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The role of serum vitamin D concentrations in predicting COVID-19 course and outcome

Božić et al., Acta Facultatis Medicae Naissensis, doi:10.5937/afmnai41-42961
Jun 2024  
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Mortality 53% Improvement Relative Risk ICU admission 30% Vitamin D for COVID-19  Božić et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Prospective study in Serbia (October - December 2021) Lower mortality with higher vitamin D levels (p=0.007) c19early.org Božić et al., Acta Facultatis Medicae .., Jun 2024 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
Prospective study of 329 hospitalized COVID-19 patients in Serbia showing vitamin D deficiency associated with significantly higher mortality.
This is the 201st of 209 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 293,154,636 vigintillion).
risk of death, 53.3% lower, OR 0.47, p = 0.007, cutoff 20ng/mL, adjusted per study, inverted to make OR<1 favor high D levels (≥20ng/mL), multivariable, RR approximated with OR.
risk of ICU admission, 30.5% lower, OR 0.70, p = 0.21, cutoff 20ng/mL, adjusted per study, inverted to make OR<1 favor high D levels (≥20ng/mL), multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Božić et al., 20 Jun 2024, prospective, Serbia, peer-reviewed, median age 69.0, 4 authors, study period October 2021 - December 2021. Contact: djordje.stevanovic.kg@gmail.com.
This PaperVitamin DAll
The Role of Serum Vitamin D Concentrations in Predicting COVID-19 Course and Outcome
Dunja Božić, Đorđe Stevanović, Mina Poskurica, Marina Petrović
Introduction/Aim. The coronavirus disease 2019 (COVID-19) pandemic had significant acute and longterm impact on people's health. As the available literature sources have shown that the premorbid conditions affect the course of COVID-19, we aimed to investigate the role of admission vitamin D concentration to predict the outcome of hospitalized COVID-19 patients. Methods. An observational, prospective cohort study was conducted on 329 COVID-19 patients hospitalized at the University Clinical Centre Kragujevac, between October and December 2021. Within 24 hours of admission, vitamin D level was measured from the peripheral venous blood. Medical history data and socio-demographic characteristics were obtained anamnestically and using Health Information System (COMTRADE, Serbia). Lethal outcome and intensive care unit (ICU) admission were considered primary end-points. Results. The prevalence of hypovitaminosis D on admission in our cohort was 27.7%. Both non-survivors and patients requiring ICU admission more frequently had hypovitaminosis D compared to survivors (42,9% versus 21,0%; p < 0,001) and patients on a standard level of care (31,5% verus 25,3%; p = 0,029). Our research showed that vitamin D concentration < 20 ng/mL was an independent predictor of mortality (aOR 2.142 [95% CI 1.226 -3.744]). However, hypovitaminosis D upon hospital admission did not show a significant impact on ICU admission. Conclusion. Low vitamin D concentration on admission could be a significant predictor of outcome in hospitalized COVID-19 patients.
References
Bilezikian, Bikle, Hewison, MECHANISMS IN ENDOCRINOLOGY: Vitamin D and COVID-19, Eur J Endocrinol, doi:10.1530/EJE-20-0665
Borsche, Glauner, Mendel, COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3: Results of a Systematic Review and Meta-Analysis, Nutrients, doi:10.3390/nu13103596
Charoenngam, Holick, Immunologic Effects of Vitamin D on Human Health and Disease, Nutrients, doi:10.3390/nu12072097
Chen, Mei, Xie, Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs, Nutr J, doi:10.1186/s12937-021-00744-y
Chiodini, Gatti, Soranna, Vitamin D Status and SARS-CoV-2 Infection and COVID-19 Clinical Outcomes, Front Public Health, doi:10.3389/fpubh.2021.736665
Djaharuddin, Munawwarah, Nurulita, Comorbidities and mortality in COVID-19 patients, Gac Sanit, doi:10.1016/j.gaceta.2021.10.085
Gallo Marin, Aghagoli, Lavine, Predictors of COVID-19 severity: A literature review, Rev Med Virol, doi:10.1002/rmv.2146
Kaya, Pamukçu, Yakar, The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies, Epidemiol Health, doi:10.4178/epih.e2021074
Mercola, Grant, Wagner, Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity, Nutrients, doi:10.3390/nu12113361
Name, Souza, Vasconcelos, Zinc, Vitamin D and Vitamin C: Perspectives for COVID-19 With a Focus on Physical Tissue Barrier Integrity, Front Nutr, doi:10.3389/fnut.2020.606398
Petrelli, Luciani, Perego, Therapeutic and prognostic role of vitamin D for COVID-19 infection: A systematic review and meta-analysis of 43 observational studies, J Steroid Biochem Mol Biol, doi:10.1016/j.jsbmb.2021.105883
Shi, Liu, Zhang, Severe Type of COVID-19: Pathogenesis, Warning Indicators and Treatment, Chin J Integr Med, doi:10.1007/s11655-021-3313-x
Teshome, Adane, Girma, Mekonnen, The Impact of Vitamin D Level on COVID-19 Infection: Systematic Review and Meta-Analysis, Front Public Health, doi:10.3389/fpubh.2021.624559
Zappulo, Cappuccilli, Cingolani, Vitamin D and the Kidney: Two Players, One Console, Int J Mol Sci, doi:10.3390/ijms23169135
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An observational, prospective cohort study was conducted on 329 COVID-19 ' 'patients hospitalized at the University Clinical Centre Kragujevac, between October and ' 'December 2021. Within 24 hours of admission, vitamin D level was measured from the peripheral ' 'venous blood. Medical history data and socio-demographic characteristics were obtained ' 'anamnestically and using Health Information System (COMTRADE, Serbia). Lethal outcome and ' 'intensive care unit (ICU) admission were considered primary end-points. Results. The ' 'prevalence of hypovitaminosis D on admission in our cohort was 27.7%. Both non-survivors and ' 'patients requiring ICU admission more frequently had hypovitaminosis D compared to survivors ' '(42,9% versus 21,0%; p &lt; 0,001) and patients on a standard level of care (31,5% verus ' '25,3%; p = 0,029). Our research showed that vitamin D concentration &lt; 20 ng/mL was an ' 'independent predictor of mortality (aOR 2.142 [95% CI 1.226 - 3.744]). 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