Association of vitamin D status with hospital morbidity and mortality in adult hospitalized COVID-19 patients
Charoenngam et al.,
Association of vitamin D status with hospital morbidity and mortality in adult hospitalized COVID-19 patients,
Endocrine Practice, doi:10.1016/j.eprac.2021.02.013
Retrospective 287 hospitalized patients in the USA showing significantly lower mortality with vitamin D sufficiency in elderly patients and patients without obesity; and lower mortality for all patients but not reaching statistical signifance.
risk of death, 34.1% lower, RR 0.66, p = 0.26, high D levels 12 of 100 (12.0%), low D levels 29 of 187 (15.5%), adjusted per study, odds ratio converted to relative risk, >=30ng/mL.
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risk of mechanical ventilation, 37.2% lower, RR 0.63, p = 0.17, high D levels 14 of 100 (14.0%), low D levels 34 of 187 (18.2%), adjusted per study, odds ratio converted to relative risk, >=30ng/mL.
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risk of ICU admission, 23.1% lower, RR 0.77, p = 0.28, high D levels 25 of 100 (25.0%), low D levels 56 of 187 (29.9%), NNT 20, adjusted per study, odds ratio converted to relative risk, >=30ng/mL.
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risk of death, 58.1% lower, RR 0.42, p = 0.05, high D levels 7 of 57 (12.3%), low D levels 25 of 79 (31.6%), NNT 5.2, adjusted per study, odds ratio converted to relative risk, >65 years old, >=30ng/mL.
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Charoenngam et al., 8 Mar 2021, retrospective, USA, peer-reviewed, 6 authors.
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Endocrine Practice 27 (2021) 271e278
Contents lists available at ScienceDirect
Endocrine Practice
journal homepage: www.endocrinepractice.org
Original Article
Association of Vitamin D Status With Hospital Morbidity and Mortality
in Adult Hospitalized Patients With COVID-19
Nipith Charoenngam, MD 1, 2, Arash Shirvani, MD, PhD 1, Niyoti Reddy, MBBS 1,
Danica M. Vodopivec, MD 1, Caroline M. Apovian, MD 3, Michael F. Holick, PhD, MD 1, *
1
Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston,
Massachusetts
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
3
Section of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
2
a r t i c l e i n f o
a b s t r a c t
Article history:
Available online 9 March 2021
Objective: To determine the association between vitamin D status and morbidity and mortality in adult
hospitalized coronavirus disease 2019 (COVID-19) patients
Methods: We performed a retrospective chart review study in COVID-19 patients aged 18 year hospitalized at Boston University Medical Center between March 1 and August 4, 2020. All studied patients
tested positive for COVID-19 and had serum levels of 25-hydroxyvitamin D (25[OH]D) results measured
within 1 year prior to the date of positive tests. Medical information was retrieved from the electronic
medical record and was analyzed to determine the association between vitamin D status and hospital
morbidity and mortality.
Results: Among the 287 patients, 100 (36%) were vitamin D sufficient (25[OH]D >30 ng/mL) and 41 (14%)
died during hospitalization. Multivariate analysis in patients aged 65 years revealed that vitamin D
sufficiency (25[OH]D 30 ng/mL) was statistically significantly associated with decreased odds of death
(adjusted OR 0.33, 95% CI, 0.12-0.94), acute respiratory distress syndrome (adjusted OR 0.22, 95% CI, 0.050.96), and severe sepsis/septic shock (adjusted OR 0.26, 95% CI, 0.08-0.88), after adjustment for potential
confounders. Among patients with body mass index <30 kg/m2, vitamin D sufficiency was statistically
significantly associated with a decreased odds of death (adjusted OR 0.18, 95% CI, 0.04-0.84). No significant association was found in the subgroups of patients aged <65 years or with body mass index 30
kg/m2.
Conclusion: We revealed an independent association between vitamin D sufficiency defined by serum
25(OH)D 30 ng/mL and decreased risk of mortality from COVID-19 in elderly patients and patients
without obesity.
© 2021 AACE. Published by Elsevier Inc. All rights reserved.
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