Vitamin D Deficiency and Outcome of COVID-19 Patients

Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses an enormous challenge to health care systems throughout the world. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. To explore possible associations of vitamin...

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Main Authors: Aleksandar Radujkovic, Theresa Hippchen, Shilpa Tiwari-Heckler, Saida Dreher, Monica Boxberger, Uta Merle
Format: Article
Language:English
Published: MDPI AG 2020-09-01
Series:Nutrients
Subjects:
Online Access:https://www.mdpi.com/2072-6643/12/9/2757
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spelling doaj-cd5673461752404382926acefb9b38a12020-11-25T03:54:05ZengMDPI AGNutrients2072-66432020-09-01122757275710.3390/nu12092757Vitamin D Deficiency and Outcome of COVID-19 PatientsAleksandar Radujkovic0Theresa Hippchen1Shilpa Tiwari-Heckler2Saida Dreher3Monica Boxberger4Uta Merle5Department of Internal Medicine V, University of Heidelberg, 69121 Heidelberg, GermanyDepartment of Internal Medicine IV, University of Heidelberg, 69121 Heidelberg, GermanyDepartment of Internal Medicine IV, University of Heidelberg, 69121 Heidelberg, GermanyDepartment of Internal Medicine IV, University of Heidelberg, 69121 Heidelberg, GermanyDepartment of Internal Medicine IV, University of Heidelberg, 69121 Heidelberg, GermanyDepartment of Internal Medicine IV, University of Heidelberg, 69121 Heidelberg, GermanyInfection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses an enormous challenge to health care systems throughout the world. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. To explore possible associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients diagnosed with coronavirus disease 2019 (COVID-19) and treated at our center. VitD status at first presentation was assessed retrospectively using accredited laboratory methods. VitD deficiency was defined as serum total 25-hydroxyvitamin D level < 12 ng/mL (<30 nM). Primary endpoint was severe course of disease (i.e., need for invasive mechanical ventilation and/or death, IMV/D). Within a median observation period of 66 days (range 2–92), 23 patients required IMV. A total of 28 patients had IMV/D, including 16 deaths. Ninety-three (50%) patients required hospitalization (inpatient subgroup). A total of 41 (22%) patients were VitD deficient. When adjusted for age, gender, and comorbidities, VitD deficiency was associated with higher risk of IMV/D and death (HR 6.12, 95% CI 2.79–13.42, <i>p</i> < 0.001 and HR 14.73, 95% CI 4.16–52.19, <i>p</i> < 0.001, respectively). Similar correlations were observed in the inpatient subgroup. Our study demonstrates an association between VitD deficiency and severity/mortality of COVID-19, highlighting the need for interventional studies on VitD supplementation in SARS-CoV-2 infected individuals.https://www.mdpi.com/2072-6643/12/9/2757vitamin DSARS-CoV-2COVID-19outcomeseverityretrospective
collection DOAJ
language English
format Article
sources DOAJ
author Aleksandar Radujkovic
Theresa Hippchen
Shilpa Tiwari-Heckler
Saida Dreher
Monica Boxberger
Uta Merle
spellingShingle Aleksandar Radujkovic
Theresa Hippchen
Shilpa Tiwari-Heckler
Saida Dreher
Monica Boxberger
Uta Merle
Vitamin D Deficiency and Outcome of COVID-19 Patients
Nutrients
vitamin D
SARS-CoV-2
COVID-19
outcome
severity
retrospective
author_facet Aleksandar Radujkovic
Theresa Hippchen
Shilpa Tiwari-Heckler
Saida Dreher
Monica Boxberger
Uta Merle
author_sort Aleksandar Radujkovic
title Vitamin D Deficiency and Outcome of COVID-19 Patients
title_short Vitamin D Deficiency and Outcome of COVID-19 Patients
title_full Vitamin D Deficiency and Outcome of COVID-19 Patients
title_fullStr Vitamin D Deficiency and Outcome of COVID-19 Patients
title_full_unstemmed Vitamin D Deficiency and Outcome of COVID-19 Patients
title_sort vitamin d deficiency and outcome of covid-19 patients
publisher MDPI AG
series Nutrients
issn 2072-6643
publishDate 2020-09-01
description Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses an enormous challenge to health care systems throughout the world. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. To explore possible associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients diagnosed with coronavirus disease 2019 (COVID-19) and treated at our center. VitD status at first presentation was assessed retrospectively using accredited laboratory methods. VitD deficiency was defined as serum total 25-hydroxyvitamin D level < 12 ng/mL (<30 nM). Primary endpoint was severe course of disease (i.e., need for invasive mechanical ventilation and/or death, IMV/D). Within a median observation period of 66 days (range 2–92), 23 patients required IMV. A total of 28 patients had IMV/D, including 16 deaths. Ninety-three (50%) patients required hospitalization (inpatient subgroup). A total of 41 (22%) patients were VitD deficient. When adjusted for age, gender, and comorbidities, VitD deficiency was associated with higher risk of IMV/D and death (HR 6.12, 95% CI 2.79–13.42, <i>p</i> < 0.001 and HR 14.73, 95% CI 4.16–52.19, <i>p</i> < 0.001, respectively). Similar correlations were observed in the inpatient subgroup. Our study demonstrates an association between VitD deficiency and severity/mortality of COVID-19, highlighting the need for interventional studies on VitD supplementation in SARS-CoV-2 infected individuals.
topic vitamin D
SARS-CoV-2
COVID-19
outcome
severity
retrospective
url https://www.mdpi.com/2072-6643/12/9/2757
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