# Exploring the Association of Vitamin D and VDR Polymorphisms with Disease Severity in COVID-19 and Influenza

**Authors:** Alexandru Constantin Sîrbu, Ioana Corina Bocșan, Octavia Sabin, Raluca Maria Pop, Ștefan Cristian Vesa, Gavriela Feketea, Violeta Briciu, Mihaela Lupșe, Anca Dana Buzoianu

PMC · DOI: 10.3390/biomedicines13112617 · 2025-10-25

## TL;DR

This study explores how vitamin D levels and genetic variations in the vitamin D receptor relate to the severity of respiratory infections like COVID-19 and influenza.

## Contribution

The study provides new insights into the potential role of vitamin D in modulating disease severity in respiratory infections.

## Key findings

- Vitamin D levels were significantly lower in severe cases of COVID-19 and influenza compared to moderate cases.
- No significant association was found between VDR polymorphisms and disease severity or vitamin D levels.
- Severe respiratory infection cases showed higher inflammatory markers and lower lymphocyte counts.

## Abstract

Background: Respiratory viral infections such as COVID-19 and influenza represent significant public health threats, especially in vulnerable populations. Vitamin D has been promoted as an immunomodulatory agent, with previous studies suggesting an association between vitamin D levels and disease severity in respiratory infections. Additionally, genetic variations in the vitamin D receptor (VDR) may influence immune responses. Methods: This study investigates the relationship between vitamin D levels, VDR polymorphisms (rs1544410, rs731236, and rs7975232), and clinical severity in hospitalized patients with COVID-19 and influenza during the 2023–2024 winter season. Results: A total of 71 patients were included in this cross-sectional study. Vitamin D levels were significantly lower in severe COVID-19 cases (8.08 ng/mL, IQR: 4.79–15.7) compared to moderate forms (32.6 ng/mL, IQR: 13.0–38.6), as well as severe influenza cases (25.6 ng/mL, IQR: 18.9–34.5). Additionally, severe COVID-19 patients exhibited higher inflammatory markers (CRP, neutrophil count) and lower lymphocyte counts. However, no significant association was found between VDR polymorphisms and disease severity or vitamin D levels. Conclusions: These findings highlight the potential role of vitamin D in modulating disease severity in respiratory viral infections, while the influence of genetic polymorphisms remains uncertain. Further research is needed to determine whether vitamin D supplementation could improve clinical outcomes in these infections.

## Linked entities

- **Genes:** VDR (vitamin D receptor) [NCBI Gene 7421]
- **Diseases:** COVID-19 (MONDO:0100096), influenza (MONDO:0005812)

## Full-text entities

- **Genes:** VDR (vitamin D receptor) [NCBI Gene 7421] {aka NR1I1, PPP1R163}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}
- **Diseases:** infections (MESH:D007239), Influenza (MESH:D007251), inflammatory (MESH:D007249), COVID-19 (MESH:D000086382), respiratory infections (MESH:D012141)
- **Chemicals:** Vitamin D (MESH:D014807)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Mutations:** rs7975232, rs731236, rs1544410

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Source: https://tomesphere.com/paper/PMC12650269