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Vitamin D Status and COVID-19 Clinical Outcomes in Hospitalized Patients

Take Home Message

In this retrospective chart review there was no association between vitamin D levels within 1 year of hospital admission for COVID-19 and clinical outcomes.

 

Results

  • Subjects with 25(OH)D < 20 ng/mL (n = 35) did not differ from those with 25(OH)D ≥ 20 ng/mL in terms of age, sex, race, BMI, or comorbidities.
  • Low 25(OH)D tended to be associated with younger age and lower frequency of preexisting pulmonary disease.
  • There were no significant between-group differences in any outcome. Results were similar in those ≥50 years, in male/female-only cohorts, and when differing 25(OH)D thresholds were used (<15 ng/mL and <30 ng/mL). There was no relationship between 25(OH)D as a continuous variable and any outcome, even after controlling for age and pulmonary disease.

Who

Data on 93 adult patients with a positive PCR test for COVID-19 admitted to Columbia University Irving Medical Center (CUIMC) in New York City were extracted from the electronic medical record and reviewed for an available 25(OH)D level within 365 days of hospitalization.

Things to Keep in Mind

  • This was a single center study of just 93 patients, had more of the patients had vitamin D levels available the data would be stronger.
  • The vitamin D values could have been measured within one year of admission and therefore may not be actual levels at the time of admission.
  • A retrospective chart review does not allow for strong conclusions.

 

Author’s Conclusions

These preliminary data do not support a relationship between prehospitalization vitamin D status and COVID-19 clinical outcomes.

Study Design

  • This was a retrospective medical record review of 700 COVID-19 positive adults admitted to the hospital, of those 93 had vitamin D levels measured within a year prior to admission.
  • Vitamin D deficiency was defined as serum 25(OH)D level less than 20 ng/mL.
  • Total calcium level, albumin, alkaline phosphatase, BUN, and creatinine obtained within 30 days of the serum 25(OH)D level were also extracted from the records.
  • The primary outcomes of interest were discharge status (deceased/discharged to hospice, discharged (not death), still admitted), intubation status (ever, never), renal replacement during hospitalization (including hemodialysis and continuous veno-venous hemofiltration), and duration of stay.
  • For patients who were intubated during the admission, the duration of intubation was also calculated.
  • Other variables of interest were age, sex assigned at birth, BMI, race, and ICD-defined comorbidities, including hypertension, diabetes, chronic kidney disease, and any pulmonary disease.

Reference

Szeto B, Zucker JE, LaSota ED, Rubin MR, Walker MD, Yin MT, Cohen A. Vitamin D Status and COVID-19 Clinical Outcomes in Hospitalized Patients. Endocr Res. 2021 Feb-May;46(2):66-73. doi: 10.1080/07435800.2020.1867162. Epub 2020 Dec 30. PMID: 33380209; PMCID: PMC7784779.

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