Association of Vitamin D Status With Hospital Morbidity and Mortality in Adult Hospitalized Patients With COVID-19

Abstract

Objective To determine the association between vitamin D status and morbidity and mortality in adult hospitalized COVID-19 patients Methods We performed a retrospective chart review study in COVID-19 patients aged ≥18 years old hospitalized at Boston University Medical Center between March 1 – August 4, 2020. All studied patients were tested positive for COVID-19 and had serum levels of 25-hydroxyvitamin D results measured within one year prior to the date of positive tests. Medical information was retrieved from the electronic medical record and were analyzed to determine the association between vitamin D status and hospital morbidity and mortality. Results Among the 287 patients, 100 (36%) patients were vitamin D-sufficient [25(OH)D >30 ng/mL] and 41 (14%) patients died during the hospitalization. Multivariate analysis in patients aged ≥65 years old revealed that vitamin D sufficiency [25(OH)D ≥30 ng/mL] was statistically significantly associated with decreased odds of death (adjusted OR 0.33, 95%CI, 0.12–0.94), acute respiratory distress syndrome (adjusted OR 0.22, 95%CI, 0.05–0.96), and severe sepsis/septic shock (adjusted OR 0.26, 95%CI, 0.08–0.88), after adjustement for potential confounders. Among patients with body mass index <30 kg/m 2 , vitamin D sufficiency was statistically significantly associated with a decreased odds of death (adjusted OR 0.18, 95%CI, 0.04–0.84). No significant association was found in the subgroups of patients aged <65 years old or BMI ≥30 kg/m 2 . Conclusion We revealed an independent association between vitamin D sufficiency defined by serum 25(OH)D ≥30 ng/mL and decreased risk of mortality from COVID-19 in elderly patients and patients without obesity.

Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis

“…As is the case with COVID-19 infection, there is ample data to suggest that vitamin D deficiency is associated with COVID-19 severity and mortality [4][5][6]33]. Although contradictory literature exists wherein the relationship between vitamin D and COVID-19 has been negated [13], several systematic reviews and meta-analyses, albeit based on observational studies, suggest a consistent negative association between serum 25-hydroxyvitamin D levels and COVID-19 disease severity [3,[34][35][36][37].…”

Vitamin D and COVID-19 severity and related mortality: a prospective study in Italy

“…Likewise, as 25OHD levels were measured when patients were admitted to the hospital, the finding of lower 25OHD in COVID-19 hospitalized patients may be expected, in view of the fact that vitamin D is considered an acute phase reactant and might decrease in case of severe acute infection [ 42 , 43 ]. In this respect, however, most of the studies that assessed the relationship between 25OHD levels measured before SARS-Cov-2 infection, evidenced a similar association between vitamin D deficiency and the severity of COVID-19 disease [ 26 , 44 – 46 ]. These include a very recent update from the large UK Biobank cohort ( n = 353,299 participants with 1082 SARS-Cov-2 affected cases) showing a significantly positive association between vitamin D insufficiency (as assessed in the baseline visit performed between 2006 and 2010) and COVID-19 hospitalization or severity [ 46 ], thus disconfirming previous information derived from the same cohort with a much lower number of SARS-Cov-2 affected cases [ 47 – 49 ].…”

Vitamin D and COVID-19 Severity and Related Mortality: A Prospective Study in Italy

“…Likewise, as 25OHD levels were measured when patients were admitted to the hospital, the finding of lower 25OHD in COVID-19 hospitalized patients may be expected, in view of the fact that vitamin D is considered an acute phase reactant and might decrease in case of severe acute infection [42,43]. In this respect, however, most of the studies that assessed the relationship between 25OHD levels measured before SARS-Cov-2 infection, evidenced a similar association between vitamin D deficiency and the severity of COVID-19 disease [26,[44][45][46]. These include a very recent update from the large UK Biobank cohort (n = 353, 299 participants with 1082 SARS-Cov-2 affected cases) showing a significantly positive association between vitamin D insufficiency (as assessed in the baseline visit performed between 2006 and 2010) and COVID-19 hospitalization or severity [46], thus disconfirming previous information derived from the same cohort with a much lower number of SARS-Cov-2 affected cases [47][48][49].…”