Vitamin D levels associate with blood glucose and BMI in COVID-19 patients predicting disease severity
di Filippo,
Vitamin D levels associate with blood glucose and BMI in COVID-19 patients predicting disease severity,
et al, The Journal of Clinical Endocrinology & Metabolism, doi:10.1210/clinem/dgab599
Retrospective 88 patients in Italy, showing vitamin D deficiency associated with severe cases, blood glucose, and BMI.
risk of death, 10.7% lower, RR 0.89, p = 1.00, high D levels 5 of 28 (17.9%), low D levels 12 of 60 (20.0%), NNT 47, >20ng/mL.
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risk of ICU admission, 41.6% lower, RR 0.58, p = 0.22, high D levels 6 of 28 (21.4%), low D levels 22 of 60 (36.7%), NNT 6.6, >20ng/mL.
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risk of severe case, 39.6% lower, RR 0.60, p = 0.04, high D levels 11 of 28 (39.3%), low D levels 39 of 60 (65.0%), NNT 3.9, >20ng/mL.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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di Filippo et al., 12 Aug 2021, retrospective, Italy, peer-reviewed, 8 authors.
Abstract: Vitamin D levels associate with blood glucose and BMI in COVID-19 patients
predicting disease severity
MD, Massimo Locatelli2, MD, Patrizia Rovere Querini3, Professor, Stefano Frara1, MD,
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Andrea Giustina1, Professor
Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS
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San Raffaele Hospital, Milan, Italy
Laboratory Medicine Service, IRCCS San Raffaele Hospital, Milan, Italy
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Vita-Salute San Raffaele University and Division of Transplantation, Immunology and
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Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy
Correspondence: Prof. Andrea Giustina, Division of Endocrinology, IRCCS San Raffaele
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Hospital, via Olgettina 60, 20132 Milano, Italy; giustina.andrea@hsr.it
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Authors’ contributions: All authors contributed equally.
Declarations: no funding supports.
Disclosure Statement: The authors have nothing to disclose.
The Work submitted for publication is original and has not been published in any language or
format and has not been submitted elsewhere for print or electronic publication consideration.
© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All
rights reserved. For permissions, please e-mail: journals.permissions@oup.com
Luigi di Filippo1, MD, Agnese Allora1, MD, Mauro Doga1, MD, Anna Maria Formenti1,
Abstract
Context: High prevalence of Vitamin-D (VD) deficiency in COVID-19 patients was reported
and inflammatory responses. Furthermore, clear associations between hypovitaminosis-D and
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fat body-mass excess and diabetes, factors associated with COVID-19 severity, have been
widely recognized.
Objective: The aim of this study was to evaluate in COVID-19 patients the relationship
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between VD levels and inflammatory response, BMI, blood glucose and disease severity.
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Design: Patients admitted to San Raffaele-Hospital for COVID-19 were enrolled in this
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study, excluding those with comorbidities and therapies influencing VD-metabolism.
25(OH)VD levels, plasma glucose levels, BMI and inflammatory parameters were evaluated
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at admission.
Results: A total of 88 patients were included. Median VD level was 16.3 ng/mL and VDdeficiency was found in 68.2% of patients. VD-deficiency was found more frequently in male
patients and in those affected by severe COVID-19. Regression analyses showed a positive
correlation between VD and PaO2/FiO2 ratio, and negative correlations between VD and
plasma glucose, BMI, Neutrophil/Lymphocyte ratio, CRP and IL-6.
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and hypothesized to increase COVID-19 severity likely due to its negative impact on immune
Patients with both hypovitaminosis-D and diabetes mellitus, as well those with
hypovitaminosis-D and overweight, were more frequently affected by a severe disease with
worse inflammatory response and respiratory parameters, compared to those without or just
one of these conditions.
Conclusions: We showed, for the first-time, a strict association of VD levels with blood
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glucose and BMI in COVID-19 patients. VD-deficiency might be a novel..
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