Vitamin D Status in Hospitalized Patients with SARS-CoV-2 Infection

J Clin Endocrinol Metab. 2021 Mar 8;106(3):e1343-e1353. doi: 10.1210/clinem/dgaa733.


Background: The role of vitamin D status in COVID-19 patients is a matter of debate.

Objectives: To assess serum 25-hydroxyvitamin D (25OHD) levels in hospitalized patients with COVID-19 and to analyze the possible influence of vitamin D status on disease severity.

Methods: Retrospective case-control study of 216 COVID-19 patients and 197 population-based controls. Serum 25OHD levels were measured in both groups. The association of serum 25OHD levels with COVID-19 severity (admission to the intensive care unit, requirements for mechanical ventilation, or mortality) was also evaluated.

Results: Of the 216 patients, 19 were on vitamin D supplements and were analyzed separately. In COVID-19 patients, mean ± standard deviation 25OHD levels were 13.8 ± 7.2 ng/mL, compared with 20.9 ± 7.4 ng/mL in controls (P < .0001). 25OHD values were lower in men than in women. Vitamin D deficiency was found in 82.2% of COVID-19 cases and 47.2% of population-based controls (P < .0001). 25OHD inversely correlates with serum ferritin (P = .013) and D-dimer levels (P = .027). Vitamin D-deficient COVID-19 patients had a greater prevalence of hypertension and cardiovascular diseases, raised serum ferritin and troponin levels, as well as a longer length of hospital stay than those with serum 25OHD levels ≥20 ng/mL. No causal relationship was found between vitamin D deficiency and COVID-19 severity as a combined endpoint or as its separate components.

Conclusions: 25OHD levels are lower in hospitalized COVID-19 patients than in population-based controls and these patients had a higher prevalence of deficiency. We did not find any relationship between vitamin D concentrations or vitamin deficiency and the severity of the disease.

Keywords: 25OHD; COVID-19; PTH; SARS-CoV-2 infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • COVID-19 / diagnosis*
  • COVID-19 / mortality
  • COVID-19 / pathology
  • COVID-19 / therapy
  • Case-Control Studies
  • Female
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Mortality
  • Prognosis
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • SARS-CoV-2 / pathogenicity
  • Severity of Illness Index
  • Spain / epidemiology
  • Vitamin D / blood*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / mortality
  • Vitamin D Deficiency / therapy


  • Vitamin D