Comparison of Length of Hospital Stay and Routine Laboratory Parameters in Covid-19 Patients With and Without Serum Vitamin D Deficiency
Abstract
Amaç :Although some recent studies have shown that serum 25-hydroxyvitamin D (25(OH)D) may be effective on the course of Covid-19 disease, the results obtained are still controversial. Therefore, in this study, it was aimed to examine whether there are differences in terms of age, gender, length of hospital stay, biochemical and hematological parameters between those with and without serum 25(OH)D deficiency in Covid-19 patients.
Gereç ve Yöntem: The data of 413 patients hospitalized in Ankara Pursaklar State Hospital whose covid-19 positivity was revealed by PCR test were evaluated retrospectively. Those with less than serum 25(OH)D (<20 ng/mL) were considered as vitamin D deficient group.
Bulgular: It was observed that there was a significant difference between the groups with and without serum 25(OH)D deficiency in terms of biochemical parameters total bilirubin (p=0.07<0.05), potassium (p=0.015<0.05) and glucose (p=0,048<0,05) values. CRP (p=0.051) and fibrinogen (p=0.048) values, which are factors of inflammation and coagulation, were found to be significantly higher in the group with 25(OH)D deficiency. Similarly, hematocrit (p=0.06<0.05) and Neutrophil count (p=0.000<0.05), which are hematological parameters, increased significantly in patients with 25(OH)D deficiency. There were no differences in age, gender and length of hospital stay between the groups with and without 25(OH)D deficiency. As a result of Binary Logistic Regression Analysis, it is seen that the variables of age, gender and length of hospital stay(p=0.103>0.05, p=0.995>0.05 and p=0.222>0.05) do not have a significant relationship with the dependent variable 25(OH)D deficiency.
Tartışma
Our findings showed that 25(OH)D deficiency in hospitalized Covid-19 patients was associated with some biochemical, hematological and inflammatory factors, but not with age, gender and length of hospital stay.
References
- 1.Thompson S, Bohn MK, Mancini N, et al. IFCC ınterim guidelines on biochemical/hematological monitoring of COVID‐19 patients. Clin Chem Lab Med. 2020;58(12):2009–16.
- 2.Mardani R, Ahmadi Vasmehjani A, Zali F, et al. Laboratory parameters in detection of COVID-19 patients with positive RT-PCR; a diagnostic accuracy study. Arch Acad Emerg Med. 2020;8(1):e43
- 3.Bonetti, G; Manelli, F; (...); Lippi, G Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy. Clınıcal Chemıstry And Laboratory Medıcıne. 2020; 58 (7) , pp.1100-1105
- 4.Liao D, Zhou F, Luo L, et al. Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study. Lancet Haematol 2020;7(9):E671e8.
- 5.Ampuero, J; Sanchez, Y; Romero-Gomez, M et al. Impact of liver injury on the severity of COVID-19: a systematic review with meta-analysis. Revısta Espanola De Enfermedades Dıgestıvas.2021; 113 (2) , pp.125-135
- 6.Palacios C and Gonzalez L. Is vitamin D deficiency a majör global public health problem? J Steroid Biochem Mol Biol 2014; 144: 138–145.
- 7.Alpdemir,M. and Alpdemir, MF. Department of Clinical Biochemistry, Balikesir State Hospital, MiVitamin D deficiency status in Turkey: A meta-analysis Int J Med Biochem 2019;2(3):118-31.
- 8.Reis, Bruna Z.; Fernandes, Alan L.; Sales, Lucas P.; et al. Influence of vitamin D status on hospital length of stay and prognosis in hospitalized patients with moderate to severe COVID-19: a multicenter prospective cohort study. 2021;114(2):598-604.
- 9.Daneshkhah A, Agrawal V, Eshein A, Subramanian H, Roy HK,Backman V. Evidence for possible association of vitamin D statuswith cytokine storm and unregulated inflammation in COVID‐19patients.Aging Clinical and Exp Res. 2020;32(10):2141‐2158
- 10.Almehmadi, Mazen; Turjoman, Abdullah; El-Askary, Ahmad; et al. Association of vitamin D deficiency with clinical presentation of COVID-19. European Journal Of Inflammatıon. Article Number: 20587392211038315 2021(19):1-10.
- 11.Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020;13:1373–80.
- 12.Ilie PC, Stefanescu S and Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res 2020; 32(7): 1195–1198.
- 13.Alipio M (2020) Vitamin D supplementation could possibly improve clinical outcomes of patients infected with coronavirus-(COVID-19). 2019 Available at 3571484.
- 14.Raharusun P (2020) Patterns of COVID-19 mortality and vitamin D: an Indonesian study. Available at SSRN 3585561.
- 15. Chen, J., Mei, K., Xie, L., Yuan, P., Ma, J., Yu, P., Zhu, W., Zheng, C., & Liu, X. Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs. Nutrition Journal, 2021: 20(1), 89.
- 16. Hastie, C. E., Pell, J. P., & Sattar, N. Vitamin D and COVID-19 infection and mortality in UK Biobank. European Journal Of Nutrition. 2021: 60(1), 545–548.
- 17.Nabatchian, F., Ashtiani, M., Davoudi, M., Teimourpour, A., & Davoudi, N. (2021). A Multivariate Analysis Model of Changes in Some Laboratory Parameters in Response to COVID-19, Diabetes, Gender, and Age. Clinical Laboratory, 67(8), 10.7754/Clin.Lab.2021.210106.
- 18.Szeto, B; Zucker, JE; Cohen, AVitamin D Status and COVID-19 Clinical Outcomes in Hospitalized Patients. Endocrıne Research 2021-46 (2) :66-73.
- 19.Demir, Mustafa; Demir, Fadime; Aygun, Hatice. Vitamin D deficiency is associated with COVID-19 positivity and severity of the disease. Journal Of Medıcal Vırology. 2021 (93): 2992-2999
- 20.Hernandez JL, Nan D, Fernandez-Ayala M, Garcia-Unzueta M, Hernandez-Hernandez MA, Lopez-Hoyos M, et al. Vitamin D status in hospitalized patients with SARS-CoV-2 infection. J Clin Endocrinol Metab. 2021;106(3):e1343 e135.
- 21.Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID‐19): a meta‐analysis. Clin Chem Lab Med. 2020;58(7):1021–8.
- 22.Ali, N and Hossain, K . Liver injury in severe COVID-19 infection: current insights and challenges. Expert Revıew Of Gastroenterology & Hepatology.2020- 14 (10) , pp.879-884.
- 23.Bao J et al (2020) Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19. Clin Chim Acta 509:180–194.
- 24.Noori, M; Nejadghaderi, SA; Safiri, SA Review on the Possible Pathophysiology of Potassium Abnormalities in COVID-19 Nov 2021 | Iranıan Journal Of Kıdney Dıseases. 2021-15 (6) :.397-407.
- 25.Boucher, B.J., 2020. Why do so many trials of vitamin D supplementation fail? Endocr. Connect. 9 (9), R195–R206. https://doi.org/10.1530/EC-20-0274.
- 26.di Filippo, L; Allora, A; Giustina, AVitamin D Levels Are Associated With Blood Glucose and BMI in COVID-19 Patients, Predicting Disease Severity. Jan 1 2022 | Journal Of Clınıcal Endocrınology & Metabolısm 107 (1) , pp.E348-E360.
- 27.Coppelli A, Giannarelli R, Aragona M, et al; Pisa COVID-19 Study Group. Hyperglycemia at hospital admission is asso-ciated with severity of the prognosis in patients hospitalized for COVID-19: the Pisa COVID-19 Study. Diabetes Care. .2020;43(10):2345-2348.
- 28.Bayramoglu, E; Akkoc, G; Elevli, M. The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital. European Journal Of Pedıatrıcs. 2021- 180 (8) , pp.2699-2705.
- 29.Bulbul MRH, Uddin MG, Faiyaz KI, Islam MR, Alam MA, Ahmed S, Hossain MZ, Lokman M, Islam MS. Hematological and inflammatory parameters in hospitalized patients with COVID-19 infection in Chattogram, Bangladesh. J Res Pharm. 2021; 25(6): 857-865.
- 30.Pimentel, Gustavo D.; Dela Vega, Maria C. M.; Pichard, Claude. Low vitamin D levels and increased neutrophil in patients admitted at ICU with COVID-19. Clınıcal Nutrıtıon Espen.2021;(44):466-468. 31. Thomas, T., Stefanoni, D., Dzieciatkowska, M.et al. Evidence of Structural Protein Damage and Membrane Lipid Remodeling in Red Blood Cells from COVID-19 Patients. Journal of proteome research. 2020;19(11), 4455–4469.
- 32.Cavezzi A, Troiani E, Corrao S. COVID-19: hemoglobin, iron, and hypoxia beyond inflammation. A narrative review. Clin Pract 2020;10(2):1271.
- 33.Tang N, Li D, et al., Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis. 2020; 18(4), 844-847.
Serum D vitamini eksikliği olan ve olmayan Covid-19 hastalarında hastanede kalış ve rutin laboratuvar parametrelerinin karşılaştırılması
Abstract
Her ne kadar son zamanlardaki bazı çalışmalar D vitamininin Covid-19 hastalığının seyri üzerine etkili olabileceğini gösterse de elde edilen sonuçların hala tartışmalı olduğu görülmektedir. Bu nedenle, çalışmada Covid-19 hastalarında D vitamini eksikliği olanlar ile olmayanlar arasındaki yaş, cinsiyet, hastanede kalma süresi, biyokimyasal ve hematolojik parametreler bakımından farklılıkların olup olmadığının incelenmesi amaçlanmıştır.
Ankara Pursaklar Devlet Hastanesi servisinde yatan Covid-19 pozitifliği PCR testi ile ortaya konmuş 413 hastanın verileri retrospektif olarak değerlendirilmiştir. D vitamini ( <20 ng/mL) den küçük olanlar D vitamini eksik grup olarak ele alınmıştır.
D vitamini eksikliği olan ve olmayan gruplar arasında biyokimyasal parametrelerden Total Bilirubin (p=0,07<0,05), potasyum (p=0,015<0,05) ve glukoz (p=0,048<0,05) açısından anlamlı bir farklılık olduğu görülmüştür. İnflamasyon ve koagülasyon faktörlerinden CRP (p=0,051) ve fibrinojen (p=0,048) değerlerinin D vitamini eksikliği olan grupta anlamlı düzeyde yüksek olduğu görülmüştür. Benzer şekilde, D vitamini eksikliği olanlarda hematolojik parametrelerden Hemotokrit (p=0,06<0,05) ve Nötrofil sayısının (p=0,000<0,05) anlamlı düzeyde arttığı görülmüştür. D Vitamini Eksikliği olan ve olmayan gruplar arasında yaş, cinsiyet ve hastanede kalma süresi bakımından farklılıklar görülmemiştir. Binary Logistic Regresyon Analizi sonucunda yaş, cinsiyet ve hastanede kalış süresi (p=0,103>0,05, p=0,995>0,05 ve p=0,222>0,05) değişkenlerinin bağımlı değişken olan D vitamini eksikliği ile anlamlı bir ilişkisi olmadığı görülmektedir.
Bulgularımız hastanede yatan Covid-19 hastalarında D vitamini eksikliğinin bazı biyokimyasal, hematolojik ve inflamasyon faktörleri ile ilişkili bulunurken yaş, cinsiyet ve kalış süresi ile ilişkili olmadığını göstermiştir.
References
- 1.Thompson S, Bohn MK, Mancini N, et al. IFCC ınterim guidelines on biochemical/hematological monitoring of COVID‐19 patients. Clin Chem Lab Med. 2020;58(12):2009–16.
- 2.Mardani R, Ahmadi Vasmehjani A, Zali F, et al. Laboratory parameters in detection of COVID-19 patients with positive RT-PCR; a diagnostic accuracy study. Arch Acad Emerg Med. 2020;8(1):e43
- 3.Bonetti, G; Manelli, F; (...); Lippi, G Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy. Clınıcal Chemıstry And Laboratory Medıcıne. 2020; 58 (7) , pp.1100-1105
- 4.Liao D, Zhou F, Luo L, et al. Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study. Lancet Haematol 2020;7(9):E671e8.
- 5.Ampuero, J; Sanchez, Y; Romero-Gomez, M et al. Impact of liver injury on the severity of COVID-19: a systematic review with meta-analysis. Revısta Espanola De Enfermedades Dıgestıvas.2021; 113 (2) , pp.125-135
- 6.Palacios C and Gonzalez L. Is vitamin D deficiency a majör global public health problem? J Steroid Biochem Mol Biol 2014; 144: 138–145.
- 7.Alpdemir,M. and Alpdemir, MF. Department of Clinical Biochemistry, Balikesir State Hospital, MiVitamin D deficiency status in Turkey: A meta-analysis Int J Med Biochem 2019;2(3):118-31.
- 8.Reis, Bruna Z.; Fernandes, Alan L.; Sales, Lucas P.; et al. Influence of vitamin D status on hospital length of stay and prognosis in hospitalized patients with moderate to severe COVID-19: a multicenter prospective cohort study. 2021;114(2):598-604.
- 9.Daneshkhah A, Agrawal V, Eshein A, Subramanian H, Roy HK,Backman V. Evidence for possible association of vitamin D statuswith cytokine storm and unregulated inflammation in COVID‐19patients.Aging Clinical and Exp Res. 2020;32(10):2141‐2158
- 10.Almehmadi, Mazen; Turjoman, Abdullah; El-Askary, Ahmad; et al. Association of vitamin D deficiency with clinical presentation of COVID-19. European Journal Of Inflammatıon. Article Number: 20587392211038315 2021(19):1-10.
- 11.Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020;13:1373–80.
- 12.Ilie PC, Stefanescu S and Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res 2020; 32(7): 1195–1198.
- 13.Alipio M (2020) Vitamin D supplementation could possibly improve clinical outcomes of patients infected with coronavirus-(COVID-19). 2019 Available at 3571484.
- 14.Raharusun P (2020) Patterns of COVID-19 mortality and vitamin D: an Indonesian study. Available at SSRN 3585561.
- 15. Chen, J., Mei, K., Xie, L., Yuan, P., Ma, J., Yu, P., Zhu, W., Zheng, C., & Liu, X. Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs. Nutrition Journal, 2021: 20(1), 89.
- 16. Hastie, C. E., Pell, J. P., & Sattar, N. Vitamin D and COVID-19 infection and mortality in UK Biobank. European Journal Of Nutrition. 2021: 60(1), 545–548.
- 17.Nabatchian, F., Ashtiani, M., Davoudi, M., Teimourpour, A., & Davoudi, N. (2021). A Multivariate Analysis Model of Changes in Some Laboratory Parameters in Response to COVID-19, Diabetes, Gender, and Age. Clinical Laboratory, 67(8), 10.7754/Clin.Lab.2021.210106.
- 18.Szeto, B; Zucker, JE; Cohen, AVitamin D Status and COVID-19 Clinical Outcomes in Hospitalized Patients. Endocrıne Research 2021-46 (2) :66-73.
- 19.Demir, Mustafa; Demir, Fadime; Aygun, Hatice. Vitamin D deficiency is associated with COVID-19 positivity and severity of the disease. Journal Of Medıcal Vırology. 2021 (93): 2992-2999
- 20.Hernandez JL, Nan D, Fernandez-Ayala M, Garcia-Unzueta M, Hernandez-Hernandez MA, Lopez-Hoyos M, et al. Vitamin D status in hospitalized patients with SARS-CoV-2 infection. J Clin Endocrinol Metab. 2021;106(3):e1343 e135.
- 21.Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID‐19): a meta‐analysis. Clin Chem Lab Med. 2020;58(7):1021–8.
- 22.Ali, N and Hossain, K . Liver injury in severe COVID-19 infection: current insights and challenges. Expert Revıew Of Gastroenterology & Hepatology.2020- 14 (10) , pp.879-884.
- 23.Bao J et al (2020) Comparative analysis of laboratory indexes of severe and non-severe patients infected with COVID-19. Clin Chim Acta 509:180–194.
- 24.Noori, M; Nejadghaderi, SA; Safiri, SA Review on the Possible Pathophysiology of Potassium Abnormalities in COVID-19 Nov 2021 | Iranıan Journal Of Kıdney Dıseases. 2021-15 (6) :.397-407.
- 25.Boucher, B.J., 2020. Why do so many trials of vitamin D supplementation fail? Endocr. Connect. 9 (9), R195–R206. https://doi.org/10.1530/EC-20-0274.
- 26.di Filippo, L; Allora, A; Giustina, AVitamin D Levels Are Associated With Blood Glucose and BMI in COVID-19 Patients, Predicting Disease Severity. Jan 1 2022 | Journal Of Clınıcal Endocrınology & Metabolısm 107 (1) , pp.E348-E360.
- 27.Coppelli A, Giannarelli R, Aragona M, et al; Pisa COVID-19 Study Group. Hyperglycemia at hospital admission is asso-ciated with severity of the prognosis in patients hospitalized for COVID-19: the Pisa COVID-19 Study. Diabetes Care. .2020;43(10):2345-2348.
- 28.Bayramoglu, E; Akkoc, G; Elevli, M. The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital. European Journal Of Pedıatrıcs. 2021- 180 (8) , pp.2699-2705.
- 29.Bulbul MRH, Uddin MG, Faiyaz KI, Islam MR, Alam MA, Ahmed S, Hossain MZ, Lokman M, Islam MS. Hematological and inflammatory parameters in hospitalized patients with COVID-19 infection in Chattogram, Bangladesh. J Res Pharm. 2021; 25(6): 857-865.
- 30.Pimentel, Gustavo D.; Dela Vega, Maria C. M.; Pichard, Claude. Low vitamin D levels and increased neutrophil in patients admitted at ICU with COVID-19. Clınıcal Nutrıtıon Espen.2021;(44):466-468. 31. Thomas, T., Stefanoni, D., Dzieciatkowska, M.et al. Evidence of Structural Protein Damage and Membrane Lipid Remodeling in Red Blood Cells from COVID-19 Patients. Journal of proteome research. 2020;19(11), 4455–4469.
- 32.Cavezzi A, Troiani E, Corrao S. COVID-19: hemoglobin, iron, and hypoxia beyond inflammation. A narrative review. Clin Pract 2020;10(2):1271.
- 33.Tang N, Li D, et al., Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of Thrombosis and Haemostasis. 2020; 18(4), 844-847.
Details
| Primary Language | English |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | Original Research |
| Authors | |
| Early Pub Date | July 26, 2023 |
| Publication Date | July 31, 2023 |
| Acceptance Date | July 10, 2023 |
| Published in Issue | Year 2023 Volume: 13 Issue: 4 |
