Low vitamin D levels are associated with Long COVID syndrome in COVID-19 survivors
Luigi Di Filippo, Stefano Frara, Fabrizio Nannipieri, Alice Cotellessa, Massimo Locatelli, Patrizia Rovere Querini, Andrea Giustina, Prof Andrea Giustina, Pharma S P A Andrea Giustina
doi:10.1210/clinem/dgad207/7116659
Purpose: Long-COVID is an emerging syndrome affecting 50-70% of COVID-19 survivors which still lacks predicting factors. Due to the extra-skeletal effects of vitamin D, we retrospectively assessed in COVID-19 survivors 6-months after hospitalization the association between 25(OH)vitamin D levels and Long-COVID. Methods: Long-COVID was defined according to NICE-guidelines. Fifty Long-COVID and 50 non-Long-COVID subjects matched on a 1:1-basis were enrolled from an outpatient-post-COVID clinic-cohort seen from August to November 2020. Therapies/comorbidities affecting calcium/vitamin-D/bone metabolism, and/or admission in ICU during hospitalization were exclusion criteria. 25(OH)vitamin D was measured at hospital-admission and 6-months after discharge.
Results: We observed lower 25(OH)vitamin D levels, evaluated at follow-up, in subjects with Long-COVID than those without (20.1vs23.2 ng/mL-p=0.03). Regarding the affected health-areas evaluated in the entire cohort, we observed lower 25(OH)vitamin D levels in those with neurocognitive symptoms at follow-up (n.7) as compared to those without (n.93) (14.6vs20.6 ng/mL-p=0.042). In patients presenting vitamin D deficiency (<20 ng/mL) both at admission and at follow-up (n.42), those affected by Long-COVID (n.22) presented lower 25(OH)vitamin D levels, at follow-up, compared to those not affected (n.20) (12.7vs15.2 ng/mL-p=0.041). In multiple-regression analyses, lower 25(OH)vitamin D levels, at follow-up, resulted as the only variable significantly associated with Long-COVID in our cohort (p=0.008, OR 1.09-CI 1.01-1.16).
Conclusions : COVID-19 survivors with Long-COVID have lower 25(OH)vitamin D levels as compared to matched-patients without Long-COVID. Our data suggest that vitamin D levels should be evaluated in COVID-19 patients after hospital-discharge. Role of vitamin D supplementation as preventive strategy of COVID-19 sequelae should be tested in randomized-controlled trials.
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'abstract': '<jats:title>Abstract</jats:title>\n'
' <jats:sec>\n'
' <jats:title>Purpose</jats:title>\n'
' <jats:p>Long-COVID is an emerging syndrome affecting 50-70% of COVID-19 '
'survivors which still lacks predicting factors. Due to the extra-skeletal effects of vitamin '
'D, we retrospectively assessed in COVID-19 survivors 6-months after hospitalization the '
'association between 25(OH)vitamin D levels and Long-COVID.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Methods</jats:title>\n'
' <jats:p>Long-COVID was defined according to NICE-guidelines. Fifty '
'Long-COVID and 50 non-Long-COVID subjects matched on a 1:1-basis were enrolled from an '
'outpatient-post-COVID clinic-cohort seen from August to November 2020. '
'Therapies/comorbidities affecting calcium/vitamin-D/bone metabolism, and/or admission in ICU '
'during hospitalization were exclusion criteria. 25(OH)vitamin D was measured at '
'hospital-admission and 6-months after discharge.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>We observed lower 25(OH)vitamin D levels, evaluated at follow-up, '
'in subjects with Long-COVID than those without (20.1vs23.2\u2005ng/mL-p\u2009=\u20090.03). '
'Regarding the affected health-areas evaluated in the entire cohort, we observed lower '
'25(OH)vitamin D levels in those with neurocognitive symptoms at follow-up (n.7) as compared '
'to those without (n.93) (14.6vs20.6\u2005ng/mL-p\u2009=\u20090.042). In patients presenting '
'vitamin D deficiency (&lt;20\u2005ng/mL) both at admission and at follow-up (n.42), those '
'affected by Long-COVID (n.22) presented lower 25(OH)vitamin D levels, at follow-up, compared '
'to those not affected (n.20) (12.7vs15.2\u2005ng/mL-p\u2009=\u20090.041). In '
'multiple-regression analyses, lower 25(OH)vitamin D levels, at follow-up, resulted as the '
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'1.09-CI 1.01-1.16).</jats:p>\n'
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' <jats:sec>\n'
' <jats:title>Conclusions</jats:title>\n'
' <jats:p>COVID-19 survivors with Long-COVID have lower 25(OH)vitamin D '
'levels as compared to matched-patients without Long-COVID. Our data suggest that vitamin D '
'levels should be evaluated in COVID-19 patients after hospital-discharge. Role of vitamin D '
'supplementation as preventive strategy of COVID-19 sequelae should be tested in '
'randomized-controlled trials.</jats:p>\n'
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