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Research Article
Vitamin D Deficiency is Associated with Increased COVID-19 Severity: Prospective Screening of At-Risk Groups is Medically Indicated
Samuel H Pepkowitz MD
Cedars-Sinai Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8384-3227
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Declarations:
Declarations
- This study involved human subjects.
- The author confirmed that all appropriate ethical guidelines for the use of human subjects have been followed, any necessary IRB and/or ethics committee review has been obtained, and information about the IRB/ethics committee is included in the manuscript.
- The author has confirmed that all necessary patient/participant consent or assent has been obtained and the appropriate institutional forms have been archived. If the IRB/ethics committee waived the requirement for patient/participant consent or assent, an explanation for the waiver is included in the text.
- The author has confirmed that a statement listing potential conflicts of interest or lack thereof is included in the text.
Non-classical actions of Vitamin D are involved in regulation of the immune system including a role in mitigation of excessive inflammation. We hypothesized that vitamin D deficiency existing prior to SARS-CoV-2 infection could contribute to patients developing severe pulmonary compromise as a result of dysfunctional hyperinflammation. Serum vitamin D concentrations of patients experiencing such severe COVID-19 manifestations that they required ICU care at any point of their hospitalization were compared to serum vitamin D concentrations of patients achieving discharge without the need for any ICU care. Having serum vitamin D < 20 ng/mL was significantly associated with increased COVID-19 severity, p=0.001. It is conjectured that population groups know to have low serum vitamin D should be prospectively screened for deficiency and if found emergently treated. Such action could both decrease the maximum severity suffered by infected individuals and lessen the strain on medical resources by decreasing the percentage of COVID-19 hospital admissions requiring ICU care.
Keywords
COVID-19, Vitamin D Deficiency, Pulmonary Inflammation, ICU Care
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Michael Tranbarger
commented on 30 September, 2020
The results, conclusions and recommendations of this study are consistent with many of the vitamin d and covid 19 studies in the last 6 months. Why, then, are Public health authorities so reluctant to implement any of these recommendations, such as screening for vitamin d levels and supplementing as appropriate. If there are valid medical reasons not to follow what appear to be such commonsense recommendations; shouldn't they be addressed in these studies? Why should these studies be done over and over again if no one is going to implement their recommendations?
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This is a preprint. It has not completed peer review.
Research Article
Vitamin D Deficiency is Associated with Increased COVID-19 Severity: Prospective Screening of At-Risk Groups is Medically Indicated
Samuel H Pepkowitz MD
Cedars-Sinai Medical Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8384-3227
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 29 Sep, 2020
Community comments: 1
Metrics
Comments: 1
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Declarations:
Declarations
- This study involved human subjects.
- The author confirmed that all appropriate ethical guidelines for the use of human subjects have been followed, any necessary IRB and/or ethics committee review has been obtained, and information about the IRB/ethics committee is included in the manuscript.
- The author has confirmed that all necessary patient/participant consent or assent has been obtained and the appropriate institutional forms have been archived. If the IRB/ethics committee waived the requirement for patient/participant consent or assent, an explanation for the waiver is included in the text.
- The author has confirmed that a statement listing potential conflicts of interest or lack thereof is included in the text.
Non-classical actions of Vitamin D are involved in regulation of the immune system including a role in mitigation of excessive inflammation. We hypothesized that vitamin D deficiency existing prior to SARS-CoV-2 infection could contribute to patients developing severe pulmonary compromise as a result of dysfunctional hyperinflammation. Serum vitamin D concentrations of patients experiencing such severe COVID-19 manifestations that they required ICU care at any point of their hospitalization were compared to serum vitamin D concentrations of patients achieving discharge without the need for any ICU care. Having serum vitamin D < 20 ng/mL was significantly associated with increased COVID-19 severity, p=0.001. It is conjectured that population groups know to have low serum vitamin D should be prospectively screened for deficiency and if found emergently treated. Such action could both decrease the maximum severity suffered by infected individuals and lessen the strain on medical resources by decreasing the percentage of COVID-19 hospital admissions requiring ICU care.
Figure 1
Figure 2
Figure 3
Figure 4
Michael Tranbarger
commented on 30 September, 2020
The results, conclusions and recommendations of this study are consistent with many of the vitamin d and covid 19 studies in the last 6 months. Why, then, are Public health authorities so reluctant to implement any of these recommendations, such as screening for vitamin d levels and supplementing as appropriate. If there are valid medical reasons not to follow what appear to be such commonsense recommendations; shouldn't they be addressed in these studies? Why should these studies be done over and over again if no one is going to implement their recommendations?