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. 2025 Apr 10;25(1):240.
doi: 10.1186/s12877-025-05873-1.

Impact of vitamin D levels on mortality in older covid-19 vaccinated patients

Chiara Ceolin  1 , Margherita Vergadoro  2   3 , Cristina Simonato  4 , Sara Cazzavillan  1 , Mario Virgilio Papa  1 , Giulia Salerno Trapella  1 , Benedetta Di Marzio  1 , Riccardo Sermasi  1 , Bruno Micael Zanforlini  1 , Chiara Curreri  1 , Anna Bertocco  1 , Maria Devita  1   5 , Alessandra Coin  1 , Luca Spiezia  2   3 , Giuseppe Sergi  1 , Marina De Rui  1
Affiliations

Impact of vitamin D levels on mortality in older covid-19 vaccinated patients

Chiara Ceolin et al. BMC Geriatr. .

Abstract

Background: Vitamin D plays a key role in regulating the immune system and vaccine response, and hypovitaminosis D is a known risk factor for mortality. However, its potential influence on mortality in SARS-CoV-2 vaccinated older adults remains underexplored. This study aims to examine survival differences between unvaccinated and vaccinated older adults with varying vitamin D levels, and to assess the impact of vitamin D on mortality.

Methods: We recruited patients aged 65 and over from the Geriatrics Unit of Azienda Ospedale - Università Padova. Clinical, pharmacological data, including vaccination status and vitamin D levels, were collected at admission, alongside mortality data 12 months post-hospitalization. Participants were divided into three groups: unvaccinated, vaccinated with vitamin D levels of 25-50 nmol/L, and vaccinated with levels > 50 nmol/L.

Results: A total of 126 participants were included (56% women, mean age 83 years). No significant differences were found in COVID-19 severity among the three groups. After 12 months, 24 deaths were recorded: 17% in unvaccinated, 19% in vaccinated with low vitamin D, and 20% in vaccinated with high vitamin D (p = 0.94). Kaplan-Meier curves showed that mortality risk for vaccinated individuals with low vitamin D was similar to unvaccinated patients but significantly higher than vaccinated individuals with high vitamin D (p = 0.04). Vitamin D levels of 25-50 nmol/L were associated with a threefold increased risk of 12-month mortality (HR: 3.79, p < 0.001).

Conclusions: Vitamin D levels can impact mortality in older vaccinated individuals. Early correction of vitamin D deficiency could potentially enhance outcomes.

Keywords: COVID-19; Older adults; SARS-CoV-2; Vaccination; Vitamin D.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Padua (protocol number 16412/AO/23, February 2023). Informed consent to participation was obtained from all subjects involved in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
Kaplan-Meyer survival curves: mortality at 12 months after discharge according to vaccinal status and vitamin D levels
See this image and copyright information in PMC

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