Prevalence of vitamin D deficiency and its prognostic impact on patients hospitalized with COVID-19

Bianconi, Vanessa; Mannarino, Massimo Raffaele; Figorilli, Filippo; Cosentini, Elena; Batori, Giuseppe; Marini, Ettore; Lombardini, Rita; Gargaro, Marco; Fallarino, Francesca; Scarponi, Anna Maria; Sahebkar, Amirhossein; Pirro, Matteo

doi:10.1016/j.nut.2021.111408

Cited by 18 publications

(13 citation statements)

References 51 publications

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“…An Italian observational study reported that the vitamin D status of patients at the time of admission appeared independent of COVID-19 severity, rate of admission to intensive care or in-hospital mortality [ 60 ]. Similarly, no significant correlation between 25(OH)D concentrations of hospitalised COVID-19 patients and length of clinical stay, mechanical ventilation rate or mortality was observed in a relatively large prospective cohort study in Brazil [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Vitamin D Status and Antibody Response to COVID-19 mRNA Vaccination in Healthy Adults

et al. 2021

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The immune response to vaccination with SARS-CoV-2 vaccines varies greatly from person to person. In addition to age, there is evidence that certain micronutrients influence the immune system, particularly vitamin D. Here, we analysed SARS-CoV-2 IgG and neutralisation potency along with 25-hydroxy-cholecalciferol [25(OH)D] concentrations in a cohort of healthy German adults from the time of vaccination over 24 weeks. Contrary to our expectations, no significant differences were found in the dynamic increase or decrease of SARS-CoV-2 IgG as a function of the 25(OH)D status. Furthermore, the response to the first or second vaccination, the maximum SARS-CoV-2 IgG concentrations achieved, and the decline in SARS-CoV-2 IgG concentrations over time were not related to 25(OH)D status. We conclude that the vaccination response, measured as SARS-CoV-2 IgG concentration, does not depend on 25(OH)D status in healthy adults with moderate vitamin D status.

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Section: Discussionmentioning

confidence: 99%

Relationship between Vitamin D Status and Antibody Response to COVID-19 mRNA Vaccination in Healthy Adults

et al. 2021

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“…Considerable discordance exists regarding the effectiveness of Vit D in the treatment of COVID-19, with some reports suggesting a beneficial effect [ 15 , 16 , 17 , 28 , 29 , 31 , 41 , 45 , 53 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 ] and others no change [ 26 , 27 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 44 , 107 , 108 , 109 ]. The reasons for these disparate findings are likely complex and multifactorial, with varying doses, duration, and timing of Vit D administration along with patient populations and sample sizes all playing roles [ 110 ].…”

Section: Discussionmentioning

confidence: 99%

“…Vitamin D (Vit D) is an oxysterol hormone with important immunomodulatory and antiviral properties [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. Even though this vitamin is often recommended as a nutritional supplement in treatment guidelines and prescribed for the management of coronavirus disease 2019 (COVID-19) [ 9 , 10 , 11 , 12 ], several studies have yielded divergent or inconclusive results [ 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 ].…”

Section: Introductionmentioning

confidence: 99%

The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2

Efird

Anderson

Jindal

et al. 2021

IJERPH

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This data-based cohort consisted of 26,508 (7%) United States veterans out of the 399,290 who tested positive for SARS-CoV-2 from 1 March to 10 September 2020. We aimed to assess the interaction of post-index vitamin D (Vit D) and corticosteroid (CRT) use on 30-day mortality among hospitalized and non-hospitalized patients with coronavirus disease 2019 (COVID-19). Combination Vit D and CRT drug use was assessed according to four multinomial pairs (−|+, −|−, +|+, +|−). Respective categorical effects were computed on a log-binomial scale as adjusted relative risk (aRR). Approximately 6% of veterans who tested positive for SARS-CoV-2 died within 30 days of their index date. Among hospitalized patients, a significantly decreased aRR was observed for the use of Vit D in the absence of CRTs relative to patients who received CRTs but not Vit D (aRR = 0.30; multiplicity corrected, p = 0.0004). Among patients receiving systemically administered CRTs (e.g., dexamethasone), the use of Vit D was associated with fewer deaths in hospitalized patients (aRR = 0.51) compared with non-hospitalized patients (aRR = 2.5) (P-for-Interaction = 0.0071). Evaluating the effect of modification of these compounds in the context of hospitalization may aid in the management of COVID-19 and provide a better understanding of the pathophysiological mechanisms underlying this and future infectious disease outbreaks.

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“…However, not all observational studies have found a relationship between vitamin D status and outcomes of COVID-19. Studies in the USA [ 25 , 26 ], Italy [ 27 ], the UK [ 28 ], and India [ 29 ] failed to confirm a beneficial effect of greater 25(OH)D levels with outcomes of length of stay, days on oxygen, ICU admission, need for assisted ventilation, or mortality, but some of these studies may have lacked sufficient power to detect a relationship between vitamin D status and less frequent outcomes, like mortality.…”

Section: Observational Studiesmentioning

confidence: 99%

Evaluating the Evidence in Clinical Studies of Vitamin D in COVID-19

Thacher

2022

Nutrients

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Laboratory evidence provides a biological rationale for the benefits of vitamin D in COVID-19, and vitamin D supplementation is associated with reduced risk of respiratory infections. Most of the clinical studies of vitamin D in COVID-19 have been observational, and the most serious problem with observational study design is that of confounding. Observational studies typically assess the relationship of 25(OH)D values with COVID-19 outcomes. Many conditions associated with low vitamin D status are also associated with worse COVID-19 outcomes. Randomized controlled trials (RCTs) overcome the problem of confounding, typically comparing outcomes between groups receiving vitamin D supplementation or placebo. However, any benefit of vitamin D in COVID-19 may be related to the dose, duration, daily vs. bolus administration, interaction with other treatments, and timing of administration prior to or during the illness. Serum 25(OH)D values >50 nmol/L have been associated with reduced infection rates, severity of COVID-19, and mortality in observational studies. Few RCTs of vitamin D supplementation have been completed, and they have shown no benefit of vitamin D in hospitalized patients. Vitamin D may benefit those with mild or asymptomatic COVID-19, and those with greater 25(OH)D values may have lower risk of acquiring infection. Because those at greatest risk of COVID-19 are also at greatest risk of vitamin D deficiency, it is reasonable to recommend vitamin D supplementation 15–20 mcg (600–800 IU) daily for the general population during the COVID-19 pandemic. Vitamin D doses greater than 100 mcg (4000 IU) daily should not be used without monitoring serum 25(OH)D and calcium.

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Prevalence of vitamin D deficiency and its prognostic impact on patients hospitalized with COVID-19

Cited by 18 publications

References 51 publications

Relationship between Vitamin D Status and Antibody Response to COVID-19 mRNA Vaccination in Healthy Adults

Relationship between Vitamin D Status and Antibody Response to COVID-19 mRNA Vaccination in Healthy Adults

The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2

Evaluating the Evidence in Clinical Studies of Vitamin D in COVID-19

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