:14. 2. Cutolo M et al. Ann N Y Acad Sci (2014) 1317:39-46. 3. Weir EK et al. Clin Med (Lond) (2020) 20:4.

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/vitamin-d-serum-status-in-a-cohort-of-covid-19-patients/