The relationship between 25(OH) vitamin D levels and COVID-19 onset and disease course in Spanish patients
, The relationship between 25(OH) vitamin D levels and COVID-19 onset and disease course in Spanish patients
, , Journal of Steroid Biochemistry and Molecular Biology, doi:10.1016/j.jsbmb.2021.105928
Retrospective 1,549 patients in Spain showing that the frequency of vitamin D deficiency was higher in admitted patients compared to the overall Spanish population, and that vitamin D deficiency was associated with increased risk of ICU admission amongst admitted patients. Adjusted vitamin D levels were lower in deceased patients, but statistical significance was not reached (authors provide only average levels, they do not provide mortality analysis based on deficiency).
risk of ICU admission, 73.2% lower, RR 0.27, p = 0.02, high D levels 3 of 214 (1.4%), low D levels 91 of 1,017 (8.9%), odds ratio converted to relative risk, >30ng/mL vs. <20ng/mL.
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Diaz-Curiel et al., 6 Jun 2021, retrospective, Spain, peer-reviewed, 8 authors.
Abstract: Journal of Steroid Biochemistry and Molecular Biology 212 (2021) 105928
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journal homepage: www.elsevier.com/locate/jsbmb
The relationship between 25(OH) vitamin D levels and COVID-19 onset and
disease course in Spanish patients
Manuel Diaz-Curiel a, *, Alfonso Cabello b, Rosa Arboiro-Pinel a, Jose Luis Mansur c,
Sarah Heili-Frades d, Ignacio Mahillo-Fernandez e, Antonio Herrero-González f,
Marjorie Andrade-Poveda a
Department of Internal Medicine, Metabolic Bone Diseases, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Spain
Department of Internal Medicine, Infectious Diseases Division, Hospital Universitario Fundación Jiménez Díaz, Spain
Centro de Endocrinología y Osteoporosis, La Plata, Buenos Aires, Argentina
Lung Diseases Department, Hospital Universitario Fundación Jiménez Díaz, Spain
Epidemiology and Biostatistics Department, Hospital Universitario Fundación Jiménez Díaz, Spain
Department of Big Data Analytics, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD, UAM), Spain
A R T I C L E I N F O
A B S T R A C T
Intensive care unit (ICU)
Objective: Currently, there are no definitive data on the relationship between low levels of vitamin D in the blood
and a more severe disease course, in terms of the need for hospital admission, intensive care unit (ICU) stay, and
mortality, in patients with coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2).
We aimed to study the association between levels of circulating 25-hydroxyvitamin D (25(OH)D) and adverse
clinical outcomes linked to SARS-CoV-2 infection.
We further aimed to observe the incidence of low, below-average, and normal levels of 25(OH)D in patients
hospitalized for COVID-19 between March 12, 2020, and May 20, 2020, and assess whether these values differed
between these patients and a normal population. Finally, we determined whether the need for transfer to the
intensive care unit (ICU) and the mortality rate were related to low levels of 25(OH)D.
Study Design: Retrospective observational study.
Setting: Quironsalud Hospitals in Madrid, Spain.
Participants: We analyzed 1549 patients (mean age, 70 years; range, 21–104 years); 835 were male (53.9 %; mean
age, 73.02 years), and 714 were female (46.1 %; mean age, 68.05 years).
Subsequently, infected patients admitted to the ICU (n = 112) and those with a fatal outcome (n = 324) were
Procedures: Serum concentrations of 25(OH)D were measured by electrochemiluminescence.
Results: More hospitalized patients (66 %, n = 1017) had low baseline levels of 25(OH)D (<20 ng/mL) than
normal individuals (45 %) (p < 0.001).
An analysis by age group revealed that COVID-19 patients between the ages of 20 and 80 years old had
significantly lower vitamin D levels than those of the normal population (p < 0.001).
Patients admitted to the ICU tended to have lower levels of 25(OH)D than other inpatients (p < 0.001); if we
stratified patients by 25(OH)D levels, we observed that the rate of ICU admission was higher among patients with
vitamin D deficiency (p < 0.001), indicating that higher vitamin D levels are associated with a lower risk of ICU
admission due to COVID-19.
ICU admission was related to sex (higher rates in men, p < 0.001) and age (p <..
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