Yasmin Adel1, Mohamed Elgamal2, Sherehan Adel Abdelsalam3

1Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Mansoura University Hospital,Faculty of Medicine, Mansoura, Egypt
2Department of Chest, Mansoura University Hospital, Faculty of Medicine, Mansoura, Egypt
3Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura, Egypt

Keywords: COVID-19, systemic lupus erythematosus, vitamin D.


Objectives: In this study, we aimed to assess the impact of serum vitamin D level in systemic lupus erythematosus (SLE) patients with novel coronavirus-2019 (COVID-19) disease on severity of infection, duration of COVID-19 disease course, and fatigue development as a complication of both SLE and COVID-19.

Patients and methods: Between April 2020 and January 2021, a total of 38 patients (31 males, 7 females; mean age: 49.2±8.1 years; range, 38 to 65 years) who were previously diagnosed with SLE and on different lines of lupus management were included. The patients presented to chest outpatient clinic and emergency hospital with manifestations suggesting COVID-19 infection. Vitamin D levels were measured in serum by enzymelinked immunosorbent assay (ELISA). Vitamin D supplement was added to treatment protocols for COVID-19.

Results: Thirteen (34.2%) patients had normal baseline serum vitamin D levels (≥30 ng/mL), nine (23.7%) patients had vitamin D insufficiency (21 to 29 ng/mL), and 16 (42.1%) patients had vitamin D deficiency (≤20 ng/mL). Low vitamin D levels (insufficiency & deficiency) patients had long SLE disease duration (p=0.06). Also, there was a significant long time spent until recovery from COVID-19 infection in low vitamin D levels (insufficiency & deficiency) patient groups versus those with normal vitamin D (p=0.019). Low baseline vitamin D level patients mainly presented with severe COVID19 symptoms (p=0.04). Patients recovered from COVID-19 had normal vitamin D levels than those who died or were lost to follow-up (p=0.07). After recovery from COVID-19, fatigue was more common in SLE patients with low baseline vitamin D level.

Conclusion: Vitamin D seems to play a certain role in the management of COVID-19 infection in SLE patients. Patients with normal vitamin D levels have less severe symptoms, shorter time to recovery, improved COVID-19 outcomes, and less development of fatigue after COVID-19 infection.

Citation: Adel Y, Elgamal M, Abdelsalam SA. Impact of vitamin D level and supplementation on systemic lupus erythematosus patients during COVID-19 pandemic. Arch Rheumatol 2022;37(2):288-299.

Ethics Committee Approval

The study protocol was approved by the Institutional research board of faculty of medicine, Mansoura University, Egypt (IRB No. Rb. 21.01.91). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

___Y.A., ___M.E., ___S.A.A.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.