Vitamin D and vitamin D binding protein levels in COVID-19 intensive care unit patients: A prospective multicenter study

TL;DR

This study compares vitamin D, vitamin D binding protein, and inflammatory markers in ICU patients with and without COVID-19 to understand their roles in disease severity and mortality.

Contribution

The study reveals lower vitamin D binding protein levels and unexpected lower D-dimer and troponin T in COVID-19 ICU patients compared to non-COVID ICU patients.

Findings

Vitamin D levels were low in all ICU patients regardless of COVID-19 status.

COVID-19 ICU patients had lower D-dimer and troponin T levels than non-COVID ICU patients.

Higher mortality rates were observed in ICU patients with COVID-19.

Abstract

Vitamin D binding protein plays a crucial role in regulating vitamin D levels by carrying vitamin D and its metabolites and immunological response by binding to endotoxins and fatty acids. We aimed to compare vitamin D, DBP, and specific inflammatory markers among intensive care unit (ICU) patients with and without the COVID19 virus.

This multicenter study in two training and research hospitals included 37 (13 female) COVID-19positive and 51 (34 female) COVID-19-negative ICU patients. 25(OH) vitamin D, DBP, C-reactive protein (CRP), procalcitonin (PCT), D-dimer, troponin T (TnT), interleukin 6 (IL-6) and ferritin levels, survival, mortality rates, duration of stay (ICU) were examined.

We observed higher ferritin and CRP levels, along with lower DBP, TnT, and D-dimer levels, in patients with COVID-19. ICU patients with COVID-19 exhibited elevated mortality rates (Odds Ratio: 3.012, 95% Confidence Interval (1.252-7.248), p=0.013). However, no statistically significant correlation was observed between mortality rates and Vitamin D or DBP levels across the ICU patient cohort.

Vitamin D values were found to be low in all intensive care patients, regardless of their COVID-19 status. Contrary to the literature, COVID-19 patients had lower D-dimer and TNT levels than negative controls. However, COVID-19-positive ICU patients have decreased DBP. Further, DBP gene polymorphism studies are needed to explain this situation.