Short-Term Outcomes in Patients With Coexistence of COVID-19 Infection and Vitamin D Deficiency: A Large Cohort Study
Yi-Ju Chan, Chia-Chen Chen, Jheng-Yan Wu
Cureus, doi:10.7759/cureus.71952
Introduction: Vitamin D deficiency (VDD) is prevalent worldwide and may influence the severity of infectious diseases, including COVID-19. This study aimed to evaluate the association between VDD and 30day clinical outcomes in patients with COVID-19. Methods: We conducted a retrospective cohort study using data from the TriNetX database, which includes de-identified electronic health records of approximately 155 million patients from 131 healthcare organizations globally. Adult patients (aged ≥18 years) with their first documented COVID-19 infection between January 2022 and September 2024 were included. Patients were categorized based on their vitamin D status within three months prior to COVID-19 diagnosis: those with documented VDD (VDD group) and those without (controls). Outcomes assessed were all-cause mortality, all-cause hospitalization, the requirement for critical care services, and a composite outcome of these events at 30-day followup. Propensity score matching (PSM) was utilized to balance covariates such as age, sex, race, and comorbidities between the groups. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox regression analysis. Results: After PSM, the study included 68,814 patients, with 34,407 in both the VDD and control groups. VDD was associated with a slight but statistically significant increase in the hazard of experiencing the composite outcome (HR 1.05, 95% CI 1.01-1.10, P=0.02). There was no significant difference in all-cause mortality (HR 1.06, 95% CI 0.92-1.22, P=0.42) or all-cause hospitalization (HR 1.01, 95% CI 0.96-1.05, P=0.80) between the groups. However, patients with VDD had a significantly higher hazard of requiring critical care services compared to controls (HR 1.28, 95% CI 1.16-1.41, P<0.01). Conclusion: Vitamin D deficiency is associated with an increased risk of requiring critical care services among COVID-19 patients, suggesting that VDD may contribute to greater disease severity. These findings underscore the potential importance of assessing and managing vitamin D deficiency in patients with COVID-19 to improve clinical outcomes.
Author Contributions All authors have reviewed the final version to be published and agreed to be accountable for all aspects of the work.
Concept and design: Jheng-Yan Wu, Yi-Ju Chan, Chia-Chen Chen Acquisition, analysis, or interpretation of data: Jheng-Yan Wu, Yi-Ju Chan, Chia-Chen Chen Critical review of the manuscript for important intellectual content: Jheng-Yan Wu Drafting of the manuscript: Yi-Ju Chan, Chia-Chen Chen
Disclosures Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board of the Chi Mei Medical Center issued approval 11302-E01. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
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