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0 0.5 1 1.5 2+ Mortality 42% Improvement Relative Risk Mortality (b) 51% Severe case 38% Severe case (b) 35% Vitamin D for COVID-19  Fatemi et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Prospective study of 248 patients in Iran (October 2020 - May 2021) Lower severe cases with higher vitamin D levels (p=0.0072) Fatemi et al., Acute and Critical Care, Nov 2021 Favors vitamin D Favors control

Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study

Fatemi et al., Acute and Critical Care, doi:10.4266/acc.2021.00605
Nov 2021  
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Prospective study of 248 hospitalized COVID+ patients in Iran with vitamin D levels measured in the previous year and again at admission, showing vitamin D status associated with severity and mortality.
This is the 109th of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion).
risk of death, 42.0% lower, RR 0.58, p = 0.07, high D levels 18 of 139 (12.9%), low D levels 25 of 109 (22.9%), NNT 10, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, vitamin D measured prior to COVID-19, multivariate.
risk of death, 51.1% lower, RR 0.49, p = 0.02, high D levels 13 of 115 (11.3%), low D levels 30 of 133 (22.6%), NNT 8.9, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, vitamin D measured on admission, multivariate.
risk of severe case, 37.9% lower, RR 0.62, p = 0.007, high D levels 38 of 139 (27.3%), low D levels 48 of 109 (44.0%), NNT 6.0, vitamin D measured prior to COVID-19.
risk of severe case, 34.8% lower, RR 0.65, p = 0.02, high D levels 31 of 115 (27.0%), low D levels 55 of 133 (41.4%), NNT 6.9, vitamin D measured on admission.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Fatemi et al., 30 Nov 2021, prospective, Iran, peer-reviewed, 5 authors, study period 1 October, 2020 - 31 May, 2021.
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Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study
Alireza Fatemi, Seyed Hossein Ardehali, Ghazaleh Eslamian, Morvarid Noormohammadi, Shirin Malek
Acute and Critical Care, doi:10.4266/acc.2021.00605
Background: As the coronavirus disease 2019 (COVID-19) pandemic continues to escalate, it is important to identify the prognostic factors related to increased mortality and disease severity. To assess the possible associations of vitamin D level with disease severity and survival, we studied 248 hospitalized COVID-19 patients in a single center in a prospective observational study from October 2020 to May 2021 in Tehran, Iran. Methods: Patients who had a record of their 25-hydroxyvitamin D level measured in the previous year before testing positive with COVID-19 were included. Serum 25-hydroxyvitamin D level was measured upon admission in COVID-19 patients. The associations between clinical outcomes of patients and 25-hydroxyvitamin D level were assessed by adjusting for potential confounders and estimating a multivariate logistic regression model. Results: The median (interquartile range) age of patients was 60 years (44-74 years), and 53% were male. The median serum 25-hydroxyvitamin D level prior to admission decreased with increasing COVID-19 severity (P=0.009). Similar findings were obtained when comparing median serum 25-hydroxyvitamin D on admission between moderate and severe patients (P=0.014). A univariate logistic regression model showed that vitamin D deficiency prior to COVID-19 was associated with a significant increase in the odds of mortality (odds ratio, 2.01; P=0.041). The multivariate Cox model showed that vitamin D deficiency on admission was associated with a significant increase in risk for mortality (hazard ratio, 2.35; P=0.019). Conclusions: Based on our results, it is likely that deficient vitamin D status is associated with increased mortality in COVID-19 patients. Thus, evaluating vitamin D level in COVID-19 patients is warranted.
CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported. AUTHOR CONTRIBUTIONS Conceptualization: AF, SHA, GE. Data curation: GE, SM. Formal analysis: SHA, GE, MN. Funding acquisition: AF, SHA, GE, MN. Methodology: AF, SHA, GE, SM. Project administration: GE. Visualization: AF, MN. Writing-original draft: AF, SHA, GE. Writing-review & editing: all authors.
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