Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests 

This observational study identified an inverse relationship between vitamin D treatment and COVID-19 related mortality: those receiving vitamin D supplementation had a lower risk of mortality. 

157 patients hosted in the IRCCS Istituto Auxologico Italiano “Mons. G. Bicchierari” nursing home on March 1 2020, most of whom were between 80 and 100 years old; (63% of those patients tested positive for COVID-19.

• Patients who survived were younger, had a lower BMI, had better activities of daily living scores (ADL) and received long term treatment of cholecalciferol compared to those who passed away.  
• A higher, male gender positivity to SARS-CoV-2 and lower scores on scales for ADLs were significantly associated with a poor outcome.  
• There was a statistically significant inverse correlation between vitamin D (cholecalciferol) treatment and mortality.  

• A small study at one center with a very senior population.  
• The researchers did not address all of the other health issues that may have been worsened by COVID-19.  
• They did assess ADLs which was a unique aspect. 

Our data further contributes to the body of evidence pointing out a possible protective role of cholecalciferol supplementation during the COVID-19 pandemic, with a statistically significant inverse correlation of vitamin D (cholecalciferol) treatment with mortality in nursing home residents. Finally, we also report the usefulness of ADL scores to predict a poor outcome in older patients affected with COVID.

A one-center observational study of residents in a nursing home March and April 2020. For each patient, the age, the BMI at the beginning of the evaluation, the presence of cardiovascular, neurological, endocrinologic, haematologic and gastroenterological comorbidities, diabetes and hypertension were collected. The concomitant chronic treatment with ACE inhibitors (ACEi), angiotensin receptor blockers (ARBs), oral anticoagulants, antiplatelet, cholecalciferol, glucocorticoids was also reported; in particular, subjects undergoing cholecalciferol treatment were all treated with a two-times-a-month 25000 UI regimen. 

Cangiano B, Fatti LM, Danesi L, Gazzano G, Croci M, Vitale G, Gilardini L, Bonadonna S, Chiodini I, Caparello CF, Conti A, Persani L, Stramba-Badiale M, Bonomi M. Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests. Aging (Albany NY). 2020 Dec 22;12(24):24522-24534. doi: 10.18632/aging.202307. Epub 2020 Dec 22. PMID: 33353888; PMCID: PMC7803543. 

https://pubmed.ncbi.nlm.nih.gov/33353888/