First Data Published on COVID-19 Severity and Vitamin D Levels

In a preprint letter (not yet peer reviewed), data is presented from 212 COVID-19 patients who had been hospitalized in three separate hospitals in Southern Asia. This is the first published data comparing the severity of symptoms to vitamin D serum levels.
Cases were all confirmed for COVID-19 and were grouped as follows:

1. Mild - presenting with mild clinical symptoms and no diagnosis of pneumonia
2. Ordinary - presenting with fever, respiratory symptoms, and a confirmed diagnosis of pneumonia
3. Severe - cases with hypoxia and respiratory distress
4. Critical - cases with respiratory failure requiring intensive care

Vitamin D levels were grouped as follows:

1. Normal - vitamin D level of 30 ng/ml (75 nmol/L) or above
2. Insufficient - vitamin D level between 21-29 ng/ml (51-74 nmol/L)
3. Deficient - vitamin D level below 20 ng/ml (50 nmol/L)

What were the findings of this study?The average vitamin D level of all 212 cases was 24 ng/ml (59 nmol/L).
Of all COVID-19 cases

• 49 (23%) cases were categorized as mild, with an average vitamin D level of 31 ng/ml (78 nmol/L)
• 59 (28%) were categorized as ordinary, with an average vitamin D level of 27 ng/ml (68 nmol/L)
• 56 (26%) were categorized as severe, with an average vitamin D level of 21 ng/ml (53 nmol/L)
• 48 (23%) were critical, with an average vitamin D level of 17 ng/ml (43 nmol/L)
• 86% of all cases among patients with normal vitamin D levels were mild, while 73% of cases among patients with vitamin D deficiency were severe or critical
• For each standard deviation increase in vitamin D level, the odds of having a mild case compared to a severe case were 7.94 times more, and the odds of having a mild case compared to a critical case were 19.61 times more
• All outcomes were statistically significant

The author concludes, "This means that serum (OH)D level in the body could account for the clinical outcomes of the patients infected with Covid-2019. An increase in serum (OH)D level in the body could either improve clinical outcomes or mitigate worst (severe to critical) outcomes. On the other hand, a decrease in serum (OH)D level in the body could worsen clinical outcomes of Covid-2019."

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