Vitamin D deficiency and SARS‑CoV‑2 infection: Big-data analysis from March 2020 to March 2021. D-COVID study
Álvarez M Neira, Jiménez G Navarro, Sánchez N Anguita, Olano M M Bermejo, R Queipó, Nuñez M Benavent, Jimenez A Parralejo, Yepes G López, Nieto C Sáez
doi:10.1101/2022.10.27.514012
Background: Vitamin D has been proposed to have immunomodulatory functions and therefore play a role in coronavirus infection . However, there is no conclusive evidence on its impact on COVID-19 infection and evolution. Objective: To study the association between COVID-19 infection and vitamin D deficiency in patients of a terciary university hospital. To investigate the clinical evolution and prognosis of patients with COVID-19 and vitamin D deficiency. Methods: Using big-data analytics and artificial intelligence through the SAVANA Manager clinical platform, we analysed clinical data from patients with COVID-19 atended in a terciary university hospital from March 2020 to March 2021. Results: Of the 143.157 analysed patients, 36.261 subjects had COVID-19 infection (25.33%); during this period; of these 2588 had vitamin D deficiency (7.14%). Among subjects with COVID-19 and vitamin D deficiency, there was a higher proportion of women OR 1.45 [95% CI 1.33-1.57], adults older than 80 years OR 2.63 [95%CI 2.38-2.91], people living in nursing homes OR 2.88 [95%CI 2.95-3.45] and walking dependence OR 3.45 [95%CI 2.85-4.26]. Regarding clinical course, a higher number of subjects with COVID-19 and vitamin D deficiency required hospitalitation OR 2.41 [95%CI 2.22-2-61], intensive unit care (ICU) OR 2.22 [95% CI 1.64-3.02], had a longer mean hospital stay 3.94 (2.29) p=0.02 and higher mortality OR 1.82 [95%CI 1.66-2.01].) Conclusion: Low serum 25 (OH) Vitamin-D level was significantly associated with a worse clinical evolution and prognosis of COVID-19 infection. We found a higher proportion of institutionalised and dependent people over 80 years of age among patients with COVID-19 and vitamin D deficiency.
DECLARATIONS
Competing interests: Benavent Nuñez M, Parralejo Jimenez A, López Yepes G report that the y are employees at Medsavana. There are no other financial competing interests regarding this paper. Funding: There are no non-financial competing interests.
References
Baeza-Yates, Ribeiro-Neto, Modern Information Retrieval
Benson, Principles of Health Interoperability HL7 and SNOMED
Charan, Goyal, Saxena, Yadav, Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis, Journal of Pharmacology and Pharmacotherapeutics,
doi:10.4103/0976-500X.103685
Crafa, Cannarella, Condorelli, Mongioì, Barbagallo et al., Influence of 25-hydroxy-cholecalciferol levels on SARS-CoV-2 infection and COVID-19 severity: A systematic review and meta-analysis, EClinicalMedicine,
doi:10.1016/j.eclinm.2021.100967
Diaz-Curiel, Cabello, Arboiro-Pinel, Mansur, Heili-Frades et al., The relationship between 25(OH) vitamin D levels and COVID-19 onset and disease course in Spanish patients, Journal of Steroid Biochemistry and Molecular Biology,
doi:10.1016/j.jsbmb.2021.105928
Driggin, Madhavan, Gupta, The role of vitamin D in cardiovascular disease and COVID-19, Reviews in Endocrine and Metabolic Disorders,
doi:10.1007/s11154-021-09674-w
Ebadi, Montano-Loza, Perspective: improving vitamin D status in the management of COVID-19, European Journal of Clinical Nutrition,
doi:10.1038/s41430-020-0661-0
González-Molero, Morcillo, Valdes, Pérez, Valero et al., Vitamin D deficiency in Spain: a population-based cohort study 1 Vitamin D deficiency in Spain: a population-based cohort study, European Journal of Clinical Nutrition,
doi:10.1038/ejcn.2010.265ï
Holick, Medical Progress Vitamin D Deficiency, N Engl J Med
Israel, Cicurel, Feldhamer, Stern, Dror et al., Vitamin D deficiency is associated with higher risks for SARS-CoV-2 infection and COVID-19 severity: a retrospective case-control study, Internal and Emergency Medicine,
doi:10.1007/s11739-021-02902-w
Laird, Rhodes, Kenny, Vitamin D and Inflammation: Potential Implications for Severity of Covid-19, Ir Med J
Lips, Cashman, Lamberg-Allardt, Bischoff-Ferrari, Obermayer-Pietsch et al., Current Vitamin D status in European and Middle East countries and strategies to prevent Vitamin D deficiency: A position statement of the European Calcified Tissue Society, European Journal of Endocrinology,
doi:10.1530/EJE-18-0736
Mateo-Pascual, Julián-Viñals, Alarcón-Alarcón, Castell-Alcalá, Ictoria et al., Vitamin D deficiency in a cohort over 65 years: prevalence and association with sociodemographic and health factors, Revista Española de Geriatría y Gerontología,
doi:10.1016/j.regg.2013.11.004
Merzon, Tworowski, Gorohovski, Vinker, Golan Cohen et al., Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study, FEBS Journal,
doi:10.1111/febs.15495
Panagiotou, Tee, Ihsan, Athar, Marchitelli et al., Low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID-19 are associated with greater disease severity, Clinical Endocrinology,
doi:10.1111/cen.14276
Sabetta, Depetrillo, Cipriani, Smardin, Burns et al., Serum 25-hydroxyvitamin D and the incidence of acute viral respiratory tract infections in healthy adults, PLoS ONE,
doi:10.1371/journal.pone.0011088
Sabetta, Depetrillo, Cipriani, Smardin, Burns et al., Serum 25-hydroxyvitamin D and the incidence of acute viral respiratory tract infections in healthy adults, PLoS ONE,
doi:10.1371/journal.pone.0011088
Von Elm, Altman, Egger, Pocock, Gøtzsche et al., The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies, International Journal of Surgery,
doi:10.1016/j.ijsu.2014.07.013
Xu, Baylink, Chen, Reeves, Xiao et al., The importance of Vitamin D metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19, Journal of Translational Medicine,
doi:10.1186/s12967-020-02488-5
Ye, Tang, Liao, Shaw, Deng et al., Does Serum Vitamin D Level Affect COVID-19 Infection and Its Severity?-A Case-Control Study, Journal of the American College of Nutrition,
doi:10.1080/07315724.2020.1826005
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