Author(s)

James O’Donovan, Julia Cheong, Duncan Chambler

Intensive Care Unit, Dorset County Hospital, Dorchester, UK.

Background: Vitamin D has garnered much attention for its role in immune function, more specifically, it’s conceivable link to the clinical severity of Covid-19 infections and therefore its potential application in prophylactic or therapeutic treatment. Vitamin D appears capable of inhibiting pulmonary inflammatory responses while enhancing innate defence mechanisms against respiratory pathogens with population-based studies showing an association between circulating vitamin D levels and lung function. We understand that infection with Sars-Cov-2 induces production of pro and anti-inflammatory cytokines, whilst Vitamin D downregulates production of pro-inflammatory Th1 cytokines including tumour necrosis factor and interferon Y, whilst increasing expression of anti-inflammatory cytokines by macrophages. Vitamin D is also involved in the renin-angiotensin system which is regulated by entry of the SARS-Cov-2 virus into cells via the ACE2 receptor, leading to cytokine storms, with subsequent fatal respiratory distress syndrome. The theoretical implications for Vitamin D status in the presentation of Covid-19 (the disease state of Sars-Cov-2) exist, yet data on its application is currently limited. Geographical variables depicting patterns between sun exposure, diet or Vit D status, and risk of death from Covid-19 have shown strong negative correlation. Aim: We aim to assess levels of Vitamin D deficiency in ICU patients who have tested positive for Sars-Cov-2 and who have exhibited respiratory symptoms. In this way, we hope to identify the possibility of Vitamin D as a significant contributing factor to disease progression in Covid patients. Sample: Male or Female patients of any age, who were admitted to the Intensive Care Unit exhibiting respiratory symptoms, with a positive Sars-Cov-2 PCR test, between 12/3/21 and 25/2/21. sample total: 79. Results: Testing was very inconsistent with only 67.1% having their Vitamin D levels checked. There was average delay in testing levels by 2 days. 64% of patients were found to be very deficient. Conclusion: This study highlights the strong correlation between Vitamin D status and severity of Covid-19 disease and thus demonstrates a potential huge shortfall in the testing and treatment of this immunodeficiency as it relates to Covid-19. Based on recommendations of Vitamin D levels required for protection of this viral syndrome, as much as 100% of patients sampled with severe disease could be deficient in Vitamin D.

Covid-19, Sars-Cov-2, Vitamin D, Viral Syndrome, Cytokine Storm

O’Donovan, J. , Cheong, J. and Chambler, D. (2023) Vitamin D Levels in COVID-19 Patients Admitted to Intensive Care. Health, 15, 845-860. doi: 10.4236/health.2023.158055.