Vitamin D Deficiency and Outcome of COVID-19 Patients

• Published in: Nutrients Vol. 12; no. 9; p. 2757
• Main Authors: Radujkovic, Aleksandar, Hippchen, Theresa, Tiwari-Heckler, Shilpa, Dreher, Saida, Boxberger, Monica, Merle, Uta
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10.09.2020; MDPI
• Subjects: Age; Aged; Betacoronavirus; blood serum; Comorbidity; Coronavirus Infections - blood; Coronavirus Infections - mortality; Coronavirus Infections - virology; Coronaviruses; COVID-19; COVID-19 infection; Data collection; death; disease severity; Female; Gender; Germany - epidemiology; health services; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Humans; Immunoassay; infection; Infections; laboratories; Male; Medical prognosis; Middle Aged; mortality; Nutritional Status; Oxygen saturation; Oxygen therapy; Pandemics; Pathogens; Patients; Pneumonia, Viral - blood; Pneumonia, Viral - mortality; Pneumonia, Viral - virology; Prognosis; Prospective Studies; Retrospective Studies; risk; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Ventilators; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - mortality; Vitamin D Deficiency - virology; Vitamin deficiency; Germany; COVID-19; severity; retrospective; SARS-CoV-2; vitamin D; outcome
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu12092757

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, p < 0.001 and HR 14.73, 95% CI 4.16–52.19, p < 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.