Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 24:10:1237903.
doi: 10.3389/fmed.2023.1237903. eCollection 2023.

Survival implications vs. complications: unraveling the impact of vitamin D adjunctive use in critically ill patients with COVID-19-A multicenter cohort study

Khalid Al Sulaiman  1   2   3   4 , Ghazwa B Korayem  5 , Ohoud Aljuhani  6 , Ali F Altebainawi  7   8 , Mohammad S Shawaqfeh  1   2 , Sumaiah J Alarfaj  5 , Reham A Alharbi  9 , Mawaddah M Ageeli  10 , Abdulrahman Alissa  11 , Ramesh Vishwakarma  12 , Alnada Ibrahim  5 , Abeer A Alenazi  13 , Suliman Alghnam  3 , Nadiyah Alshehri  1 , Maqbulah M Alshammari  8 , Alaa Alhubaishi  5 , Mohammed Aldhaeefi  14 , Faisal F Alamri  15   16 , Yadullah Syed  6 , Raymond Khan  6 , Mai Alalawi  17 , Khalaf A Alanazi  18 , Faisal S Alresayes  2 , Khalid J Albarqi  2 , Ghassan Al Ghamdi  19   20
Affiliations

Survival implications vs. complications: unraveling the impact of vitamin D adjunctive use in critically ill patients with COVID-19-A multicenter cohort study

Khalid Al Sulaiman et al. Front Med (Lausanne). .

Abstract

Background: Despite insufficient evidence, vitamin D has been used as adjunctive therapy in critically ill patients with COVID-19. This study evaluates the effectiveness and safety of vitamin D as an adjunctive therapy in critically ill COVID-19 patients.

Methods: A multicenter retrospective cohort study that included all adult COVID-19 patients admitted to the intensive care units (ICUs) between March 2020 and July 2021. Patients were categorized into two groups based on their vitamin D use throughout their ICU stay (control vs. vitamin D). The primary endpoint was in-hospital mortality. Secondary outcomes were the length of stay (LOS), mechanical ventilation (MV) duration, and ICU-acquired complications. Propensity score (PS) matching (1:1) was used based on the predefined criteria. Multivariable logistic, Cox proportional hazards, and negative binomial regression analyses were employed as appropriate.

Results: A total of 1,435 patients were included in the study. Vitamin D was initiated in 177 patients (12.3%), whereas 1,258 patients did not receive it. A total of 288 patients were matched (1:1) using PS. The in-hospital mortality showed no difference between patients who received vitamin D and the control group (HR 1.22, 95% CI 0.87-1.71; p = 0.26). However, MV duration and ICU LOS were longer in the vitamin D group (beta coefficient 0.24 (95% CI 0.00-0.47), p = 0.05 and beta coefficient 0.16 (95% CI -0.01 to 0.33), p = 0.07, respectively). As an exploratory outcome, patients who received vitamin D were more likely to develop major bleeding than those who did not [OR 3.48 (95% CI 1.10, 10.94), p = 0.03].

Conclusion: The use of vitamin D as adjunctive therapy in COVID-19 critically ill patients was not associated with survival benefits but was linked with longer MV duration, ICU LOS, and higher odds of major bleeding.

Keywords: COVID-19; MV duration; SARS-CoV-2; bleeding; critically ill; intensive care units (ICUs); mortality; vitamin D.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram showing patients recruited with COVID-19. COVID-19, Coronavirus disease; ICU, intensive care unit; LOS, length of stay.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: an overview. J Chinese Med Assoc. (2020) 83:217–20. 10.1097/JCMA.0000000000000270 - DOI - PMC - PubMed
    1. Convalescent plasma for the treatment of COVID-19: perspectives of the national institutes of health COVID-19 treatment guidelines panel . Annal Int Med. (2021) 174:93–5. 10.7326/M20-6448 - DOI - PMC - PubMed
    1. Trochoutsou A, Kloukina V, Samitas K, Xanthou G. Vitamin-D in the immune system: genomic and non-genomic actions. Mini-Rev Med Chem. (2015) 15:953–63. 10.2174/1389557515666150519110830 - DOI - PubMed
    1. Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, et al. . Epidemic influenza and vitamin D. Epidemiol Infect. (2006) 134:1129–40. 10.1017/S0950268806007175 - DOI - PMC - PubMed
    1. Nair P, Venkatesh B, Center JR. Vitamin D deficiency and supplementation in critical illness - The known knowns and known unknowns. Crit Care. (2018) 22:276. 10.1186/s13054-018-2185-8 - DOI - PMC - PubMed