Gaba Manish, Vishnoi Ramnivas, Kumar Naveen, Medam Ashok Kumar Reddy, Suseel Sankuratri, Pandey Ankita, Dewan Arun
Internal Medicine, Max Smart Super Specialty Hospital, New Delhi, IND.
Cureus. 2024 Nov 29;16(11):e74737. doi: 10.7759/cureus.74737. eCollection 2024 Nov.
Vitamin D deficiency is an important problem when facing a viral disease. Vitamin D deficiency is widely prevalent in India and plays an important role in immunoregulation. The deficiency can lead to severe viral infections.
Vitamin D deficiency should be considered an independent risk factor in assessing the severity of COVID-19 infection. This study aims to establish this link. Our study is conducted with young individuals with no comorbidities. This has been done to exclusively evaluate vitamin D deficiency as an independent risk factor.
A retrospective record-based analysis was done on all patients with COVID-19 infection admitted at Max Smart Hospital, Saket, Delhi, from 1st September 2020 to 30th April 2022. Data gathering was done from 18th May 2023 to 30th May 2023. Vitamin D assay was checked as a part of routine care for all patients. The patients were divided into two groups. They consisted of vitamin D-sufficient and vitamin D-deficient patients. The primary endpoint was evaluated based on the outcomes, duration of stay, and severity of disease in these two groups.
A total of 137 patients who met the inclusion criteria were included in the study. On presentation, 75.2% of patients had mild disease, 10.9% were classified as having moderate severity, and 13.9% had severe disease. The mean duration of hospital stay was 6.94±2.96 days. Vitamin D levels were normal in 31.4% (n=43) and vitamin D deficiency was noted in 68.6% (n=94) of patients. Vitamin D deficiency was reported in 64.9% (n=61, p-value=0.011) in the age group of <50 years and 35.1% (n=33, p-value=0.011) in the >50 years group. It was more frequently seen in male patients (67%, n=63, p-value=0.023) as compared to female patients (33%, n=31, p-value=0.023). Vitamin D deficiency was found in 74.5% (n=70, p-value=0.553) of patients with mild disease, 12.8% (n=12, p-value=0.553) with moderate-severity disease, and 12.8% (n=12, p-value=0.553) with severe disease. None of the patients with normal vitamin D levels required ICU admission on presentation. In the deficient group, 2.1% (n=2, p-value=0.335) of patients required ICU admission. The mean duration of hospital stay in the deficient group was 6.72±2.96 days (p-value=0.204). There was no mortality reported in this study.
Our study does show an increased incidence of moderate and severe disease in patients with vitamin D deficiency. This is in line with the evidence presented by several observational studies and meta-analyses. A specific randomized controlled trial focused on evaluating vitamin deficiency and the incidence of viral illness may be warranted to further evaluate this topic. Vitamin D deficiency is an easily correctable factor.
面对病毒性疾病时，维生素D缺乏是一个重要问题。维生素D缺乏在印度广泛流行，且在免疫调节中起重要作用。这种缺乏会导致严重的病毒感染。
在评估新冠病毒感染的严重程度时，应将维生素D缺乏视为一个独立的风险因素。本研究旨在确立这种联系。我们的研究针对无合并症的年轻个体进行。这样做是为了专门评估维生素D缺乏作为一个独立风险因素的情况。
对2020年9月1日至2022年4月30日期间在德里萨克特马克斯·斯马特医院收治的所有新冠病毒感染患者进行基于回顾性记录的分析。数据收集于2023年5月18日至2023年5月30日进行。对所有患者进行维生素D检测作为常规护理的一部分。患者被分为两组。一组是维生素D充足的患者，另一组是维生素D缺乏的患者。根据这两组患者的治疗结果、住院时间和疾病严重程度评估主要终点。
共有137名符合纳入标准的患者被纳入研究。就诊时，75.2%的患者病情较轻，10.9%被归类为中度严重，13.9%病情严重。平均住院时间为6.94±2.96天。31.4%（n = 43）的患者维生素D水平正常，68.6%（n = 94）的患者存在维生素D缺乏。年龄<50岁组中64.9%（n = 61，p值 = 0.011）的患者报告有维生素D缺乏，>50岁组中35.1%（n = 33，p值 = 0.011）的患者有维生素D缺乏。男性患者（67%，n = 63，p值 = 0.023）比女性患者（33%，n = 31，p值 = 0.023）更常出现维生素D缺乏。病情较轻的患者中74.5%（n = 70，p值 = 0.553）存在维生素D缺乏，中度严重疾病患者中12.8%（n = 12，p值 = 0.553）存在维生素D缺乏，严重疾病患者中12.8%（n = 12，p值 = 0.553）存在维生素D缺乏。维生素D水平正常的患者就诊时均无需入住重症监护病房。在缺乏组中，2.1%（n = 2，p值 = 0.335）的患者需要入住重症监护病房。缺乏组的平均住院时间为6.72±2.96天（p值 = 0.204）。本研究中未报告死亡病例。
我们的研究确实表明维生素D缺乏患者中中度和重度疾病的发病率增加。这与多项观察性研究和荟萃分析提供的证据一致。可能需要进行一项专门针对评估维生素缺乏与病毒疾病发病率的随机对照试验，以进一步评估这个话题。维生素D缺乏是一个易于纠正的因素。
