Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness

DOI record: { "DOI": "10.1371/journal.pone.0263069", "ISSN": [ "1932-6203" ], "URL": "http://dx.doi.org/10.1371/journal.pone.0263069", "abstract": "<jats:sec id=\"sec001\">\n<jats:title>Objective</jats:title>\n<jats:p>Studies have demonstrated a potential correlation between low vitamin D status and both an increased risk of infection with SARS-CoV-2 and poorer clinical outcomes. This retrospective study examines if, and to what degree, a relationship exists between pre-infection serum 25-hydroxyvitamin D (25(OH)D) level and disease severity and mortality due to SARS-CoV-2.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Participants</jats:title>\n<jats:p>The records of individuals admitted between April 7<jats:sup>th</jats:sup>, 2020 and February 4<jats:sup>th</jats:sup>, 2021 to the Galilee Medical Center (GMC) in Nahariya, Israel, with positive polymerase chain reaction (PCR) tests for SARS-CoV-2 (COVID-19) were searched for historical 25(OH)D levels measured 14 to 730 days prior to the positive PCR test.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Design</jats:title>\n<jats:p>Patients admitted to GMC with COVID-19 were categorized according to disease severity and level of 25(OH)D. An association between pre-infection 25(OH)D levels, divided between four categories (deficient, insufficient, adequate, and high-normal), and COVID-19 severity was ascertained utilizing a multivariable regression analysis. To isolate the possible influence of the sinusoidal pattern of seasonal 25(OH)D changes throughout the year, a cosinor model was used.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results</jats:title>\n<jats:p>Of 1176 patients admitted, 253 had records of a 25(OH)D level prior to COVID-19 infection. A lower vitamin D status was more common in patients with the severe or critical disease (&lt;20 ng/mL [87.4%]) than in individuals with mild or moderate disease (&lt;20 ng/mL [34.3%] <jats:italic>p</jats:italic> &lt; 0.001). Patients with vitamin D deficiency (&lt;20 ng/mL) were 14 times more likely to have severe or critical disease than patients with 25(OH)D ≥40 ng/mL (odds ratio [OR], 14; 95% confidence interval [CI], 4 to 51; <jats:italic>p</jats:italic> &lt; 0.001).</jats:p>\n</jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions</jats:title>\n<jats:p>Among hospitalized COVID-19 patients, pre-infection deficiency of vitamin D was associated with increased disease severity and mortality.</jats:p>\n</jats:sec>", "author": [ { "ORCID": "http://orcid.org/0000-0002-7178-6771", "affiliation": [], "authenticated-orcid": true, "family": "Dror", "given": "Amiel A.", "sequence": "first" }, { "ORCID": "http://orcid.org/0000-0001-6869-8626", "affiliation": [], "authenticated-orcid": true, "family": "Morozov", "given": "Nicole", "sequence": "additional" }, { "affiliation": [], "family": "Daoud", "given": "Amani", "sequence": "additional" }, { "affiliation": [], "family": "Namir", "given": "Yoav", "sequence": "additional" }, { "affiliation": [], "family": "Yakir", "given": "Orly", "sequence": "additional" }, { "affiliation": [], "family": "Shachar", "given": "Yair", "sequence": "additional" }, { "affiliation": [], "family": "Lifshitz", "given": "Mark", "sequence": "additional" }, { "affiliation": [], "family": "Segal", "given": "Ella", "sequence": "additional" }, { "affiliation": [], "family": "Fisher", "given": "Lior", "sequence": "additional" }, { "affiliation": [], "family": "Mizrachi", "given": "Matti", "sequence": "additional" }, { "affiliation": [], "family": "Eisenbach", "given": "Netanel", "sequence": "additional" }, { "affiliation": [], "family": "Rayan", "given": "Doaa", "sequence": "additional" }, { "affiliation": [], "family": "Gruber", "given": "Maayan", "sequence": "additional" }, { "affiliation": [], "family": "Bashkin", "given": "Amir", "sequence": "additional" }, { "affiliation": [], "family": "Kaykov", "given": "Edward", "sequence": "additional" }, { "affiliation": [], "family": "Barhoum", "given": "Masad", "sequence": "additional" }, { "affiliation": [], "family": "Edelstein", "given": "Michael", "sequence": "additional" }, { "affiliation": [], "family": "Sela", "given": "Eyal", "sequence": "additional" } ], "container-title": "PLOS ONE", "container-title-short": "PLoS ONE", "content-domain": { "crossmark-restriction": false, "domain": [ "www.plosone.org" ] }, "created": { "date-parts": [ [ 2022, 2, 3 ] ], "date-time": "2022-02-03T18:54:53Z", "timestamp": 1643914493000 }, "deposited": { "date-parts": [ [ 2022, 2, 3 ] ], "date-time": "2022-02-03T18:55:25Z", "timestamp": 1643914525000 }, "editor": [ { "affiliation": [], "family": "Jin", "given": "Dong-Yan", "sequence": "first" } ], "indexed": { "date-parts": [ [ 2024, 3, 31 ] ], "date-time": "2024-03-31T18:58:30Z", "timestamp": 1711911510781 }, "is-referenced-by-count": 62, "issue": "2", "issued": { "date-parts": [ [ 2022, 2, 3 ] ] }, "journal-issue": { "issue": "2", 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