Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Abstract

Background & aim Verify the prevalence of hypovitaminosis D and obesity in elderly patients infected by new coronavirus. The patients developed severe symptoms and were admitted in intensive care unit (ICU) to receive invasive ventilation due to diagnosis of acute respiratory distress syndrome (ARDS). Methods A cross-sectional descriptive study composed of elderly (age ≥ 60 years) admitted to the ICU. Were collected demographic (sex, age), anthropometric data, presence of comorbidities (hypertension, diabetes, heart disease, lung, neurological and oncological diseases), severity score in ICU (SAPS III), PaO 2 /FiO 2 ratio, analysis of C-reactive protein (CRP) and serum dosage of 25-hydroxy vitamin D (25 OHD) in the first day of hospitalization to identify elderly with hypovitaminosis D (low values < 30 ng/mL). The diagnosis of obesity in elderly was determined by calculating the body mass index (BMI) ≥ 30 kg/m 2 . Results A total of 176 elderly met the inclusion criteria. 54% were elderly men and mean age of 72.9 ± 9.1 years. The median BMI was 30.5 (28.1–33) kg/m 2 with 68.7% having a nutritional diagnosis of obesity and 15.3% had BMI ≥ 35 kg/m 2 . The most prevalent comorbidities were hypertension (72.2%) and diabetes (40.9%). Prevalence of hypovitaminosis D with values of 25 OHD <30 ng/mL, < 20 ng/mL and <10 ng/mL was 93.8%, 65.9% and 21% respectively. The prevalence of hypovitaminosis D (<30 ng/mL) in obese elderly was 94.2%. There was a negative and significant bivariate correlation between BMI and levels of 25 OHD (r = - 0.15; p = 0.04). Conclusion Hypovitaminosis D and obesity in elderly have a high prevalence in critically ill patients in ICU infected by the new coronavirus. Laboratory investigation of vitamin D becomes important, especially in obese elderly patients.

Influence of 25-hydroxy-cholecalciferol levels on SARS-CoV-2 infection and COVID-19 severity: A systematic review and meta-analysis

“…The remaining 52 articles were carefully read. Based on the inclusion and exclusion criteria, 12 articles were excluded because of the inability to extract the data required [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , whereas 9 were excluded because the patients received vitamin D supplementation [ 24 , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] ], one study was excluded because it considered VDD for values < 30 ng/ml in disagreement with the above-mentioned guidelines [25] , and one study was excluded since it did not define a cut-off for VDD [26] (Supplementary Table 4) . Finally, 29 articles met our inclusion criteria and, therefore, were included in this meta-analysis ( Fig.…”

“…For these reasons, several authors have evaluated the difference in 25(OH)D levels between infected patients and healthy ones, as well as the role of VDD in the risk of developing COVID-19 and its complications, but with contrasting results [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] . Therefore, this meta-analysis aims to shed light on the numerous data in the literature on this topic to establish whether hypovitaminosis D represents a real risk factor for SARS-CoV-2 infection and, therefore, whether its integration can be an additional weapon in the fight against COVID-19.…”

Shedding light on vitamin D: the shared mechanistic and pathophysiological role between hypovitaminosis D and COVID-19 risk factors and complications

“…Although, low serum 1,25(OH)D was more likely found in COVID-19 patients (regardless of the severity) compared to healthy individuals (Pereira et al 2020 ), it was noted that vitamin D deficiency was not associated with a higher rates of infection by SARS-COV-2. Similarly, Alguwaihes et al found that in the hospital settings, hypovitaminosis D was not associated with SARS-COV-2 infection, but was associated with increased risk of mortality, especially in severely deficient cases (Alguwaihes et al 2021 ). In a randomized controlled trial done by Murai et al, it was concluded that even after patients received a high dose of Vit D (200,000 IU), there was no significant reduction in hospital or ICU stay compared to patients who received placebo (Murai et al 2021 ).…”

Cardiovascular Disease Complicating COVID-19 in the Elderly

“…Among older hospitalized COVID-19 patients in Italy, a retrospective study of 87 persons with an average age of 72 years found that over 50% were hypertensive but that hypertension did not predict mortality [ 31 ]. A case series of 5700 adults, median age 63 years, hospitalized in the New York City area for COVID-19, found that 56.6% of the patients had HBP, but the report did not address differences in outcome based on comorbidities or medications [ 18 ]. A study of 184 COVID-19 patients with a mean age of 64.7 years, admitted to a New York City hospital, found a positive correlation between hypertension and mortality [ 32 ].…”

“…The aforementioned conditions are more prevalent in those over age 65 and extremely common in those over age 85. Low vitamin D levels, common in the obese state, may add further risk [ 18 ].…”