Association between Vitamin D Status and Secondary Infections in Patients with Severe COVID-19 Admitted in the Intensive Care Unit of a Tertiary-Level Hospital in Turkey
Batur et al.
, Association between Vitamin D Status and Secondary Infections in Patients with Severe COVID-19 Admitted in the..
, Diagnostics, doi:10.3390/diagnostics13010059
Retrospective 194 ICU patients and 30 non-COVID-19 patients in Turkey, showing significantly lower vitamin D levels in COVID-19 patients. There was significantly higher COVID-19 mortality with vitamin D deficiency, and significantly higher risk of secondary hospital infections.
Severe COVID-19 patients with vitamin D deficiency may have increased risks due to secondary infections.
This study is excluded in the after exclusion results of meta
unadjusted differences between groups.
risk of death, 71.9% lower, RR 0.28, p < 0.001, high D levels (≥20ng/mL) 17 of 76 (22.4%), low D levels (<20ng/mL) 94 of 118 (79.7%), NNT 1.7.
secondary infection, 23.3% lower, RR 0.77, p = 0.03, high D levels (≥20ng/mL) 40 of 76 (52.6%), low D levels (<20ng/mL) 81 of 118 (68.6%), NNT 6.2, growth in culture.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Batur et al., 26 Dec 2022, retrospective, Turkey, peer-reviewed, 2 authors, study period March 2020 - June 2021.
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Association between Vitamin D Status and Secondary
Infections in Patients with Severe COVID-19 Admitted in the
Intensive Care Unit of a Tertiary-Level Hospital in Turkey
Lutfiye Karcioglu Batur 1, *
and Suna Koç 2
Citation: Batur, L.K.; Koç, S.
Association between Vitamin D
Status and Secondary Infections in
Patients with Severe COVID-19
Admitted in the Intensive Care Unit
of a Tertiary-Level Hospital in Turkey.
Diagnostics 2023, 13, 59. https://
Academic Editor: Aw Tar-Choon
Department of Molecular Biology and Genetics, Faculty of Engineering and Natural Sciences,
Biruni University, Istanbul 34010, Turkey
Department of Anesthesiology and Reanimation, Medical Faculty, Biruni University, Istanbul 34010, Turkey
Correspondence: firstname.lastname@example.org; Tel.: +90-444-82-76 (ext. 2133)
Abstract: There are several studies showing that the vitamin D status can determine risk of COVID19 infections, severity and mortality from coronavirus disease 2019 (COVID-19). However, the
association between vitamin D (25(OH)D) and secondary infections in the prognosis of COVID-19
patients has not been reported yet. The aim was to investigate whether the vitamin D status affects
the rates of secondary infections in patients with severe COVID-19 hospitalized in the intensive care
unit (ICU) of a tertiary-level hospital in Turkey. The data of 194 patients with diagnosis of severe
COVID-19 who were admitted to the ICU from March 2020 to June 2021 and older than 18 years were
evaluated in this retrospective study. The patients were divided into two groups according to total
serum 25(OH)D level as normal group (≥20 ng/mL) and low group (<20 ng/mL). The 25(OH)D
level was low in 118 (60.8%) and normal in 76 (39.2%) patients. The mean age of the low group
was significantly higher than that of the normal group (67.02 ± 14.47 vs. 61.70 ± 14.38; p = 0.013).
The systolic and diastolic blood pressure as well as the Glasgow coma scale score of the low group
were significantly lower than that of the normal group (p = 0.004, 0.002 and 0.001, respectively). The
intubation rate and APACHE (Acute Physiology and Chronic Health Evaluation) score of the low
group was significantly higher than that of the normal group (p = 0.001). The platelets number and
blood pH decreased, and the neutrophil/lymphocyte ratio, procalcitonin, lactate, urea, creatinine
and lactate dehydrogenase concentrations increased significantly in the low group (p < 0.05). The
mortality rate was 79.7% in the low group and 22.4% in the normal group (p < 0.001). Microbiological
growth was observed in 68.6% of the normal group and 52.6% of the normal group (p = 0.025). The
number of cultures with resistant bacteria was significantly higher in the low group (25.9%) than that
in the normal group (17.5%) (p = 0.035). The severe COVID-19 patients hospitalized with vitamin D
deficiency may have increased risks of poor prognosis and mortality due to secondary infections in
Keywords: vitamin D status; COVID-19; Intensive Care Unit; secondary infections
Received: 25 October 2022
Revised: 16 December 2022
Accepted: 17 December 2022
Published: 26 December 2022
Copyright: © 2022 by the authors.
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