![]() ![]() To better understand the temporal sequence between low 25(OH)D levels and their association with the severity of acute COVID-19 disease, we determined whether the severity of disease among patients admitted with acute COVID-19 correlated with their most recent pre-infection 25(OH)D serum levels. In other words, it is difficult to ascertain a definitive causative effect of baseline vitamin D status on a clinical presentation during active COVID-19 infection. When this is the case, determining the direction and temporality of the association between acute COVID-19 disease and low 25(OH)D serum levels is a challenge. However, serum 25(OH)D is often measured during hospitalization for COVID-19. ![]() In addition, hospitalized COVID-19 patients have been shown to present lower mean and median levels of 25(OH)D than the general population and COVID-19 outpatients. Low serum 25(OH)D levels among hospitalized COVID-19 patients have also been linked with increased disease severity and poorer clinical outcomes. Īs with other respiratory infections, a link between vitamin D deficiency and COVID-19 infection is emerging. Factors associated with poorer COVID-19 prognoses include geographic location in northern countries, older age, darker skin pigmentation, BAME ethnicity (Black and minority ethnic groups), male sex, obesity, and history of preexisting conditions such as diabetes and hypertension these risk factors are also independently associated with vitamin D deficiency. ĬOVID-19 is an acute respiratory infection caused by the SARS-CoV-2 virus, theorized to have emerged in China in December 2019, which rapidly developed into a global pandemic. Meta-analyses of randomized controlled trials conducted between 20 suggest that vitamin D supplementation reduced the risk of acute respiratory infection as compared with placebos. Consistent with laboratory data, clinical studies have established an association between low 25-hydroxyvitamin D (25(OH)D) levels and an increased risk of acquiring influenza and respiratory viruses. Studies have previously demonstrated that social habits in specific ethnic groups and a preference to wear long clothing outdoors are independent risk factors for vitamin D deficiency, particularly among women. Epidemiological risk factors for vitamin D deficiency include greater skin pigmentation, low sun exposure, use of skin-covering clothes, and a diet low in fish and dairy products. Vitamin D deficiency is a global health problem, and its high prevalence in the Middle East has been established. Experimental laboratory evidence evaluating the impact of vitamin D on immunological responses has shown inhibitory effects on the production of pro-inflammatory cytokines, including TNF-alpha and IL-6, by various mechanisms, including down-regulating viral-induced NFkB activation. Vitamin D is most often recognized for its role in bone health, but a low vitamin D status has been associated with a range of autoimmune, cardiovascular, and infectious diseases due to its role as an essential immunologic mediator. ![]()
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