The Impact of Vitamin D Level on the Severity and Outcome of Hospitalized Patients with COVID-19 Disease

Dania AlKhafaji,1 Reem Al Argan,1 Waleed Albaker,1 Abdulmohsen Al Elq,1 Mohammed Al-Hariri,2 Abir AlSaid,1 Abrar Alwaheed,1 Safi Alqatari,1 Alaa Alzaki,1 Sara Alwarthan,1 Fatimah AlRubaish,1 Haya AlGuaimi,1 Fatema Ismaeel,1 Nidaa Alsaeed,1 Zainab AlElq,1 Fatma Zainuddin3 1Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia; 2Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia; 3Department of Medical Allied Services, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi ArabiaCorrespondence: Mohammed Al-Hariri Tel +966507275028Email mtalhariri@iau.edu.saPurpose: The world is experiencing a life-altering and extraordinary situation in response to the COVID-19 pandemic. There are limited data and controversies regarding the relationship between vitamin D (Vit D) status and COVID-19 disease. Thus, this study was designed to investigate the association between Vit D levels and the severity or outcomes of COVID-19 disease.Methods: A cross-sectional observational study was conducted in the Eastern province of Saudi Arabia from January to August 2021. All the admitted patients who were diagnosed with COVID-19 infection were distributed into three groups depending on their Vit D levels: normal, insufficiency, and deficiency. For the three groups, demographic data, and laboratory investigations as well as data regarding the severity of COVID-19 were collected and analysed.Results: A total of 203 diagnosed cases of COVID-19 were included in this study. The Vit D level was normal (> 30) in 31 (15.3%) cases, insufficient in 45 (22.2%) cases and deficient in 127 (62.6%) cases. Among the included cases, 58 (28.6%) were critical cases, 109 (53.7%) were severe and 36 (17.7%) had a mild-moderate COVID-19 infection. The most prevalent comorbidity of patients was diabetes mellitus 117 (57.6%), followed by hypertension 70 (34.5%), cardiac disease 24 (11.8%), chronic kidney disease 19 (9.4%) and chronic respiratory disease in 17 (8.4%) cases. Importantly, the current study did not detect any significant association between Vit D status and COVID-19 severity (p-value=0.371) or outcomes (hospital stay, intensive care units admission, ventilation, and mortality rate) (p-value > 0.05), even after adjusting the statistical model for the confounders.Conclusion: In hospital settings, Vit D levels are not associated with the severity or outcomes of COVID-19 disease. Further, well‐designed studies are required to determine whether Vit D status provides protective effects against worse COVID-19 outcomes.Keywords: vitamin D, COVID-19, severity, observational, Saudi Arabia