Abstract: nutrients Article Bad Prognosis in Critical Ill Patients with COVID-19 during Short-Term ICU Stay regarding Vitamin D Levels Lourdes Herrera-Quintana 1 , Yenifer Gamarra-Morales 1 , Héctor Vázquez-Lorente 1 , Jorge Molina-López 2, * , José Castaño-Pérez 3 , Juan Francisco Machado-Casas 3 , Ramón Coca-Zúñiga 3 , José Miguel Pérez-Villares 3 and Elena Planells 1, * 1 2 3 *



 Citation: Herrera-Quintana, L.; Gamarra-Morales, Y.; Vázquez-Lorente, H.; Molina-López, J.; Castaño-Pérez, J.; Machado-Casas, J.F.; Coca-Zúñiga, R.; Pérez-Villares, J.M.; Planells, E. Bad Prognosis in Critical Ill Patients with COVID-19 during Short-Term ICU Stay regarding Vitamin D Levels. Nutrients 2021, 13, 1988. https://doi.org/10.3390/nu13061988 Academic Editors: Dimitrios T. Karayiannis and Zafeiria Mastora Received: 4 May 2021 Accepted: 5 June 2021 Department of Physiology, Institute of Nutrition and Food Technology “Jose Mataix”, School of Pharmacy, University of Granada, 18071 Granada, Spain; lourdesherrera@ugr.es (L.H.-Q.); jennifer_gamo@hotmail.com (Y.G.-M.); hectorvazquez@ugr.es (H.V.-L.) Faculty of Education, Psychology and Sports Sciences, University of Huelva, 21007 Huelva, Spain Intensive Care Unit, Virgen de las Nieves Hospital, Fuerzas Armadas Avenue, 18014 Granada, Spain; jcastaoperez@yahoo.com (J.C.-P.); jmachc2@hotmail.com (J.F.M.-C.); ramon.coca.sspa@juntadeandalucia.es (R.C.-Z.); josem.perez.villares.sspa@juntadeandalucia.es (J.M.P.-V.) Correspondence: jorge.molina@ddi.uhu.es (J.M.-L.); elenamp@ugr.es (E.P.) Abstract: Background and aims: Vitamin D inadequacy may be involved in the mechanisms of SARS-CoV-2 infection and in potential risk factors for disease propagation or control of coronavirus disease 2019 (COVID-19). This study assessed a short-term evolution of vitamin D status and its influence upon different clinical parameters in critically ill patients with COVID-19. Methods: A prospective analytical study in which 37 critically ill volunteers between 41 and 71 years of age with COVID-19 were evaluated at baseline and three days of intensive care unit (ICU) stay. 25-OH-D3 and 25-OH-D2 were analyzed by liquid chromatography–tandem mass spectrometry and total 25-OH-D levels were calculated as the sum of both. Results: All patients presented low 25-OH-D levels at baseline, decreasing total 25-OH-D (p = 0.011) mainly through 25-OH-D2 (p = 0.006) levels during ICU stay. 25-OH-D2 levels decreased a mean of 41.6% ± 89.6% versus 7.0% ± 23.4% for the 25-OH-D3 form during the ICU stay. Patients who did not need invasive mechanical ventilation presented higher levels of 25-OH-D2 at baseline and follow-up. Lower 25-OH-D and 25-OH-D3 levels were associated with higher D-dimer at baseline (p = 0.003; p = 0.001) and at follow up (p = 0.029), higher procalcitonin levels (p = 0.002; p = 0.018) at follow up, and lower percentage lymphocyte counts (p = 0.044; p = 0.040) during ICU stay. Conclusions: Deficient vitamin D status in critical patients was established at the admission and further worsened after three days of stay. Lower vitamin D levels were related to key altered clinical and biochemical parameters on patients with SARS-CoV-2 infection. Given the different response of the 25-OH-D3 and 25-OH-D2 forms, it would be useful to monitor them on the evolution of the critically ill patient. Published: 9 June 2021 Keywords: coronavirus disease 2019; SARS-CoV-2; Vitamin D; critical care; intensive care patient Publisher’s Note:..