Pre-infection 25-hydroxyvitamin D3 levels and  association with severity of COVID-19 illness.

Vitamin D deficiency is a predictive risk factor associated with poorer COVID-19 clinical disease course and mortality.

• Of 1176 patients admitted, 253 had records of a 25(OH)D level prior to COVID-19 infection.  
• A lower vitamin D status was more common in patients with the severe or critical disease  than in individuals with mild or moderate disease.  
• Patients with vitamin D deficiency (<20 ng/mL) were 14 times more likely to have severe or critical disease than patients with 25(OH)D ≥40 ng/mL

The records of adult individuals admitted between April 7th, 2020 and February 4th, 2021 to the Galilee Medical Center (GMC) in Nahariya, Israel, with positive polymerase chain reaction (PCR) tests for SARS-CoV-2 (COVID-19) were searched for historical 25(OH)D levels measured 14 to 730 days prior to the positive PCR test.

• Vitamin D deficiency is often part of a range of health conditions that might increase COVID–=19 disease severity and mortality 
• Supplementation history of subjects was not determined 
• An association of vitamin D and COVID-19 does not indicate that supplementation would impact outcomes

“Our study contributes to a continually evolving body of evidence that suggests a patient’s history of vitamin D deficiency is a predictive risk factor associated with poorer COVID-19 clinical disease course and mortality. The use of historical results obtained before the COVID-19 pandemic as part of a public health survey enabled us to suggest vitamin D deficiency contributes to the causal pathway of COVID-19 mortality risk and disease severity. Our study warrants further studies investigating if and when vitamin D supplementation among vitamin D deficient individuals in the community impacts the outcome of an eventual COVID-19 episode.” 

• A retrospective study 
• Patients admitted to GMC with COVID-19 were categorized according to disease severity and level of 25(OH)D.  
• An association between pre-infection 25(OH)D levels, divided between four categories (deficient, insufficient, adequate, and high-normal), and COVID-19 severity was ascertained utilizing a multivariable regression analysis.  
• To isolate the possible influence of seasonal 25(OH)D changes throughout the year, a cosinor model, which  is used for variables that are influenced by biological rhythms, was used.

Dror AA, Morozov N, Daoud A, Namir Y, Yakir O, Shachar Y, Lifshitz M, Segal E, Fisher L, Mizrachi M, Eisenbach N, Rayan D, Gruber M, Bashkin A, Kaykov E, Barhoum M, Edelstein M, Sela E. Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness. PLoS One. 2022 Feb 3;17(2):e0263069. doi: 10.1371/journal.pone.0263069. PMID: 35113901; PMCID: PMC8812897.