Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;93(12):6605-6610.
doi: 10.1002/jmv.27215. Epub 2021 Aug 11.

Dexamethasone treatment may mitigate adverse effects of vitamin D deficiency in hospitalized Covid-19 patients

Charlotte Wenban  1 , Randeep S Heer  1 , Vadir Baktash  1 , Pirabakaran Kandiah  1 , Theodora Katsanouli  1 , Asmita Pandey  1 , Ryan Goindoo  1 , Afiyah Ajaz  1 , Koenraad Van den Abbeele  1 , Amit K J Mandal  1 , Constantinos G Missouris  1   2
Affiliations

Dexamethasone treatment may mitigate adverse effects of vitamin D deficiency in hospitalized Covid-19 patients

Charlotte Wenban et al. J Med Virol. 2021 Dec.

Abstract

Aims: We have previously demonstrated that vitamin D deficiency might be associated with worse outcomes in hospitalized Covid-19 patients. The aim of our study was to explore this relationship with dexamethasone therapy.

Methods: We prospectively studied two cohorts of hospitalized Covid-19 patients between March and April and between September and December 2020 (n = 192). Patients were tested for serum 25-hydroxyvitamin D (25-OH-D) levels during admission. The first cohort not treated with dexamethasone (n = 107) was divided into vitamin D deficient (25-OH-D ≤ 30 nmol/L) (n = 47) and replete subgroups (25-OH-D > 30 nmol/L) (n = 60). The second cohort treated with dexamethasone (n = 85) was similarly divided into deficient (25-OH-D ≤ 30 nmol/L) (n = 27) and replete subgroups (25-OH-D > 30 nmol/L) (n = 58). Primary outcome was in-hospital mortality and secondary outcomes were elevation in markers of cytokine storm and ventilatory requirement.

Results: No mortality difference was identified between cohorts and subgroups. The "no dexamethasone" cohort 25-OH-D deplete subgroup recorded significantly higher peak D-Dimer levels (1874 vs. 1233 µgFEU/L) (p = 0.0309), CRP (177 vs. 107.5) (p = 0.0055), and ventilatory support requirement (25.5% vs. 6.67%) (p = 0.007) compared to the replete subgroup. Among the 25-OH-D deplete subgroup higher peak neutrophil counts, peak CRP, peak LDH, peak ferritin, and lower trough lymphocyte counts were observed, without statistical significance. In the "dexamethasone" cohort, there was no apparent association between 25-OH-D deficiency and markers of cytokine storm or ventilatory requirement.

Conclusion: Vitamin D deficiency is associated with elevated markers of cytokine storm and higher ventilatory requirements in hospitalized Covid-19 patients. Dexamethasone treatment appears to mitigate adverse effects of vitamin D deficiency.

Keywords: covid-19; cytokine storm; dexamethasone; ventilation; vitamin D.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Flow chart depicting allocation of patients to groups based on dexamethasone therapy and subgroups based on inpatient 25‐OH‐D level
See this image and copyright information in PMC

References

    1. Liu N, Sun J, Wang X, Zhang T, Zhao M, Li H. Low vitamin D status is associated with coronavirus disease 2019 outcomes: a systematic review and meta‐analysis. Int J Infect Dis. 2021;104:58‐64. 10.1016/j.ijid.2020.12.077 - DOI - PMC - PubMed
    1. Sze S, Pan D, Nevill CR, et al. Ethnicity and clinical outcomes in COVID‐19: a systematic review and meta‐analysis. EClinicalMedicine. 2020;29‐30:100630. 10.1016/j.eclinm.2020.100630 - DOI - PMC - PubMed
    1. Panarese A, Shahini E. Letter: Covid‐19, and vitamin D. Aliment Pharmacol Ther. 2020;51:993‐995. 10.1111/apt.15752 - DOI - PMC - PubMed
    1. Baktash V, Hosack T, Patel N, et al. Vitamin D status and outcomes for hospitalised older patients with COVID‐19. Postgrad Med J. 2020;97:442‐447. 10.1136/postgradmedj-2020-138712 - DOI - PMC - PubMed
    1. Recovery Collaborative G, Horby P, Lim WS, et al. Dexamethasone in hospitalized patients with Covid‐19. N Engl J Med. 2021;384:693‐704. 10.1056/nejmoa2021436 - DOI - PMC - PubMed