Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19
G E Carpagnano, V Di Lecce, V N Quaranta, A Zito, E Buonamico, E Capozza, A Palumbo, G Di Gioia, V N Valerio, O Resta
Journal of Endocrinological Investigation, doi:10.1007/s40618-020-01370-x
Purpose 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. Methods 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. Results 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 (p = 0.019). Conclusions 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.
Author contributions GEC and VDL, made substantial contribution to the conception and design of the work, VDL, EB, EC, GDG, AP, VNV to the data acquisition, VDL, EC, VQ, to the analysis, and VQ, AZ, GEC, OR to the interpretation. GEC, VDL, EB, VQ, EC helped in drafting the article and OR revised it critically for important intellectual content. All authors gave the final approval of the version to be published and agreed for the accuracy or integrity of any part of the work. Funding This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
Availability of data and material The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Compliance with ethical standards Conflict of interest All authors disclose no interests related to the present work.
Ethics approval 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.
Research involving human participants and/or animals The study was approved by our local ethical committee and informed consent was obtained.
Informed consent Informed consent was obtained from all individual participants included in the study. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which..
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'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\xa0days of hospitalization, severe vitamin D deficiency patients had a 50% mortality '
'probability, while those with vitamin D\u2009≥\u200910\xa0ng/mL had a 5% mortality risk '
'(<jats:italic>p</jats:italic>\u2009=\u20090.019).</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'
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