May 16, 2023 — Patients with long-term COVID had lower levels of vitamin D than patients who had recovered from COVID-19, a new study shows, suggesting that taking vitamin D supplements could help prevent or alleviate the debilitating condition.
The lower vitamin D levels in patients with long-term COVID, where the effects of the initial COVID infection last longer than 12 weeks, were most notable in those with “brain fog.”
These findings by Luigi di Filippo, MD, and colleagues, were recently presented at the European Congress of Endocrinology in Istanbul, and the study was also published in Journal of Clinical Endocrinology and Metabolism.
“Our data suggest that vitamin D levels should be assessed in patients with COVID-19 after hospital discharge,” the researchers from San Raffaele Hospital, in Milan, Italy, wrote.
The researchers noted as a strength that this controlled study included patients with multiple symptoms of prolonged COVID and had longer follow-up than most previous studies (6 months vs. 3 months).
“The highly controlled nature of our study helps us better understand the role of vitamin D deficiency in long-term COVID and to establish that there is likely a link between vitamin D deficiency and long-term COVID,” he said in a statement. press release lead author Andrea Giustina, MD. .
But, he said, “it’s not yet known whether vitamin D supplements could improve symptoms or reduce this risk entirely.”
Supplement if deficient?
Amiel Dror, MD, PhD, who led a related study study that showed that people with a vitamin D deficiency were more likely to have severe COVID, he agreed.
“The novelty and significance of this [new] lies in the fact that it broadens our current understanding of the interaction between vitamin D and COVID-19, taking it beyond the acute phase of the disease,” said Dror, from Bar-Ilan University Azrieli College of Medicine. in Safed, Israel.
“It is amazing to see how vitamin D levels continue to influence the health of patients even after recovery from the initial infection,” he said.
“The findings certainly add weight to the argument for conducting a randomized, controlled trial,” he said, which “would allow us to determine conclusively whether vitamin D supplementation can effectively reduce the risk or severity of long-term COVID.”
“In the meantime,” Dror said, “given the safety profile of vitamin D and its broad health benefits, it might be reasonable to test vitamin D levels in hospitalized patients with COVID-19. If it is found that the levels are low, supplementation could be considered.”
“However, it is important to note that this must be done under medical supervision,” he said, “and further studies are needed to establish the optimal timing and dose of supplementation.”
Low vitamin D and prolonged COVID risk
Low vitamin D levels have been associated with an increased likelihood of needing mechanical ventilation and poorer survival in hospitalized COVID patients, but the risk of prolonged COVID associated with vitamin D is not well understood.
The researchers analyzed data from adults aged 18 years and older who had been hospitalized at San Raffaele Hospital with a confirmed diagnosis of COVID and then discharged during the first wave of the pandemic from March to May 2020, and then seen 6 months later in a follow-up clinic.
Patients were excluded if they had been admitted to the intensive care unit during their hospitalization or if medical data or blood samples were not available to determine vitamin D levels at admission and at the 6-month follow-up.
UK National Institute for Health and Care Excellence guidelines were used to define prolonged COVID as the presence of at least two or more of 17 symptoms that were absent prior to COVID infection and could only be attributed to that acute illness.
The investigators identified 50 patients with long-term COVID at the 6-month follow-up and compared them to 50 patients without long-term COVID based on age, gender, other medical conditions, and the need for noninvasive mechanical ventilation.
The patients had a mean age of 61 years and 56% were men; 28% had been on a ventilator during their COVID hospitalization.
The most common symptoms at 6 months in patients with long-term COVID were weakness (38%), bad taste in the mouth (34%), shortness of breath (34%), and loss of smell (24%).
Most symptoms were related to the cardiorespiratory system (42%), sense of well-being (42%), or the senses (36%), and fewer patients had symptoms related to neurocognitive impairment (headache or mental confusion, 14%). , or ear, nose and throat (12%) or the gastrointestinal system (4%).
Patients with long-term COVID had lower average vitamin D levels than patients without long-term COVID, and vitamin D levels were significantly lower in patients with symptoms such as headache or brain fog.
The researchers used a type of analysis called multiple regression, which showed that vitamin D at follow-up was the only variable that was significantly associated with prolonged COVID.
The findings “strongly reinforce the clinical utility of…evaluation of vitamin D as a potential modifiable pathophysiological factor underlying this emerging critical health problem worldwide,” the researchers concluded.
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