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Vitamin D insufficiency as a potential culprit in critical COVID‐19 patients
Author(s) -
Munshi Ruhul,
Hussein Mohammad H.,
Toraih Eman A.,
Elshazli Rami M.,
Jardak Christina,
Sultasrin,
Youssef Mohanad R.,
Omar Mahmoud,
Attia Abdallah S.,
Fawzy Manal S.,
Killackey Mary,
Kandil Emad,
Duchesne Juan
Publication year - 2021
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.26360
Subject(s) - medicine , confidence interval , odds ratio , covid-19 , receiver operating characteristic , vitamin d and neurology , gastroenterology , strictly standardized mean difference , disease , infectious disease (medical specialty)
Background As an immune modulator, vitamin D has been implicated in the coronavirus disease‐2019 (COVID‐19) outcome. We aim to systematically explore the association of vitamin D serum levels with COVID‐19 severity and prognosis. Methods The standardized mean difference (SMD) or odds ratio and 95% confidence interval (CI) were applied to estimate pooled results from six studies. The prognostic performance of vitamin D serum levels for predicting adverse outcomes with detection of the best cutoff threshold was determined by receiver operating characteristic curve analysis. Decision tree analysis by combining vitamin D levels and clinical features was applied to predict severity in COVID‐19 patients. Results Mean vitamin D serum level of 376 patients, was 21.9 nmol/L (95% CI = 15.36–28.45). Significant heterogeneity was found ( I 2 = 99.1%, p < .001). Patients with poor prognosis ( N = 150) had significantly lower serum levels of vitamin D compared with those with good prognosis ( N = 161), representing an adjusted standardized mean difference of −0.58 (95% Cl = −0.83 to −0.34, p < .001). Conclusion Serum vitamin D levels could be implicated in the COVID‐19 prognosis. Diagnosis of vitamin D deficiency could be a helpful adjunct in assessing patients' potential of developing severe COVID‐19. Appropriate preventative and/or therapeutic intervention may improve COVID‐19 outcomes.