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Vitamin D Status in Hospitalized Patients with SARS-CoV-2 Infection.

Take Home Message

Serum25OHD levels were significantly lower in hospitalized COVID-19 patients than in population-based controls of similar age and gender in this study even after researchers adjusted for some related factors. In addition, even though patients hospitalized for COVID-19 had higher prevalence of vitamin D deficiency than the population controls, no association between circulating levels of 25OHD and the severity of SARS-CoV-2 infection was reported.

 

Purpose

The purpose of this retrospective case-control study was to assess serum 25-hydroxyvitamin D (25OHD) levels in hospitalized patients with COVID-19 and to analyze the possible influence of vitamin D status on disease severity.

 

Results

  • Vitamin D-deficient COVID-19 patients had a greater prevalence of hypertension and cardiovascular diseases, raised serum ferritin and troponin levels, as well as a longer length of hospital stay than those with serum 25OHD levels ≥20 ng/mL.
  • The COVID-19 patients who were taking vitamin D had an overall lower percentage of the combined severity endpoint and ICU admissions, and shorter hospital stay though it did not reach significance.
  • Vitamin D levels were significantly lower in COVID-19 patients compared to controls (mean ± standard deviation 25OHD levels were 13.8 ± 7.2 ng/mL, compared with 20.9 ± 7.4 ng/mL in controls). This was true even after adjusting for age, smoking, hypertension, diabetes mellitus, history of cardiovascular events, immunosuppression, body mass index, serum corrected calcium, glomerular filtration rate, and the month of vitamin D assessment.
  • 2% of COVID-19 cases and 47.2% of population-based controls were vitamin D deficient.
  • 25OHD values were lower in men than in women.
  • Vitamin D-deficient COVID-19 patients had a greater prevalence of hypertension and cardiovascular diseases, raised serum ferritin and troponin levels, as well as a longer length of hospital stay than those with serum 25OHD levels ≥20 ng/mL.
  • No causal relationship was found between vitamin D deficiency and COVID-19 severity as a combined endpoint or as its separate components.

Who

216 COVID-19 patients admitted to the University Hospital Marqués de Valdecilla in Santander, northern Spain, from March 10 to March 31, 2020, and 197 sex-matched population-based controls recruited from the Camargo Cohort who did not take vitamin D supplements. Of the 216 patients, 19 were on vitamin D supplements and were analyzed separately.

Things to Keep in Mind

  • The COVID-19 patients studied were all hospitalized; it is not clear if studying those testing positive for COVID-19 who did not require hospitalization would lead to different results.
  • The group of COVID-19 positive subjects taking vitamin D was small with only 19 participants therefore not much can be concluded from that group.
  • Because this was an observational study, it is difficult to determine whether vitamin D levels are due to the disease, or if vitamin D levels had an effect on the disease.
  • The study was conducted in a single Spanish hospital, making generalizations to other countries and ethnicities difficult.
  • Different methodology for assessing vitamin D was used in the control group compared to the study group, though the techniques are said to be closely correlated.

 

Author’s Conclusions

25OHD levels are lower in hospitalized COVID-19 patients than in

population-based controls and these patients had a higher prevalence of deficiency. We

did not find any relationship between vitamin D concentrations or vitamin deficiency and

the severity of the disease.

Study Design

  • Demographic, clinical, and outcome data of COVID-19 patients were gathered from hospital records, stored in a computerized database, and independently reviewed by 2 researchers.
  • Serum 25OHD levels were measured in both groups.
  • The association of serum 25OHD levels with COVID-19 severity (admission to the intensive care unit, requirements for mechanical ventilation, or mortality) was also evaluated.

Reference

Hernández JL, Nan D, Fernandez-Ayala M, García-Unzueta M, Hernández-Hernández MA, López-Hoyos M, Muñoz-Cacho P, Olmos JM, Gutiérrez-Cuadra M, Ruiz-Cubillán JJ, Crespo J, Martínez-Taboada VM. Vitamin D Status in Hospitalized Patients with SARS-CoV-2 Infection. J Clin Endocrinol Metab. 2021 Mar 8;106(3):e1343-e1353. doi: 10.1210/clinem/dgaa733. PMID: 33159440; PMCID: PMC7797757.

View Full Abstract

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2021-06-14T15:44:20-05:00