Archive \ Volume.14 2023 Issue 4

Correlation between Serum Vitamin D Levels, COVID-19 Severity, and Inflammation in Diabetic Patients: A Retrospective Study

Anmar Khan , Asmaa Mandili , Faten Al-Hadrami , Abrar Babateen , Mazen Ghaith , Ahmad Obaid , Ahmed Qasem , Wahaj Khan , Bayan Bokhari , Banan Atwah , Khalid Al-Qethami , Saeed Kabrah

Abstract

The recent COVID-19 pandemic has created significant health challenges, necessitating the enhancement of our immune systems. Through the modulation of immune response, Vitamin D vitally reduces the risk of infection and minimizes mortality rates. This retrospective study aimed to assess the relationship between the severity of COVID-19 infection in diabetes individuals and their blood vitamin D levels. A total of 2070 COVID-19 patients were split into two groups for this case-control retrospective study: non-diabetic (n=1723) and diabetic (n= 347). Electronic medical records from March to August 2020 obtained from the King Faisal Specialist Hospital and Research Center and Al-Noor Specialist Hospital, Saudi Arabia, were used as the base of the extraction of Demographic and clinical laboratory data. COVID-19 infection was confirmed in all patients through RT-PCR. Serum vitamin D level was measured by automated ELISA. A significant difference (p<0.05) in blood vitamin D levels between COVID-19 individuals with diabetes and those without was noted from the results of the study. We observed a marginal but significant negative correspondence between vitamin D levels and oxygen saturation as a measure of COVID-19 severity (p=0.016). Vitamin D levels were also found to be positively correlated with inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate (p=0.038 and p<0.001,) while showing a negative correlation with D-dimer (p=0.017). The results of our investigation suggest that vitamin D supplementation may be helpful in the management and prevention of COVID-19 infection, as well as in reducing the severity of risk and inflammation among diabetic patients.


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Vancouver
Khan A, Mandili A, Al-Hadrami F, Babateen A, Ghaith M, Obaid A, et al. Correlation between Serum Vitamin D Levels, COVID-19 Severity, and Inflammation in Diabetic Patients: A Retrospective Study. Arch Pharm Pract. 2023;14(4):84-8. https://doi.org/10.51847/49bwgHlyXx
APA
Khan, A., Mandili, A., Al-Hadrami, F., Babateen, A., Ghaith, M., Obaid, A., Qasem, A., Khan, W., Bokhari, B., Atwah, B., et al. (2023). Correlation between Serum Vitamin D Levels, COVID-19 Severity, and Inflammation in Diabetic Patients: A Retrospective Study. Archives of Pharmacy Practice, 14(4), 84-88. https://doi.org/10.51847/49bwgHlyXx

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References
  1. Ghebreyesus TA. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19-25 May 2020.
  2. Yanga J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidity and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-5.
  3. Corrao S, Pinelli K, Vacca M, Raspanti M, Argano C. Type 2 diabetes mellitus and COVID-19: a narrative review. Front Endocrinol. 2021;12:609470.
  4. Batiha GE, Gari A, Elshony N, Shaheen HM, Abubakar MB, Adeyemi SB, et al. Hypertension and its management in COVID-19 patients: The assorted view. Int J Cardiol Cardiovasc Risk Prev. 2021;11:200121. doi:10.1016/j.ijcrp.2021.200121
  5. Gibertoni D, Reno C, Rucci P, Fantini MP, Buscaroli A, Mosconi G, et al. COVID-19 incidence and mortality in non-dialysis chronic kidney disease patients. PLoS One. 2021;16(7):e0254525.
  6. Gerayeli FV, Milne S, Cheung C, Li X, Yang CW, Tam A, et al. COPD and the risk of poor outcomes in COVID-19: A systematic review and meta-analysis. EClinicalMedicine. 2021;33:100789.
  7. Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 Diabetes and its Impact on the Immune System. Curr Diabetes Rev. 2020;16(5):442-9.
  8. Hribar CA, Cobbold PH, Church FC. Potential Role of Vitamin D in the Elderly to Resist COVID-19 and to Slow Progression of Parkinson's Disease. Brain Sci. 2020;10(5):284.
  9. Singh S, Kaur R, Singh RK. Revisiting the role of vitamin D levels in the prevention of COVID-19 infection and mortality in European countries post infections peak. Aging Clin Exp Res. 2020;32(8):1609-12.
  10. Teshome A, Adane A, Girma B, Mekonnen ZA. The Impact of Vitamin D Level on COVID-19 Infection: Systematic Review and Meta-Analysis. Front Public Health. 2021;9:624559.
  11. Heidari S, Mohammadi S, Fathi M, Cigary S, Alisamir M, Mirkarimi M, et al. Association of vitamin D status with COVID-19 disease severity in pediatric patients: A retrospective observational study. Health Sci Rep. 2022;5(3):e569. 
  12. Hansdottir S, Monick MM. Vitamin D effects on lung immunity and respiratory diseases. Vitam Horm. 2011;86:217-37. 
  13. Zhou YF, Luo BA, Qin LL. The association between vitamin D deficiency and community-acquired pneumonia: A meta-analysis of observational studies. Medicine (Baltimore). 2019;98(38):e17252.
  14. Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011;55(1):96-108.
  15. Merzon E, Tworowski D, Gorohovski A, Vinker S, Golan Cohen A, Green I, et al. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study. FEBS J. 2020;287(17):3693-702. 
  16. Kara M, Ekiz T, Ricci V, Kara Ö, Chang KV, Özçakar L. 'Scientific Strabismus' or two related pandemics: coronavirus disease and vitamin D deficiency. Br J Nutr. 2020;124(7):736-41. 
  17. Dror AA, Morozov N, Daoud A, Namir Y, Yakir O, Shachar Y, et al. Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness. PLoS One. 2022;17(2):e0263069.
  18. De Smet D, De Smet K, Herroelen P, Gryspeerdt S, Martens GA. Serum 25(OH)D Level on Hospital Admission Associated With COVID-19 Stage and Mortality. Am J Clin Pathol. 2021;155(3):381-8.
  19. Maghbooli Z, Sahraian MA, Ebrahimi M, Pazoki M, Kafan S, Tabriz HM, et al. Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection. PloS one. 2020;15(9):e0239799.
  20. Carpagnano GE, Di Lecce V, Quaranta VN, Zito A, Buonamico E, Capozza E, et al. Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. J Endocrinol Invest. 2021;44(4):765-71.
  21. Pizzini A, Aichner M, Sahanic S, Böhm A, Egger A, Hoermann G, et al. Impact of vitamin D deficiency on COVID-19—a prospective analysis from the Covid Registry. Nutrients. 2020;12(9):2775.
  22. Baktash V, Hosack T, Patel N, Shah S, Kandiah P, Van den Abbeele K, et al. Vitamin D status and outcomes for hospitalised older patients with COVID-19. Postgrad Med J. 2021;97(1149):442-7. 
  23. Abrishami A, Dalili N, Mohammadi Torbati P, Asgari R, Arab-Ahmadi M, Behnam B, et al. Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study. Eur J Nutr. 2021;60(4):2249-57. 
  24. Zidrou C, Vasiliadis AV, Tsatlidou M, Sentona M, Vogiatzis S, Beletsiotis A. The Relationship Between Vitamin D Status and the Clinical Severity of COVID-19 Infection: A Retrospective Single-Center Analysis. Cureus. 2022;14(2):e22385.
  25. Laird E, Ward M, McSorley E, Strain JJ, Wallace J. Vitamin D and bone health: potential mechanisms. Nutrients. 2010;2(7):693-724. 
  26. L Bishop E, Ismailova A, Dimeloe S, Hewison M, White JH. Vitamin D and Immune Regulation: Antibacterial, Antiviral, Anti-Inflammatory. JBMR Plus. 2020;5(1):e10405. 
  27. Ismailova A, White JH. Vitamin D, infections and immunity. Rev Endocr Metab Disord. 2022;23(2):265-77. 
  28. Hughes DA, Norton R. Vitamin D and respiratory health. Clin Exp Immunol. 2009;158(1):20-5. 
  29. Soliman AR, Abdelaziz TS, Fathy A. Impact of Vitamin D Therapy on the Progress COVID-19: Six Weeks Follow-Up Study of Vitamin D Deficient Elderly Diabetes Patients. Proc Singapore Healthcare. 2022;31:20101058211041405.
  30. Illescas-Montes R, Melguizo-Rodríguez L, Ruiz C, Costela-Ruiz VJ. Vitamin D and autoimmune diseases. Life Sci. 2019;233:116744.
  31. Aranow C. Vitamin D and the immune system. J Investig Med. 2011;59(6):881-6.
  32. Komisarenko YI, Bobryk MI. Vitamin D Deficiency and Immune Disorders in Combined Endocrine Pathology. Front Endocrinol (Lausanne). 2018;9:600. 
  33. Singh SK, Jain R, Singh S. Vitamin D deficiency in patients with diabetes and COVID- 19 infection. Diabetes Metab Syndr. 2020;14(5):1033-5.
  34. AlHewishel MA, Bahgat M, Al Huwaiyshil A, Alsubie MA, Alhassan A. 25 (OH) D serum level in non-diabetic and type II diabetic patients: a Cross-Sectional Study. Cureus. 2020;12(6).
  35. Alguwaihes AM, Al-Sofiani ME, Megdad M, Albader SS, Alsari MH, Alelayan A, et al. Diabetes and Covid-19 among hospitalized patients in Saudi Arabia: a single-centre retrospective study. Cardiovasc Diabetol. 2020;19(1):1-2.
  36. Liu Z, Li J, Huang J, Guo L, Gao R, Luo K, et al. Association between diabetes and COVID-19: A retrospective observational study with a large sample of 1,880 cases in Leishenshan hospital, Wuhan. Front Endocrinol (Lausanne). 2020;11:478. 
  37. de Almeida-Pititto B, Dualib PM, Zajdenverg L, Dantas JR, De Souza FD, Rodacki M, et al. Severity and mortality of COVID 19 in patients with diabetes, hypertension and cardiovascular disease: a meta-analysis. Diabetol Metab Syndr. 2020;12(1):1-2.
  38. Peng M, He J, Xue Y, Yang X, Liu S, Gong Z. Role of Hypertension on the Severity of COVID-19: A Review. J Cardiovasc Pharmacol. 2021;78(5):e648-55.
  39. Moftakhar L, Moftakhar P, Piraee E, Ghaem H, Valipour A, Azarbakhsh H. Epidemiological characteristics and outcomes of COVID-19 in diabetic versus non-diabetic patients. Int J Diabetes Dev Ctries. 2021;41(3):383-8.
  40. Elamari S, Motaib I, Zbiri S, Elaidaoui K, Chadli A, Elkettani C. Characteristics and outcomes of diabetic patients infected by the SARS-CoV-2. Pan Afr Med J. 2020;37:32.
  41. Hu R, Gao H, Huang D, Jiang D, Chen F, Fu B, et al. Successful blood glucose management of a severe COVID-19 patient with diabetes: A case report. Medicine (Baltimore). 2020;99(26):e20844.
  42. Li G, Deng Q, Feng J, Li F, Xiong N, He Q. Clinical Characteristics of COVID-19 Patients with and without Diabetes in Wuhan Red Cross Hospital. J Diabetes Res. 2020;2020.
  43. Dey RK, Hilmy AI, Imad HA, Yoosuf AA, Latheef AA. COVID-19 and emergencies in patients with diabetes: two case reports. J Med Case Rep. 2021;15(1):57.
  44. Wang Z, Du Z, Zhu F. Glycosylated hemoglobin is associated with systemic inflammation, hypercoagulability, and prognosis of COVID-19 patients. Diabetes Res Clin Pract. 2020;164:108214.
  45. Alhakak A, Butt JH, Gerds TA, Fosbøl EL, Mogensen UM, Krøll J, et al.  Glycated haemoglobin levels among 3295 hospitalized COVID-19 patients, with and without diabetes, and risk of severe infection, admission to an intensive care unit and all-cause mortality. Diabetes Obes Metab. 2022;24(3):499-510. 
  46. Kaufman HW, Niles JK, Kroll MH, Bi C, Holick MF. SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PloS one. 2020;15(9):e0239252.
  47. Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020;13(10):1373-80.
  48. Khan MUF, Ali BR, Mohammed HQ, Al-Shammari HMT, Jalil AT, Hindi NKK, et al. RETRACTED ARTICLE: Serum level estimation of some biomarkers in diabetic and non-diabetic COVID-19 infected patients. Appl Nanosci. 2023;13(4):1-8.
  49. Wu T, Zuo Z, Kang S, Jiang L, Luo X, Xia Z, et al. Multi-organ Dysfunction in Patients with COVID-19: A Systematic Review and Meta-analysis. Aging Dis. 2020;11(4):874-94. 
  50. Yan Y, Yang Y, Wang F, Ren H, Zhang S, Shi X, et al. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes. BMJ Open Diabetes Res Care. 2020;8(1):e001343.

 

 

 


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