Association of Vitamin D and Secondary Infection in COVID-19

ABSTRACT

Introduction: Vitamin D plays a role in the modulation of cytokine release, inflammation, innate and adaptive immunity. It has been frequently discussed that the hyperinflammatory response that causes acute respiratory distress syndrome or other organ damage due to SARS-CoV-2 at the beginning of the pandemic can be modulated by the adequacy of vitamin D. The relationship of vitamin D with many conditions such as mortality, number of intensive care unit stays, disease severity, and organ damage has been investigated, but the information on its effect on secondary infections that occur during the course of the disease is limited. In this study, it was aimed to reveal the relationship of vitamin D with secondary infections that occur during the course of COVID-19 disease. Materials and Methods: Medical records of patients hospitalized in the COVID-19 pandemic service with the diagnosis of COVID-19 were evaluated retrospectively. Results: One hundred eighty-one patients were included in the study. The mean of 25(OH) vitamin D was found to be 18.76 ± 9.82 ng/mL. When 25-hydroxy vitamin D was compared with gender, disease severity, mortality, need for mechanical ventilation and presence of symptoms, no statistically significant difference was found (p> 0.05). The medical data of the patients during their hospitalization were analyzed and secondary infection was detected in 14.9% (n= 27). When 25-hydroxy vitamin D and the presence of secondary infection were compared, the 25(OH)D vitamin level of those with secondary infection was found to be low and this was found to be statistically significant (p= 0.016). As a result of the evaluation made by ROC analysis, 25-hydroxy vitamin D was found to have a diagnostic value in predicting positive culture results in COVID-19 patients (AUC= 0.771, 95% Confidence Interval= 0.612-0.810, p= 0.003, p< 0.05). Conclusion: While vitamin D continues to be an important topic of discussion in COVID-19 disease due to its effects on the immune system, it should not be forgotten that low vitamin D increases the risk of secondary infection developing in the course of COVID-19 and this may have an impact on prognosis.