Assessment of vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate cancer using electronic medical records
Galaznik et al.
, Assessment of vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate cancer using..
, Journal of Clinical Oncology, doi:10.1200/JCO.2021.39.15_suppl.6589 (Preprint)
Retrospective 16,287 breast cancer and 14,919 prostate cancer showing increased risk of COVID-19 cases with vitamin D deficiency.
risk of case, 35.1% lower, OR 0.65, p = 0.01, high D levels 13,903, low D levels 2,384, adjusted per study, inverted to make OR<1 favor high D levels, breast cancer patients, logistic regression, RR approximated with OR.
risk of case, 32.4% lower, OR 0.68, p = 0.045, high D levels 13,601, low D levels 1,318, adjusted per study, inverted to make OR<1 favor high D levels, prostate cancer patients, logistic regression, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Galaznik et al., 28 May 2021, retrospective, USA, preprint, 6 authors.
Abstract: Assessment of Vitamin D deficiency and COVID-19 diagnosis in patients with breast or
prostate cancer using Electronic Medical Records
Aaron Galaznik, MD MBA1 | Emelly Rusli, MPH1 | Vicki Wing, MS1 | Rahul Jain, PhD1 | Sheila Diamond, MS CGC1 | David Fajgenbaum, MD MBA MSc FCPP2
1 Medidata Acorn AI, a Dassault Systèmes company, New York, NY, 10014 | 2 Castleman Disease Collaborative Network and the University of Pennsylvania, Philadelphia, PA, 19104
While patients with cancer are known to be at increased risk
of infection in part due to the immunocompromising nature of
cancer treatments, recent data indicate a particularly high
risk for COVID-19 infection and poor outcomes. 1
Our study suggests
populations, such as breast
and prostate cancer
patients, may have an
elevated risk of
COVID-19 infection if
vitamin D deficient.
Vitamin D deficiency has been previously reported in two
leading causes of cancer deaths: breast and prostate. 4
In this study, we performed a retrospective cohort analysis on
nationally representative electronic medical records (EMR) to
assess whether vitamin D deficiency affects risk of COVID19 among these patients.
Vitamin D may play an important role in COVID-19. A recent
study demonstrated vitamin D deficiency may increase risk of
COVID-19 infection, and a small randomized controlled trial
in Spain reported significant improvement in mortality among
hospitalized patients treated with calcifediol. 2,3
Figure 1. Study Timeline
A total of 16,287 breast cancer and 14,919 prostate cancer patients were included in the study. (Figure 2)
Table 1. Patient Demographic and Clinical Characteristics
TOTAL (N = 16,287)
<70 years (n, %)
70-79 years (n, %)
80+ years (n, %)
Congestive heart failure (n, %)
Obesity (n, %)
Diabetes mellitus (n, %)
Age (Mean, SD)
Sex (n, %)
Race (n, %)
Native Hawaiian/Pacific Islander
American Indian or Alaska Native
Vitamin D deficient (n, %)
Quan Charlson Comorbidity Index (Mean, SD)
Liver disease (n, %)
Figure 2. Patient Attrition
Patient with ≥ 1 encounter
between 3/1/2018 and
3/1/2019, and after 3/1/2020
Age ≥ 18 and non-missing sex
n = 1,630,384 (52.8%)
Patients with breast (female) or prostate (male) cancer
were identified between 3/1/2018 and 3/1/2020 from
Healthjump EMR data provided pro-bono by the COVID-19
Logistic regressions, adjusted for baseline demographic
and clinical characteristics assessed in the 12 months prior
to 3/1/2020, were conducted to estimate the effect of
The average age was 68.9 years in the breast cancer cohort
and 73.6 years in the prostate cancer cohort.
Approximately 15% of the breast cancer cohort and 9% of
the prostate cancer cohort had vitamin D deficiency.
The most common comorbid conditions were obesity
(approximately a third..
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.