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. 2021 Jul;97(1149):442-447.
doi: 10.1136/postgradmedj-2020-138712. Epub 2020 Aug 27.

Vitamin D status and outcomes for hospitalised older patients with COVID-19

Vadir Baktash  1 , Tom Hosack  1 , Nishil Patel  1 , Shital Shah  1 , Pirabakaran Kandiah  1 , Koenraad Van den Abbeele  1 , Amit K J Mandal  1 , Constantinos G Missouris  2   3
Affiliations

Vitamin D status and outcomes for hospitalised older patients with COVID-19

Vadir Baktash et al. Postgrad Med J. 2021 Jul.

Abstract

Purpose: Older adults are more likely to be vitamin D deficient. The aim of the study was to determine whether these patients have worse outcomes with COVID-19.

Methods: We conducted a prospective cohort study between 1 March and 30 April 2020 to assess the importance of vitamin D deficiency in older patients with COVID-19. The cohort consisted of patients aged ≥65 years presenting with symptoms consistent with COVID-19 (n=105). All patients were tested for serum 25-hydroxyvitamin D (25(OH)D) levels during acute illness. Diagnosis of COVID-19 was confirmed via viral reverse transcriptase PCR swab or supporting radiological evidence. COVID-19-positive arm (n=70) was sub-divided into vitamin D-deficient (≤30 nmol/L) (n=39) and -replete groups (n=35). Subgroups were assessed for disease severity using biochemical, radiological and clinical markers. Primary outcome was in-hospital mortality. Secondary outcomes were laboratory features of cytokine storm, thoracic imaging changes and requirement of non-invasive ventilation (NIV).

Results: COVID-19-positive arm demonstrated lower median serum 25(OH)D level of 27 nmol/L (IQR=20-47 nmol/L) compared with COVID-19-negative arm, with median level of 52 nmol/L (IQR=31.5-71.5 nmol/L) (p value=0.0008). Among patients with vitamin D deficiency, there was higher peak D-dimer level (1914.00 μgFEU/L vs 1268.00 μgFEU/L) (p=0.034) and higher incidence of NIV support and high dependency unit admission (30.77% vs 9.68%) (p=0.042). No increased mortality was observed between groups.

Conclusion: Older adults with vitamin D deficiency and COVID-19 may demonstrate worse morbidity outcomes. Vitamin D status may be a useful prognosticator.

Keywords: General medicine (see internal medicine); calcium & bone; diabetes & endocrinology; geriatric medicine.

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Conflict of interest statement

Competing interests: All authors understand the policy of declaration of interests. CGM is a former member of the Fellowship of Postgraduate Medicine (FPM) council and is currently an FPM Fellow. VB, TH, NP, SS, PK, KVdA, AKJM all declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow chart, depicting recruitment of patients upon admission via the emergency department, with subsequent separation. CRP, C reactive protein; LDH, lactate dehydrogenase.
Figure 2
Figure 2
ROC curves for vitamin D and COVID-19 status (left) and ventilatory support requirement (right). ROC, receiver operating characteristic.
See this image and copyright information in PMC

Comment in

  • Vitamin D and COVID-19: causal factor or bystander?
    Cheung CL, Cheung BMY. Cheung CL, et al. Postgrad Med J. 2021 Jul;97(1149):413-414. doi: 10.1136/postgradmedj-2020-139388. Epub 2021 Jan 15. Postgrad Med J. 2021. PMID: 33452160 Free PMC article. No abstract available.

References

    1. Panarese A, Shahini E. COVID-19, and vitamin D. Aliment Pharm Ther 2020;51:993. - PMC - PubMed
    1. Alipio M. Vitamin D Supplementation Could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (COVID-2019). SSRN Journal.
    1. Cantorna MT. Mechanisms underlying the effect of vitamin D on the immune system. Proc Nutr Soc 2010;69:286–9. - PMC - PubMed
    1. GOV.UK . SACN vitamin D and health report. 2016. Available https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report (accessed 24th Jun 2020)
    1. British Nutrition Foundation . BNF busts the myths on nutrition and COVID-19. 2020. Available https://www.nutrition.org.uk/press-office/pressreleases/covid (accessed 24th Jun 2020)

MeSH terms