Low Circulating Vitamin D in Intensive Care Unit–Admitted COVID-19 Patients as a Predictor of Negative Outcomes

Abstract

Background Vitamin D deficiency has been associated with an increased risk of respiratory infections. Objectives The study aimed to evaluate the serum 25-hydroxyvitamin D [25(OH)D] concentration in patients admitted to the intensive care unit (ICU) as a predictor of coronavirus disease 2019 (COVID-19) mortality. Methods A single-center retrospective observational study was conducted. Forty adult patients (50% men) with confirmed COVID-19 who were admitted to the ICU were enrolled. The primary endpoint was mortality at day 60. Serum 25(OH)D concentration was measured on the day of admission to the ICU. We used the Mann–Whitney test, Fisher's exact test, Kaplan–Meier analysis, and receiver operator characteristic (ROC) analysis to assess serum 25(OH)D concentration as a predictor of COVID-19 mortality. Results All 40 patients had a low median (IQR) serum 25(OH)D concentration at admission [12 (9–15) ng/mL]. The median (IQR) serum 25(OH)D concentration was greater in survivors [13.3 (10.0–17.1) ng/mL, n = 22] than in nonsurvivors [9.6 (7.9–14.2) ng/mL; n = 18], P = 0.044. The area under the ROC curve was 0.69 (95% CI: 0.52, 0.86; P = 0.044). The 60-d mortality rate of those with serum 25(OH)D concentrations ≤9.9 ng/mL (n = 14, 71%) tended to be greater than that of those with concentrations >9.9 ng/mL (n = 26, 31%) (P = 0.065), and they had a 5.6-fold higher risk of death (OR: 5.63; 95% CI: 1.35, 23.45; P = 0.018). Conclusions The ICU patients had a low serum 25(OH)D concentration. Serum 25(OH)D concentrations ≤9.9 ng/mL on admission can be used to predict in-hospital mortality in patients with COVID-19. This trial was registered at clinicaltrials.gov as NCT04450017.

Vitamin D Intake May Reduce SARS-CoV-2 Infection Morbidity in Health Care Workers

“…Vitamin D is postulated to play an important immunomodulatory role, and deficiency is associated with increased incidence of ARVI, including COVID-19 [ 26 , 27 , 28 ]. Our previous results also showed that severe vitamin D deficiency is associated with severity and death in COVID-19 patients [ 29 ], and were comparable to recent findings [ 4 , 30 ]. Dissanayake and colleagues, whose meta-analysis included 72 COVID-19 observational and 4 interventional randomized studies, have shown not only correlations between 25(OH)D level and severity or mortality, but also some clinical benefits and improvement in inflammatory markers of vitamin D supplementation in treating COVID-19 [ 22 ].…”

COVID-19 and Vitamin D (Co-VIVID Study): a systematic review and meta-analysis of randomized controlled trials

“…Despite vaccination rollouts, much focus has been documented on additional preventive measures such as using vitamin D supplementation to be promising in COVID-19 [7,8]. While strong observational evidence [9][10][11] indicate the association of low vitamin D levels to the COVID-19 susceptibility, severity and mortality outcomes, the beneficial use of vitamin D supplements in COVID-19 has been reported in some non-randomized observational cohorts [12,13]. However, there is still a scarcity of information through randomized controlled trials (RCTs) on the use of vitamin D supplementation in COVID-19 patients.…”

Nosocomial Infection in Patients with Severe and Critical COVID-19

“…Выявленные статистически значимые различия в концентрации витамина Д у пациентов с инфекцией и без инфекции указывают на его протективную роль при бактериальной инфекции и сепсисе [23]. Кроме этого, концентрация витамина Д менее 10 нг/мл является независимым предиктором неблагоприятного исхода у пациентов с тяжелым течением COVID-19 [24].…”