Vitamin D status and relationship with COVID-19 disease severity in Zambian adult patients - a prospective observational study.

Abstract

Background

Vitamin D deficiency is known to be associated with respiratory tract infections. In a Zambian setting with adequate sunshine, it is not clear whether severity of COVID-19 infection is associated with Vitamin D status. We therefore set to explore this relationship in adult COVID-19 patients in Lusaka, Zambia.

Methods

Newly diagnosed COVID-19 patients were enrolled, stratified as critical, moderate and mild disease. Whole blood was collected from each participant and plasma was isolated. Total serum Vitamin D was quantified using Enzyme immunosorbent linked assay (ELISA).  Statistical analysis was performed using STATA statistical software version 14 (STATA Corp, Texas, TX, USA). Graphs were generated using GraphPad version 9.02. Kruskal- Wallis used to compare serum vitamin D levels and baseline characteristics among the different patients.

Results

143 patients evaluated, 32 Critical, 27 moderate and 39 mild cases were enrolled.  Vitamin D deficiency was seen in 45% of critical, 33. % of moderate and 5.13% of mild disease, p =0.010. The mild patients were younger than those with critical and moderate disease, p = <0. 001. Controlling for confounders, Vitamin D insufficiency, comorbid condition, shortness of breath and chest pains were significantly associated with severe disease.

Conclusions

This suggests that Vitamin D deficiency is associated with severity of SARS-CoV-2. Clinical trials of vitamin D supplementation in patients with Covid-19 in our setting is needed.  We advocate for larger population studies to understand the burden of Vitamin D deficiency in an African setting.

Key Words: Covid-19, Vitamin D status, mild, moderate, critical