Vitamin D status and outcomes for hospitalised older patients with COVID-19
Prospective study of 105 hospitalized patients, showing lower vitamin D levels in the COVID-19 positive group (27.0 nmol/L vs 52.0 nmol/L, p=0.0008), and non-statistically significant higher mortality with vitamin D deficiency.
risk of death, 28.6% lower, RR 0.71, p = 0.50, high D levels 4 of 31 (12.9%), low D levels 6 of 39 (15.4%), adjusted per study, inverted to make RR<1 favor high D levels, >30nmol/L.
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Baktash et al., 27 Aug 2020, prospective, United Kingdom, peer-reviewed, 8 authors.
Abstract: Vitamin D status and outcomes for hospitalised older
patients with COVID-19
Vadir Baktash,1 Tom Hosack,1 Nishil Patel,1 Shital Shah,1 Pirabakaran Kandiah,1
Koenraad Van Den Abbeele,1 Amit K J Mandal ,1 Constantinos G Missouris1,2
1
Department of Medicine,
Frimley Health NHS Foundation
Trust, Wexham Park Hospital,
Slough, UK
2
Department of Cardiology,
University of Cyprus Medical
School, Nicosia, Cyprus
Correspondence to
Constantinos G Missouris,
Department of Medicine,
Wexham Park Hospital,
Frimley Health NHS
Foundation Trust, Wexham
Street, Slough, UK; dinos.mis
souris@nhs.net
Received 18 July 2020
Accepted 1 August 2020
Revised 1 August 2020
ABSTRACT
Purpose Older adults are more likely to be vitamin
D deficient. The aim of the study was to determine
whether these patients have worse outcomes with
COVID-19.
Methods We conducted a prospective cohort study
between 1 March and 30 April 2020 to assess the
importance of vitamin D deficiency in older patients with
COVID-19. The cohort consisted of patients aged ≥65 years
presenting with symptoms consistent with COVID-19
(n=105). All patients were tested for serum 25hydroxyvitamin D (25(OH)D) levels during acute illness.
Diagnosis of COVID-19 was confirmed via viral reverse
transcriptase PCR swab or supporting radiological evidence.
COVID-19-positive arm (n=70) was sub-divided into
vitamin D-deficient (≤30 nmol/L) (n=39) and -replete
groups (n=35). Subgroups were assessed for disease
severity using biochemical, radiological and clinical markers.
Primary outcome was in-hospital mortality. Secondary
outcomes were laboratory features of cytokine storm,
thoracic imaging changes and requirement of non-invasive
ventilation (NIV).
Results COVID-19-positive arm demonstrated lower
median serum 25(OH)D level of 27 nmol/L
(IQR=20–47 nmol/L) compared with COVID-19-negative
arm, with median level of 52 nmol/L
(IQR=31.5–71.5 nmol/L) (p value=0.0008). Among
patients with vitamin D deficiency, there was higher peak
D-dimer level (1914.00 μgFEU/L vs 1268.00 μgFEU/L)
(p=0.034) and higher incidence of NIV support and high
dependency unit admission (30.77% vs 9.68%)
(p=0.042). No increased mortality was observed between
groups.
Conclusion Older adults with vitamin D deficiency and
COVID-19 may demonstrate worse morbidity outcomes.
Vitamin D status may be a useful prognosticator.
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