Vitamin D Deficiency and Outcome of COVID-19 Patients

Nutrients. 2020 Sep 10;12(9):2757. doi: 10.3390/nu12092757.

Abstract

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.

Keywords: COVID-19; SARS-CoV-2; outcome; retrospective; severity; vitamin D.

MeSH terms

  • Aged
  • Betacoronavirus*
  • Coronavirus Infections / blood
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / virology
  • Female
  • Germany / epidemiology
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / virology
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Severity of Illness Index
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / mortality*
  • Vitamin D Deficiency / virology

Substances

  • Vitamin D
  • 25-hydroxyvitamin D

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2