Low serum 25‐hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID‐19 are associated with greater disease severity

Abstract

Summary Objectives Vitamin D deficiency (VDD) has been proposed to play a role in Coronavirus Disease 2019 (COVID‐19) pathophysiology. We aim to evaluate our implementation of a local protocol for treatment of VDD among patients hospitalized for COVID‐19; to assess the prevalence of VDD among COVID‐19 inpatients, and examine potential associations with disease severity and fatality. Design and Participants We conducted a retrospective interim audit of a local clinical care pathway for 134 inpatients with COVID‐19. Prevalence of VDD, compliance with local treatment protocol and relationship of baseline serum 25(OH)D with markers of COVID‐19 severity and fatality were analysed. Results 55.8% of eligible patients received Colecalciferol replacement, albeit not all according to the suggested protocol. Patients admitted to ITU were younger than those managed on medical wards (61.1 years ± 11.8 vs. 76.4 years ± 14.9, respectively, p<0.001), with greater prevalence of hypertension, higher baseline respiratory rate, National Early Warning Score‐2 and C‐Reactive protein level. While mean serum 25(OH)D levels were comparable (p=0.3), only 19% of ITU patients had 25(OH)D levels greater than 50 nmol/L vs. 39.1% of non‐ITU patients (p=0.02). However, there was no association with fatality, potentially due to small sample size and prompt diagnosis and treatment of VDD. Conclusions Higher prevalence of VDD was observed in patients requiring ITU admission compared to patients managed on medical wards. Larger prospective studies and/or clinical trials are needed to validate and extend our observations.

Comparison Of The 25oh-vitamin D Levels Between Old Patients Hospitalized For Sars-cov-2 Pneumonia And Patients With Other Acute Illnesses: A Retrospective Case-control Study.

“…Nevertheless, neither mortality nor duration of hospitalization was associated with the vitamin D status [25]. Likewise, other small series reported a higher prevalence of 25OH-vitamin D deficiency in the patients with a worse outcome [26] or in those requiring ICU admission [27] In conclusion, our results do not support the hypothesis of a specific role of the vitamin D deficiency in the risk of COVID-19 infection. In fact, no differences were found between the 25OH-vitamin D levels of the patients affected by COVID-19 related pneumonia and those of other patients hospitalized because of other acute illnesses.…”

Effective Immune Functions of Micronutrients against SARS-CoV-2

“…It has been suggested that supplementation of vitamin D at an oral dose of 200,000 to 300,000 international units (IU) and other micronutrients for a week can strengthen the immune system against COVID-19 [ 96 , 97 ]. An observational study also demonstrated an inverse relationship between the critical outcome of COVID-19 and serum levels of 25 hydroxyvitamin D (25(OH)D) [ 98 ]. However, in contrast, a study from the UK reported no statistical relationship between serum 25(OH) D level and COVID-19 [ 99 ].…”

Up to 40% of COVID-19 Critically Ill Patients Have Vitamin D Deficiency

“…Patients with severe ARDS [10,11] or requiring ICU [12] are frequently severely vitamin D deficient [13]. In addition, low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID-19 are associated with greater disease severity [14]. Vitamin D treatment has been found to decrease other viral respiratory infections, especially in persons with vitamin D deficiency [15].…”