Impact of vitamin D on the course of COVID-19 during pregnancy: A case control study

Vitamin D deficiency may be a risk factor for COVID-19 severity in pregnant women.

To evaluate the vitamin D status of pregnant women with COVID-19, and the association between vitamin D level and severity of COVID-19.

• Apgar 5th min scores were significantly lower in the COVID-19 group than the control group (p < 0.05).
• The vitamin D levels of the patients in the COVID-19 group (12.46) were significantly lower than the control group (18.76) (p = 0.004).
• There was a significant difference in 25-OH D vitamin levels between COVID-19 and control group (p = 0.000).
• The majority of the patients in the control group had vitamin D insufficiency and deficiency, but severe 25-OH D vitamin deficiency had the highest rate in the COVID-19 patients.
• Five mothers died in the severe COVID-19 category. While one mother was at 12 gestational weeks, four of them were in mid-late third trimester of the pregnancy. 25-OH D vitamin level of those were ranging between 4.5 and 12.
• There was a statistically significant relationship between groups in terms of COVID-19 severity and 25-OH D vitamin level (p < 0.05).
• Although 25-OH D vitamin levels were low in both groups, 25-OH D vitamin levels of those in the mild COVID-19 group (13.69) were significantly higher than those in the moderate or severe COVID-19 group (9.06) (p < 0.05).
• There was a significant relationship between groups in terms of 25-OH D vitamin deficiency and COVID-19 severity (p = 0.000). In both mild and moderate + severe COVID-19 groups, the majority of the patients had severe 25-OH D vitamin deficiency.
• There was no statistically significant relationship between vitamin D supplementation and COVID-19 severity (p > 0.05). However, it was observed that all of those who had severe COVID-19 were the patients who did not take vitamin D supplementation. In those taking vitamin D supplementation, the mild COVID-19 rate was 77.8 %; while moderate and severe was 22.2 %.

159 women with a single pregnancy who tested positive for SARS-CoV-2, and randomly selected 332 healthy pregnant women.

• This is a case control study, no intervention took place.
• The study included a low number of moderate and severe COVID-19 cases.

The vitamin D levels are low in pregnant women with COVID-19. Also, there is a significant difference regarding to vitamin D level and COVID-19 severity in pregnant women. Maintenance of adequate vitamin D level can be useful as an approach for the prevention of an aggressive course of the inflammation induced by this novel coronavirus in pregnant women.

• In this case control study, 159 women with a single pregnancy who had tested positive for SARS-CoV-2, and randomly selected 332 healthy pregnant women with similar gestational ages were included as controls.
• The study was conducted between July–December 2020 at the Ministry of Health Ankara City Hospital, Ankara, Turkey.
• COVID-19 patients were classified as mild, moderate, and severe according to the Chinese management guideline for COVID-19 (version 6.0).
• Vitamin D deficiency was defined as 25-hydroxycholecalciferol <20 ng/mL (50 nmol/L), and 25-OH D vitamin <10 ng/mL was defined as severe vitamin D deficiency, also 25-OH D vitamin level between 20−29 ng/mL (525−725 nmol/L) was defined as vitamin D insufficiency.

Sinaci S, Ocal DF, Yucel Yetiskin DF, Uyan Hendem D, Buyuk GN, Goncu Ayhan S, Tanacan A, Ozgu-Erdinc AS, Moraloglu Tekin O, Sahin D. Impact of vitamin D on the course of COVID-19 during pregnancy: A case control study. J Steroid Biochem Mol Biol. 2021 Aug 11;213:105964. doi: 10.1016/j.jsbmb.2021.105964. Epub ahead of print. PMID: 34390830; PMCID: PMC8356729.