Vitamin D Deficiency and Low Serum Calcium as Predictors of Poor Prognosis in Patients with Severe COVID-19

Bennouar, Salam; Cherif, A. Bachir; Kessira, Amel; Bennouar, Djamel-Eddine; Abdi, Samia

doi:10.1080/07315724.2020.1856013

Cited by 78 publications

(76 citation statements)

References 25 publications

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“…Established risk factors for severe COVID-19 include advanced age, obesity, chronic illness, non-Caucasian ethnicity, and work-related contact with COVID-19 patients (6). Furthermore, several studies suggest that genetic factors [5] and vitamin D deficiency [6,7] may also increase the risk for severe COVID-19-and SARS-CoV-2-related mortality.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Metabolites and Clinical Outcome in Hospitalized COVID-19 Patients

et al. 2021

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(1) Background: Vitamin D, a well-established regulator of calcium and phosphate metabolism, also has immune-modulatory functions. An uncontrolled immune response and cytokine storm are tightly linked to fatal courses of COVID-19. The present retrospective study aimed to inves-tigate vitamin D status markers and vitamin D degradation products in a mixed cohort of 148 hospitalized COVID-19 patients with various clinical courses of COVID-19. (2) Methods: The serum concentrations of 25(OH)D3, 25(OH)D2, 24,25(OH)2D3, and 25,26(OH)2D3 were determined by a validated liquid-chromatography tandem mass-spectrometry method in leftover serum samples from 148 COVID-19 patients that were admitted to the University Hospital of the Medical Uni-versity of Graz between April and November 2020. Anthropometric and clinical data, as well as outcomes were obtained from the laboratory and hospital information systems. (3) Results: From the 148 patients, 34 (23%) died within 30 days after admission. The frequency of fatal outcomes did not differ between males and females. Non-survivors were significantly older than survivors, had higher peak concentrations of IL-6 and CRP, and required mechanical ventilation more frequently. The serum concentrations of all vitamin D metabolites and the vitamin D metabolite ratio (VMR) did not differ significantly between survivors and non-survivors. Additionally, the need for res-piratory support was unrelated to the serum concentrations of 25(OH)D vitamin D and the two vitamin D catabolites, as well as the VMR. (4) Conclusion: The present results do not support a relevant role of vitamin D for the course and outcome of COVID-19.

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Section: Introductionmentioning

confidence: 99%

Vitamin D Metabolites and Clinical Outcome in Hospitalized COVID-19 Patients

et al. 2021

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“…In a systematic review and meta-analysis, hypocalcemia was related to poor prognosis, and the mean difference in serum calcium levels among patients with poor outcomes (26%) was 0.69 mg/dL [165]. Given the importance of calcium-phosphorus metabolism in this clinical scenario, Bennouar et al found that a cutoff value of 16 ng/mL for VD and 8.2 mg/dL for corrected calcium could predict poor prognosis (hazard ratios 6.9 and 6.2, respectively) in COVID-19 patients with a sensitivity of 76% and 84% and a specificity of 69% and 60%, respectively [166].…”

Section: Parathyroid Glands and Calcium-phosphorus Metabolismmentioning

confidence: 99%

COVID-19 and the Endocrine System: A Comprehensive Review on the Theme

Lisco

Tullio

Stragapede

et al. 2021

JCM

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: Background and aim. The review aimed to summarize advances in the topic of endocrine diseases and coronavirus disease 2019 (COVID-19). Methods. Scientific and institutional websites and databases were searched and data were collected and organized, when plausible, to angle the discussion toward the following clinical issues. (1) Are patients with COVID-19 at higher risk of developing acute or late-onset endocrine diseases or dysfunction? (2) May the underlying endocrine diseases or dysfunctions be considered risk factors for poor prognosis once the infection has occurred? (3) Are there defined strategies to manage endocrine diseases despite pandemic-related constraints? Herein, the authors considered only relevant and more frequently observed endocrine diseases and disorders related to the hypothalamic-pituitary region, thyroid and parathyroid glands, calcium-phosphorus homeostasis and osteoporosis, adrenal glands, and gonads. Main. Data highlight the basis of some pathophysiological mechanisms and anatomical alterations of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-induced endocrine dysfunctions. Some conditions, such as adrenal insufficiency and cortisol excess, may be risk factors of worse clinical progression once the infection has occurred. These at-risk populations may require adequate education to avoid the SARS-CoV-2 infection and adequately manage medical therapy during the pandemic, even in emergencies. Endocrine disease management underwent a palpable restraint, especially procedures requiring obligate access to healthcare facilities for diagnostic and therapeutic purposes. Strategies of clinical triage to prioritize medical consultations, laboratory, instrumental evaluations, and digital telehealth solutions should be implemented to better deal with this probably long-term situation.

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“…Of these, 653 studies were duplicate articles or were excluded based on predetermined eligibility criteria during title/abstract review. According to the inclusion and exclusion criteria, we identified 11 studies [23,24,33,[25][26][27][28][29][30][31][32] that were eligible for this review and meta-analysis (Fig. 1), involving 1,347 participants.…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

“…1), involving 1,347 participants. Ten were cohort [23,24,[26][27][28][30][31][32][33], and one case-control [25]. The characteristics of selected studies and participants are summarised in Table 1.…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

Is the vitamin D status of patients with COVID-19 associated with reduced mortality?

Bignardi¹,

P²,

B³

et al. 2021

Preprint

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A systematic review with meta–analysis was performed to assess a possible association between plasma vitamin D levels and mortality in patients with COVID–19. PubMed, EMBASE, and Cochrane Library databases were searched. Studies involving COVID-19 patients that reported an association between plasma vitamin D levels and COVID–19 mortality published until February 5, 2020, were included. The risk ratio (RR) and confidence interval (CI) were pooled using a fixed–effects or random-effects model. A total of 11 studies that measured plasma vitamin D levels at admission were included in the meta–analysis, ten cohorts and one case-controls. Low plasma vitamin D levels (25(OH)D) in patients with COVID-19 were not associated with mortality (RR=1.35, 95%CI 0.84–1.86). Subgroup analysis by vitamin D cut–off (<20 or 25 ng/ml and <10 or 12 ng/ml) showed were not associated with mortality. When the RR in mortality analysis was calculated included four studies that did not perform adjusted analysis for confounding factors, the result was 1.43 (95% CI 1.18–1.69), suggesting that confounders may have led many observational studies to incorrectly estimate the association between vitamin D status and mortality in COVID–19 patients. Deficient vitamin D levels were not associated with a higher mortality rate in patients with COVID–19. Randomized clinical trials are needed to assess this association.

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Vitamin D Deficiency and Low Serum Calcium as Predictors of Poor Prognosis in Patients with Severe COVID-19

Cited by 78 publications

References 25 publications

Vitamin D Metabolites and Clinical Outcome in Hospitalized COVID-19 Patients

Vitamin D Metabolites and Clinical Outcome in Hospitalized COVID-19 Patients

COVID-19 and the Endocrine System: A Comprehensive Review on the Theme

Is the vitamin D status of patients with COVID-19 associated with reduced mortality?

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