Vitamin D Status and Mortality from SARS CoV-2: A Prospective Study of Unvaccinated Caucasian Adults
Barrett et al.,
Vitamin D Status and Mortality from SARS CoV-2: A Prospective Study of Unvaccinated Caucasian Adults,
Nutrients, doi:10.3390/nu14163252
Prospective study of 232 hospitalized COVID-19 pneumonia patients, showing higher risk of mortality with vitamin D deficiency.
risk of death, 78.4% lower, OR 0.22, p = 0.006, high D levels (≥30nmol/L) 144, low D levels (<30nmol/L) 88, adjusted per study, inverted to make OR<1 favor high D levels (≥30nmol/L), multivariable, RR approximated with OR.
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risk of ICU admission, 15.3% lower, OR 0.85, p = 0.63, high D levels (≥30nmol/L) 144, low D levels (<30nmol/L) 88, adjusted per study, inverted to make OR<1 favor high D levels (≥30nmol/L), multivariable, RR approximated with OR.
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risk of progression, 52.6% lower, OR 0.47, p = 0.12, high D levels (≥30nmol/L) 144, low D levels (<30nmol/L) 88, adjusted per study, inverted to make OR<1 favor high D levels (≥30nmol/L), extended oxygen requirement, multivariable, RR approximated with OR.
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Barrett et al., 9 Aug 2022, prospective, Ireland, peer-reviewed, mean age 56.0, 19 authors, study period March 2020 - April 2021.
Contact:
johnfaul@rcsi.ie (corresponding author).
Abstract: nutrients
Article
Vitamin D Status and Mortality from SARS CoV-2: A
Prospective Study of Unvaccinated Caucasian Adults
Robert Barrett 1 , Modar Youssef 2 , Irfan Shah 2 , Julia Ioana 2 , Abdullah Al Lawati 2 , Abdullah Bukhari 2 ,
Suzanne Hegarty 2 , Liam J. Cormican 2 , Eoin Judge 2 , Conor M. Burke 2,3 , Catriona Cody 4 , Joseph Feely 5 ,
Katrina Hutchinson 6 , William Tormey 5 , Eoghan O’ Neill 7 , Aoife O’ Shea 1 , Meabh Connolly 1 ,
Daniel M. A. McCartney 1 and John L. Faul 2,3,8, *
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Citation: Barrett, R.; Youssef, M.;
Shah, I.; Ioana, J.; Lawati, A.A.;
Bukhari, A.; Hegarty, S.; Cormican, L.J.;
Judge, E.; Burke, C.M.; et al. Vitamin
D Status and Mortality from SARS
CoV-2: A Prospective Study of
Unvaccinated Caucasian Adults.
Nutrients 2022, 14, 3252. https://
doi.org/10.3390/nu14163252
Academic Editors: Andrea P. Rossi
and Marwan El Ghoch
Received: 24 June 2022
School of Biological and Health Sciences, Technological University Dublin, D08 NF82 Dublin, Ireland
Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
Department of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
Department of Intensive Care Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
Department of Biochemistry, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
Eurofins Biomnis, Sandyford, Co. Dublin, D18 A4CO Dublin, Ireland
Department of Microbiology, Connolly Hospital Dublin, D15 X40D Dublin, Ireland
Department of Medicine, Royal College of Surgeons in Ireland, D02 YN 77 Dublin, Ireland
Correspondence: johnfaul@rcsi.ie
Abstract: COVID-19 and a low vitamin D state share common risk factors, which might explain why
vitamin D deficiency has been linked with higher COVID-19 mortality. Moreover, measures of serum
vitamin D may become lower during systemic inflammatory responses, further confounding the
association via reverse causality. In this prospective study (recruited over 12 months), we examined
whether the association between a low vitamin D state and in-hospital mortality due to SARS-CoV-2
pneumonia in unvaccinated subjects is explained by (i) the presence of shared risk factors (e.g., obesity,
advanced age) or (ii) a reduction in serum 25(OH)D due to COVID-19 (i.e., reverse causality). In this
cohort of 232 (mean age = 56 years) patients (all had SARS-CoV-2 diagnosed via PCR AND required
supplemental oxygen therapy), we failed to find an association between serum vitamin D and levels
of CRP, or other inflammatory markers. However, the hazard ratio for mortality for subjects over
70 years of age (13.2) and for subjects with a serum 25(OH)D level less than 30 nmol·L−1 (4.6)
remained significantly elevated even after adjustment for gender, obesity and the presence of diabetes
mellitus. Subjects <70 years and >70 years had significantly higher mortality with a serum 25(OH)D
less than 30 nmol·L−1 (11.8% and 55%), than with a serum 25(OH)D greater than 30 nmol·L−1 (2.2%
and 25%). Unvaccinated Caucasian adults with a low vitamin D state have higher mortality due
to SARS CoV-2 pneumonia, which is not explained by confounders and is not closely linked with
elevated serum CRP.
Accepted: 3 August 2022
Published: 9 August 2022
Keywords: COVID-19; vitamin D; hospitalization; mortality; Ireland
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