Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19

DOI record: { "DOI": "10.1007/s40618-020-01370-x", "ISSN": [ "1720-8386" ], "URL": "http://dx.doi.org/10.1007/s40618-020-01370-x", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Purpose</jats:title>\n <jats:p>Hypovitaminosis D is a highly spread condition correlated with increased risk of respiratory tract infections. Nowadays, the world is in the grip of the Coronavirus disease 19 (COVID 19) pandemic. In these patients, cytokine storm is associated with disease severity. In consideration of the role of vitamin D in the immune system, aim of this study was to analyse vitamin D levels in patients with acute respiratory failure due to COVID-19 and to assess any correlations with disease severity and prognosis.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>In this retrospective, observational study, we analysed demographic, clinical and laboratory data of 42 patients with acute respiratory failure due to COVID-19, treated in Respiratory Intermediate Care Unit (RICU) of the Policlinic of Bari from March, 11 to April 30, 2020.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>Eighty one percent of patients had hypovitaminosis D. Based on vitamin D levels, the population was stratified into four groups: no hypovitaminosis D, insufficiency, moderate deficiency, and severe deficiency. No differences regarding demographic and clinical characteristics were found. A survival analysis highlighted that, after 10 days of hospitalization, severe vitamin D deficiency patients had a 50% mortality probability, while those with vitamin D ≥ 10 ng/mL had a 5% mortality risk (<jats:italic>p</jats:italic> = 0.019).</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusions</jats:title>\n <jats:p>High prevalence of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure, treated in a RICU. Patients with severe vitamin D deficiency had a significantly higher mortality risk. Severe vitamin D deficiency may be a marker of poor prognosis in these patients, suggesting that adjunctive treatment might improve disease outcomes.</jats:p>\n </jats:sec>", "alternative-id": [ "1370" ], "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "7 June 2020" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "18 July 2020" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "9 August 2020" }, { "group": { "label": "Compliance with ethical standards", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Conflict of interest", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "All authors disclose no interests related to the present work." }, { "group": { "label": "Ethics approval", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "The study was approved by the Institutional Review Board of Teaching Hospital Policlinico of Bari (Ethical Committee No. 6380). The procedures used in this study adhere to the tenets of the Declaration of Helsinki." }, { "group": { "label": "Research involving human participants and/or animals", "name": "EthicsHeading" }, "name": "Ethics", "order": 4, "value": "The study was approved by our local ethical committee and informed consent was obtained." }, { "group": { "label": "Informed consent", "name": "EthicsHeading" }, "name": "Ethics", "order": 5, "value": "Informed consent was obtained from all individual participants included in the study." } ], "author": [ { "affiliation": [], "family": "Carpagnano", "given": "G. E.", "sequence": "first" }, { "affiliation": [], "family": "Di Lecce", "given": "V.", "sequence": "additional" }, { "affiliation": [], "family": "Quaranta", "given": "V. 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