Influence of vitamin d status on the prognosis of COVID 19 in patients with kidney transplant

Purpose: The protective role of Vitamin D as an immunomodulator has been demonstrated in different pathologies included the viral etiology. This effect has been described by different mechanisms among these acting as an immunoprotein inducer, participates in growth and cell differentiation and acts as a mediator of apoptosis. Some evidence suggests that it could influence the SARS-COV 2 infection and its prognosis. Kidney transplant (KT) patients are more susceptible to 25 (OH) VitD (Calcidiol) deficiencies. The purpose of this study is to evaluate the Vitamin D status in transplant patients who have been diagnosed with COVID-19 and its possible correlation with prognosis. Methods: It is an observational, retrospective, cross-sectional and descriptive study that includes kidney transplant patients diagnosed with COVID-19 and with serum 25 (OH) Vit D Results: 79 patients were evaluated. The mean age was 58 years, 60.8% were men. 86% were KT, 11% were simultaneous pancreas and kidney transplant (SPK). 39 (48%) presented neumonia, 22 (28%)flu-like syndrom. 14 (17%) asyntomatic and 2(2,5%) fever. From this patients 39,2% had not changes in the antiinflamatorie therapy, 20.3%, required increased dose of corticosteroids, and 30.4% required methylprednisolone bolus or initiation of anti-interleukin therapy. The mean of Vit D was 21.41+/- 11% we found that 52% has Vit D 30 ng / dl In 32 patientes who required intensification of treatment we found that 73% had Vit D levels <20 ng. 11 patients need an citical care unit, of these 62.5% had levels below <20 ng / dl. There were 12 deaths. 66% of deaths had vitamin D values <20 ng / dl. Conclusions: We were able to observe that vitamin D levels could influence in the prognosis of SARS-COV 2 infection. Vitamin D deficiency was found in a high percentage of transplant patients with COVID 19. Low levels of 25 OH Vit D were evidenced in patients who required greater intensification of antiinflamatory treatment and in deaths.