Exploring the link between vitamin D and clinical outcomes in COVID-19

Am J Physiol Endocrinol Metab. 2021 Mar 1;320(3):E520-E526. doi: 10.1152/ajpendo.00517.2020. Epub 2021 Jan 6.

Abstract

The immunomodulating role of vitamin D might play a role in COVID-19 disease. We studied the association between vitamin D and clinical outcomes in COVID-19 patients. This is a retrospective cohort study on COVID-19 patients with documented vitamin D levels within the last year. Vitamin D levels were grouped as ≥ 20 ng/mL or < 20 ng/mL. Main outcomes were mortality, need for mechanical ventilation, new DVT or pulmonary embolism, and ICU admission. A total of 270 patients (mean ± SD) age, 63.81 (14.69) years); 117 (43.3%) males; 216 (80%) Blacks; 139 (51.5%) in 65 and older age group were included. Vitamin D levels were less than 20 ng/mL in 95 (35.2%) patients. During admission, 72 patients (26.7%) died, 59 (21.9%) needed mechanical ventilation, and 87 (32.2%) required ICU. Vitamin D levels showed no significant association with mortality (OR = 0.69; 95% CI, 0.39-1.24; P = 0.21), need for mechanical ventilation (OR = 1.23; 95% CI, 0.68-2.24; P = 0.49), new DVT or PE(OR= 0.92; 95% CI, 0.16-5.11; P = 1.00) or ICU admission (OR = 1.38; 95% CI, 0.81-2.34; P = 0.23). We did not find any significant association of vitamin D levels with mortality, the need for mechanical ventilation, ICU admission and the development of thromboembolism in COVID-19 patients.NEW & NOTEWORTHY Low vitamin D has been associated with increased frequency and severity of respiratory tract infections in the past. Current literature linking clinical outcomes in COVID-19 with low vitamin D is debatable. This study evaluated the role of vitamin D in severe disease outcomes among COVID-19 patients and found no association of vitamin D levels with mortality, the need for mechanical ventilation, ICU admission, and thromboembolism in COVID-19.

Keywords: critical care; mechanical ventilation; mortality; thromboembolism; vitamin D.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnosis*
  • COVID-19 / mortality*
  • COVID-19 / pathology
  • COVID-19 / therapy
  • Cohort Studies
  • Female
  • Hospital Mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Mortality
  • Prognosis
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / pathogenicity
  • Severity of Illness Index
  • Vitamin D / blood*
  • Vitamin D / physiology

Substances

  • Vitamin D