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Vitamin D Supplementation could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (Covid2019)

Published time: 9 April 2020

Authors: Mark M. Alipio

Keywords: Coronavirus, COVID-2019, Clinical outcome, Infectious disease, Public health, Vitamin D


The rapid spread of COVID-2019 in many areas of the world calls for preventive health measures.
Although basic guidelines on infection control are recommended, treatment has remained the best
choice to avert mortality. However, for the time being, there are no known vaccines for the disease.
In this paper, a multinomial logistic regression was used to predict clinical outcomes of patients
infected with COVID-2019 based on 25-hydroxyvitamin D [25(OH)D] levels, the barometer for
Vitamin D status. A retrospective multicentre study of 212 cases with laboratory-confirmed
infection of SARS-CoV-2 was conducted. Data pertaining to clinical features and serum 25(OH)D
levels were extracted from the medical records. For statistical analysis, Mann-Whitney U and χ²
tests were used to compare differences in the clinical outcomes. Multinomial logistic regression
was used to explore the association between serum 25(OH)D level and clinical outcomes of the
cases. Frequency and percentage were used for categorical variables. Mean was used for
continuous variables. A p-value below 0.01 was considered statistically significant. Of the 212
cases of COVID-2019, majority had ordinary clinical outcome. Mean serum 25(OH)D level was
23.8 ng/ml. Serum 25(OH)D level was lowest in critical cases, but highest in mild cases. Serum
25(OH)D levels were statistically significant among clinical outcomes. Majority had insufficient
Vitamin D status, most of them were not severe. Vitamin D status is significantly associated with
clinical outcomes. A multinomial logistic regression analysis reported that for each standard
deviation increase in serum 25(OH)D, the odds of having a mild clinical outcome rather than a
severe outcome were increased approximately 7.94 times (OR=0.126, p<0.001) while
interestingly, the odds of having a mild clinical outcome rather than a critical outcome were
increased approximately 19.61 times (OR=0.051, p<0.001). The results suggest that an increase in
serum 25(OH)D level in the body could either improve clinical outcomes or mitigate worst (severe
to critical) outcomes, while a decrease in serum 25(OH)D level in the body could worsen clinical
outcomes of COVID-2019 patients. In conclusion, this study provides substantial information to
clinicians and health policy-makers. Vitamin D supplementation could possibly improve clinical
outcomes of patients infected with COVID-2019. Further research should conduct randomized
controlled trials and large population studies to evaluate this recommendation.




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