Bad Prognosis in Critical Ill Patients with COVID-19 during Short-Term ICU Stay regarding Vitamin D Levels
Herrera-Quintana et al.,
Bad Prognosis in Critical Ill Patients with COVID-19 during Short-Term ICU Stay regarding Vitamin D Levels,
Nutrients, doi:10.3390/nu13061988
Prospective analysis of 37 critical COVID-19 patients, showing mechanical ventilation associated with lower vitamin D levels.
Herrera-Quintana et al., 9 Jun 2021, prospective, Spain, peer-reviewed, 9 authors, study period 1 March, 2020 - 1 June, 2020.
Contact:
jorge.molina@ddi.uhu.es (corresponding author), lourdesherrera@ugr.es, jennifer_gamo@hotmail.com, hectorvazquez@ugr.es, jcastaoperez@yahoo.com, jmachc2@hotmail.com, ramon.coca.sspa@juntadeandalucia.es, josem.perez.villares.sspa@juntadeandalucia.es, elenamp@ugr.es.
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
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