Vitamin D in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with non-invasive ventilation support

In this study involving 118 patients at the San Paolo Hospital in Miliam Italy, a significant proportion of COVID-19 patients had vitamin D deficiency and patients requiring assistance with breathing were even more likely to be deficient.

From April 8 to May 25 2020, 118 patients (74males, 44 females; median age 61.0 years, range 24-92 years) were enrolled in the study conducted at the Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.

The study was deisgined to evaluate the concentration of VitD in COVID-19 patients experiencing acute respiratory infections of different levels of severity excluding those who underwent invasive respiratory support.

• There was a  negative  correlation  between  VitD  levels  CRP  (a marker of inflammation).   
• VitnD  levels  in  O2  support  patients  were  significantly higher than in both CPAP and NIMV patients.  
• No statistical differences were found for CRP levels among the three type of oxygen support.  
• Fewer patients with  O2 support had VitD  <30 ng/mL and <20 ng/mL than CPAP and NIMV patients.  
• There were no relationships between Vit D or CRP and the three classes of IgM and of IgG SARS-CoV-2 antibodies values.  

The authors conclusions are more like recommendations and theory because the main conclusion is really that low vitamin D deficiency is likely in COVID-19 patients and that patients requiring assistance with breathing are even more likely to be deficient. Since there is no complete view of their entire health status and history it is challenging to draw definitive conclusion specific to Vit D.

Our study shows that a significant proportion of COVID-19 patients have a VitD deficiency and that this condition is more frequent in CPAP and in NIMV patients.

The levels of serum VitD and C-reactive protein (CRP) were analyzed. Of the patients  with ventilation support, 52 (44.1%) received oxygen via nasal cannula, oxygen mask or an oxygen mask with a reservoir, 48 (40.7%) were on a continuous positive airway pressure device (CPAP) and 18 (15,3%) on non-invasive mechanical ventilation (NIMV). 

Barassi A, Pezzilli R, Mondoni M, Rinaldo RF, DavÌ M, Cozzolino M, Melzi D’Eril GV, Centanni S. Vitamin D in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients with non-invasive ventilation support. Panminerva Med. 2021 Jan 25. doi: 10.23736/S0031-0808.21.04277-4. Epub ahead of print. PMID: 33494567. 

https://pubmed.ncbi.nlm.nih.gov/33494567/