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0 0.5 1 1.5 2+ Mortality -12% Improvement Relative Risk Ventilation 16% ICU admission 28% Severe case -68% Vitamin D for COVID-19  Davoudi et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 153 patients in Iran (February - March 2020) Higher severe cases with higher vitamin D levels (not stat. sig., p=0.3) Davoudi et al., BMC Infectious Diseases, May 2021 Favors vitamin D Favors control

Lack of association between vitamin D insufficiency and clinical outcomes of patients with COVID-19 infection

Davoudi et al., BMC Infectious Diseases, doi:10.1186/s12879-021-06168-7
May 2021  
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Retrospective 153 hospitalized patients in Iran, showing no significant difference in outcomes based on vitamin D levels. Adjusted results are only provided for vitamin D as a continuous variable.
This is the 64th of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion). This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups.
risk of death, 12.3% higher, RR 1.12, p = 1.00, high D levels (≥30ng/mL) 2 of 57 (3.5%), low D levels (<30ng/mL) 3 of 96 (3.1%).
risk of mechanical ventilation, 15.8% lower, RR 0.84, p = 1.00, high D levels (≥30ng/mL) 1 of 57 (1.8%), low D levels (<30ng/mL) 2 of 96 (2.1%), NNT 304.
risk of ICU admission, 27.8% lower, RR 0.72, p = 0.74, high D levels (≥30ng/mL) 3 of 57 (5.3%), low D levels (<30ng/mL) 7 of 96 (7.3%), NNT 49.
risk of severe case, 68.4% higher, RR 1.68, p = 0.30, high D levels (≥30ng/mL) 9 of 57 (15.8%), low D levels (<30ng/mL) 9 of 96 (9.4%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Davoudi et al., 18 May 2021, retrospective, Iran, peer-reviewed, 11 authors, study period February 2020 - March 2020.
Contact: (corresponding author).
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Lack of association between vitamin D insufficiency and clinical outcomes of patients with COVID-19 infection
Alireza Davoudi, Narges Najafi, Mohsen Aarabi, Atefeh Tayebi, Roja Nikaeen, Hamideh Izadyar, Zahra Salar, Leila Delavarian, Narges Vaseghi, Zahra Daftarian, Fatemeh Ahangarkani
BMC Infectious Diseases, doi:10.1186/s12879-021-06168-7
Background: A protective effect of vitamin D against COVID-19 infection is under investigation. We aimed to analyze the effect of vitamin D sufficiency on the clinical outcomes of patients infected with COVID-19. Methods: In this cross-sectional study we analyzed the vitamin D levels of COVID-19 patients who were admitted to Razi Hospital (an infectious disease referral center in Mazandaran province in northern Iran) from February to March 2020. Overall, a cutoff point of 30 ng/mL was used for the definition of vitamin D sufficiency. Results: One hundred fifty-three patients were analyzed in this study who had laboratory documentation of a 25(OH) D level at the time of hospitalization. The vitamin D levels of the patients were 27.19 ± 20.17 ng/mL. In total, 62.7% (n = 96) of the patients had a 25(OH) D level of less than 30 ng/mL and 37.25% (n = 57) had a 25(OH) D level of more than 30 ng/mL. In total, 49% (n = 75) of the patients suffered from at least one underlying disease. The univariate and multivariable regression showed that vitamin D sufficiency was not associated with a statistically significant lower risk of adverse clinical outcomes of COVID-19 such as duration of hospitalization and severity of infection (P > 0.05). Conclusions: Sufficient vitamin D levels were not found to be protective against adverse clinical outcomes in patients infected with COVID-19. Chronic disorders in COVID-19 patients were found to have greater relevance than vitamin D levels in determining the adverse outcomes of the infection. Further studies are needed to determine the role of vitamin D level in predicting the outcomes of COVID-19 infection.
Authors' contributions AD, NN and FA designed the project, collected data, wrote and performed the critical review of the manuscript. MA, AT, HI, ZS, LD, RN, NV and ZD contributed to clinical data collection. MA and RN carried out statistical interpretation. All authors read and approved the final manuscript. Declarations Ethics approval and consent to participate This study was approved by the Ethics Committee of Ramsar international branch of Mazandaran University of Medical Sciences with code: IR.MAZUMS.RIB.REC.1399.019. In addition, written informed consent was obtained from all subjects or, for subjects under the age of 18, from a parent and/or legal guardian. In this study all applied methods were carried out in accordance with relevant guidelines and regulations. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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