Plasma 25(OH)D Level is Associated with the Nucleic Acid Negative Conversion Time of COVID-19 Patients: An Exploratory Study

Abstract

Purpose

Vitamin D, an essential nutrient and a pleiotropic steroid hormone, has been reported to be associated with the risk and severity in patients infected with Coronavirus Disease-2019 (COVID-19). The role of vitamin D in predicting clinical outcome for COVID-19 patients is unknown. Here, we aimed to determine the prognostic value of plasma 25(OH)D level in COVID-19 patients.

Patients and Methods

A total of 158 patients infected with novel COVID-19 Omicron variants in Shanghai were recruited in this study and were categorized into three groups by the tertile levels of plasma 25(OH)D. Plasma 25(OH)D level was determined along with routine blood tests related to liver and renal functions in newly diagnosed COVID-19 patients at admission. The nucleic acid negative conversion time of throat swab samples was evaluated as the primary clinical outcome. The prognostic value of clinical characteristics and plasma 25(OH)D level was assessed using the Kaplan–Meier plot and Cox proportional hazards regression tests.

Results

Higher level of plasma 25(OH)D level in COVID-19 patients was independently associated with shorter nucleic acid negative conversion time from COVID-19 infection (multivariate adjusted HR: 0.54, 95%CI: 0.35–0.82, P=0.004, tertile 2 vs 1; multivariate adjusted HR: 0.60, 95%CI: 0.39–0.90, P=0.014, tertile 3 vs 1).

Conclusion

Plasma 25(OH)D level may serve as an independent prognostic factor in COVID-19 patient. Our findings indicate the protective roles of vitamin D supplementation in the regiment of patients with COVID-19.

Keywords:

• SARS-CoV-2
• COVID-19
• plasma 25(OH)D level
• nucleic acid negative conversion time

Abbreviations

vitD, plasma 25(OH)D level; WBC#, white blood cell count; RDW, red blood cell distribution width; RBC#, red blood cell count; PLT#, platelet count; NEUT%, neutrophil percentage; MPV, mean platelet volume; NEUT#, neutrophil count; MONO%, monocyte percentage; MONO#, monocyte count; MCHC, mean corpuscular hemoglobin concentration; MCV, mean corpuscular volume; LYMPH%, lymphocyte percentage; MCH, mean corpuscular hemoglobin; HGB, hemoglobin; LYMPH#, lymphocyte count; HCT, hematocrit; EO#, eosinophil count; EO%, eosinophil percentage; BASO%, basophil percentage; BASO#, basophil count; A/G, albumin-globulin ratio; ALB, albumin; ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; UREA, urea; CREA, creatinine; DBIL, direct bilirubin; GGT, γ-glutamyl transpeptidase; TBIL, total bilirubin; TP, total protein; TBA, total biliary acid; UA, uric acid; PA, prealbumin; ADA, adenosine deaminase; eGFR, estimated glomerular filtration rate; CG, cholyglycine.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study was supported, in part, by the National Natural Science Foundation of Shanghai (Grant No. 20ZR1434100), and the Shanghai Shenkang Three-Year Action grant (SHDC2022CRS031).