Vitamin D Status Is Associated With In-Hospital Mortality and Mechanical Ventilation: A Cohort of COVID-19 Hospitalized Patients

Abstract

Objective: To explore the possible associations of serum 25-hydroxyvitamin D [25(OH)D] concentration with coronavirus disease 2019 in-hospital mortality and need for invasive mechanical ventilation. Patients and Methods: A retrospective, observational, cohort study was conducted at 2 tertiary academic medical centers in Boston and New York. Eligible participants were hospitalized adult patients with laboratory-confirmed COVID-19 between February 1, 2020, and May 15, 2020. Demographic and clinical characteristics, comorbidities, medications, and disease-related outcomes were extracted from electronic medical records. Results: The final analysis included 144 patients with confirmed COVID-19 (median age, 66 years; 64 [44.4%] male). Overall mortality was 18%, whereas patients with 25(OH)D levels of 30 ng/mL (to convert to nmol/L, multiply by 2.496) and higher had lower rates of mortality compared with those with 25(OH)D levels below 30 ng/mL (9.2% vs 25.3%; P¼.02). In the adjusted multivariable analyses, 25(OH)D as a continuous variable was independently significantly associated with lower in-hospital mortality (odds ratio, 0.94; 95% CI, 0.90 to 0.98; P¼.007) and need for invasive mechanical ventilation (odds ratio, 0.96; 95% CI, 0.93 to 0.99; P¼.01). Similar data were obtained when 25(OH)D was studied as a continuous variable after logarithm transformation and as a dichotomous (<30 ng/mL vs !30 ng/mL) or ordinal variable (quintiles) in the multivariable analyses. Conclusion: Among patients admitted with laboratory-confirmed COVID-19, 25(OH)D levels were inversely associated with in-hospital mortality and the need for invasive mechanical ventilation. Further observational studies are needed to confirm these findings, and randomized clinical trials must be conducted to assess the role of vitamin D administration in improving the morbidity and mortality of COVID-19.

Vitamin D Deficiency Is Associated With Higher Hospitalization Risk From COVID-19: A Retrospective Case-control Study

“…We have clearly demonstrated that vitamin D insufficiency and deficiency exponentially increase the risk of the disease by a factor of 2.3 to 3.6, even after adjustments for age and sex. However, we did not find any association between low 25(OH)D levels or vitamin D status and excess mortality risk, as observed in previous studies ( 6 , 8 , 11 , 12 ).…”

Vitamina D em pacientes com COVID-19: atuais perspectivas

“…Quando se trata do uso de ventilação mecânica ou comprometimento pulmonar em comparação aos baixos níveis de 25(OH)D nos pacientes com COVID-19, evidenciou-se uma ausência de relação positiva em ambos os casos (Angelidi et al, 2021;Orchard et al, 2021;Reis et al, 2021;Pizzini et al, 2020)…”

“…Verifica-se que a maioria dos estudos observacionais analisados apresentou associação da deficiência de vitamina D e COVID-19 com diferentes perspectivas e desfechos. Em relação a mortalidade,Angelidi et al (2021), De Smet et al (2021), Karahan Katkat (2021), Orchard et al (2021), Reis et al (2021) e Sulli et al (2021) não mostraram associação significativa quando comparados com as concentrações séricas de 25(OH)D. No entanto, Alcala-Diaz et al (2021), Alsafar et al (2021), Carpagnano et al (2021) e Vassiliou et al (2020) relataram que pacientes com deficiência grave de 25(OH)D possuíram maior risco de mortalidade por COVID-19, principalmente, quando comparados àqueles com maiores concentrações de 25(OH)D.…”

Study of Vitamin D Status in Pneumonia among Children between 6 Months to 3 Years of Age

“…25(OH) vit. D level was reported in ng/ml, which can be multiplied by 2.496 to be converted to nmol/l [14].…”