Prevalence and Clinical Outcomes of Vitamin D Deficiency in COVID-19 Hospitalized Patients: A Retrospective Single-Center Analysis
Afaghi et al.
, Prevalence and Clinical Outcomes of Vitamin D Deficiency in COVID-19 Hospitalized Patients: A Retrospective..
, The Tohoku Journal of Experimental Medicine, doi:10.1620/tjem.255.127
Retrospective 646 COVID-19+ hospitalized patients in Iran, showing higher mortality with vitamin D deficiency.
risk of death, 55.0% lower, RR 0.45, p = 0.002, high D levels 97 of 537 (18.1%), low D levels 51 of 109 (46.8%), NNT 3.5, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >20ng/mL, multivariate.
risk of mechanical ventilation, 55.9% lower, RR 0.44, p < 0.001, high D levels 89 of 537 (16.6%), low D levels 41 of 109 (37.6%), NNT 4.8, >20ng/mL, unadjusted.
risk of ICU admission, 34.1% lower, RR 0.66, p < 0.001, high D levels 211 of 537 (39.3%), low D levels 65 of 109 (59.6%), NNT 4.9, >20ng/mL, unadjusted.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Afaghi et al., 12 Oct 2021, retrospective, Iran, peer-reviewed, 7 authors.
Abstract: The Effect of Vitamin D Deficiency on COVID-19 Patients
Tohoku J. Exp. Med., 2021, 255, 127-134
Prevalence and Clinical Outcomes of Vitamin D Deficiency in
COVID-19 Hospitalized Patients: A Retrospective Single-Center
Siamak Afaghi,1,* Farzad Esmaeili Tarki,1,* Fatemeh Sadat Rahimi,2 Sara Besharat,3
Shayda Mirhaidari,4 Anita Karimi1 and Nasser Malekpour Alamdari5
Department of Internal Medicine, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences,
Critical Care and Quality Improvement Research Center, Department of General Surgery, Shahid Modarres
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Clinical Research and Development Center, Department of Radiology, Shahid Modarres Hospital, Shahid
Beheshti University of Medical Sciences, Tehran, Iran
Clinical Instructor of Surgery, Northeastern Ohio University (NEOMED), Rootstown, OH, USA
Vascular and Laparoscopic Surgery, Clinical Research and Development Center, Shahid Modarres Hospital,
Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Vitamin D attenuates inflammatory responses to viral respiratory infections. Hence, vitamin D deficiency
may be a highly significant prognostic factor for severity and mortality in COVID-19 patients. To evaluate
the complications and mortality in different vitamin D status groups in COVID-19 hospitalized patients, we
conducted this retrospective study on 646 laboratory-confirmed COVID-19 patients who were hospitalized
in Shahid Modarres Hospital, Tehran, Iran from 16th March 2020 until 25th February 2021. Overall,
patients with vitamin D deficiency, insufficiency and sufficiency were 16.9%, 43.6% and 39.5%, respectively.
The presence of comorbidity, length of hospitalization, ICU admission, and invasive mechanical ventilation
requirement and overall complications were significantly more in patients with vitamin D deficiency (p-value
< 0.001). 46.8% (51/109) of vitamin D deficient patients died due to the disease, whilst the mortality rate
among insufficient and sufficient vitamin D groups was 29.4% (83/282) and 5.5% (14/255), respectively. In
univariate analysis, age > 60 years (odds ratio (OR) = 6.1), presence of comorbidity (OR = 10.7),
insufficient vitamin D status (OR = 7.2), and deficient vitamin D status (OR = 15.1) were associated with
increase in COVID-19 mortality (p-value < 0.001). Finally, the multivariate analysis adjusted for age, sex,
and comorbidities indicated vitamin D deficiency as an independent risk factor for mortality (OR = 3.3,
p-value = 0.002). Vitamin D deficiency is a strong risk factor for mortality and severity of SARS-CoV-2
infection. Vitamin D supplementation may be able to prevent or improve the prognosis of COVID-19 during
Keywords: COVID-19; prognosis; vitamin D; vitamin D deficiency
Tohoku J. Exp. Med., 2021 October, 255 (2), 127-134.
have entered a concerning second phase of the disease
spread. Exceeding 30 different mutations of Severe Acute
Respiratory Syndrome-Coronavirus (SARS-CoV2), the
causative agent of COVID-19, have been recently revealed
(Yao et al. 2020a). By rising discoveries in the number of
new strains, the worldwide enthusiasm has been remarkably
increased for studies evaluating the effects of antiviral drugs
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