Effect of Vitamin D Status on Adult COVID-19 Pneumonia Induced by Delta Variant: A Longitudinal, Real-World Cohort Study

In this small observational study from China in adults with COVID-19 pneumonia induced by the Delta variant, lung lesions progressed faster and improved more slowly in patients with vitamin D deficiency.

• 161 cases were initially included in the study, 46 (29%) of which were diagnosed with pneumonia. Of these, 18 were included in the VDD group and 28 were controls.  
• Differences in sex, vaccination status, and comorbidities were not statistically significant between groups. The median age and baseline 25(OH)D concentrations were 37 years and 21 ng/ml, respectively.  
• After the onset of pneumonia, a higher percentage of patients in the VDD group had fever (33% vs. 7.1%; p = 0.04) compared to the control group, the interval for pneumonia resolution was longer (28 vs. 21 days; p = 0.02), lesions progressed more rapidly (p = 0.01) within 3 to 7 days and improved more slowly (p = 0.007) within more than 28 days. The VDD group also had higher interleukin-6 levels (18.7 vs. 14.6 pg/ml; p = 0.04) and cycle thresholds for N gene (22.8 vs. 31.3; p = 0.04) and ORF1ab gene (20.9 vs. 28.7; p = 0.03) were lower within 3 to 7 days. 

161 adult patients infected with the Delta variant of SARS-CoV-2, 46 of which were diagnosed with pneumonia.

• The study was a small, single-center study, and the authors noted that there were some confounding factors.  
• The study did not report on patient symptoms or severity. The authors also noted that the study focused on the dynamics of lung lesions, and it is not clear if there is a linear correlation between lesion volume and disease severity and prognosis. 

Vitamin D status may have effects on the progression and resolution, but not the onset of Delta variant-induced pneumonia in adults. Non–[vitamin-D deficiency] status may play a lung protective role by reducing viral load and regulating inflammatory response to inhibit the progression of pneumonia. CT image diagnosis system based on AI may have promising applications in the surveillance and diagnosis of novel SARS-CoV-2 variant-induced pneumonia.

• This longitudinal cohort study examined the effect of vitamin D status on COVID-19 pneumonia induced by the Delta variant of SARS-CoV-2. 
• Participants in the study were adult patients (>18 years of age) infected with the SARS-CoV-2 Delta variant between June 14, 2021, and April 1, 2022, who were tested for 25(OH)D concentration on admission and had regular chest scans by computed tomography (CT) imaging during hospitalization and after discharge. 
• Lung lesion dynamics were observed within six time periods after the onset of pneumonia. 
• Patients with pneumonia were divided into vitamin D deficiency (VDD; serum 25(OH)D < 20 ng/mL) and control (serum 25(OH)D ≥ 20 ng/mL) groups. 

Huang H, Zheng J, Liu Y, Zhou Q, Peng D. Effect of vitamin D status on adult COVID-19 pneumonia induced by Delta variant: A longitudinal, real-world cohort study. Front Med (Lausanne). 2023 Mar 24;10:1121256. doi: 10.3389/fmed.2023.1121256.