Vitamin D deficiency is associated with higher hospitalisation risk from COVID-19: a retrospective case-control study
Jude et al.
, Vitamin D deficiency is associated with higher hospitalisation risk from COVID-19: a retrospective..
, Journal of Clinical Endocrinology & Metabolism, doi:10.1210/clinem/dgab439
Retrospective 80,670 people in the UK with vitamin D levels measured within the last 12 months, showing higher risk of hospitalization with low vitamin D levels.
risk of hospitalization, 71.6% lower, RR 0.28, p < 0.001, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >25 nmol/L, control prevalence approximated with overall prevalence.
risk of hospitalization, 57.9% lower, RR 0.42, p < 0.001, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >50 nmol/L, control prevalence approximated with overall prevalence.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Jude et al., 17 Jun 2021, retrospective, United Kingdom, peer-reviewed, 5 authors.
Abstract: The Journal of Clinical Endocrinology & Metabolism, 2021, Vol. 106, No. 11, e4708–e4715
Clinical Research Article
Clinical Research Article
Edward B. Jude,1,2,3 Stephanie F. Ling,1,2 Rebecca Allcock,4 Beverly X. Y. Yeap,2
and Joseph M. Pappachan2,3,4
Tameside and Glossop Integrated Care NHS Foundation Trust, Fountain Street, Ashton-under-Lyne,
OL6 9RW, UK; 2The University of Manchester, Oxford Road, Manchester, M13 9PL, UK; 3Manchester
Metropolitan University, All Saints Building, Manchester, M15 6BH, UK; and 4Royal Preston Hospital,
Lancashire Teaching Hospitals NHS Foundation Trust, Sharoe Green Lane, Fulwood, Preston, PR2 9HT, UK
ORCiD numbers: 0000-0002-3186-4122 (E. B. Jude); 0000-0003-0886-5255 (J. M. Pappachan).
Abbreviations: 25(OH)D, 25-hydroxyvitamin D; IQR, interquartile range; NICE, National Institute for Health and Clinical Care
Excellence; OR, odds ratio; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Received: 2 April 2021; Editorial Decision: 11 June 2021; First Published Online: 17 June 2021; Corrected and Typeset:
15 July 2021.
Context: One risk factor for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection is postulated to be vitamin D deficiency. To better understand the role
of vitamin D deficiency in the disease course of COVID-19, we undertook a retrospective
case-control study in North West England.
Objective: To examine whether hospitalization with COVID-19 is more prevalent in
individuals with lower vitamin D levels.
Methods: The study included individuals with test results for serum 25-hydroxyvitamin
D (25[OH]D) between April 1, 2020, and January 29, 2021, from 2 districts in North West
England. The last 25(OH)D level in the previous 12 months was categorized as “deficient”
if less than 25 nmol/L and “insufficient” if 25 to 50 nmol/L.
Results: The study included 80 670 participants. Of these, 1808 were admitted to the
hospital with COVID-19, of whom 670 died. In a primary cohort, median serum 25(OH)D
in nonhospitalized participants with COVID-19 was 50.0 nmol/L (interquartile range [IQR],
34.0-66.7) vs 35.0 nmol/L (IQR, 21.0-57.0) in those admitted with COVID-19 (P < 0.005).
In a validation cohort, median serum 25(OH)D was 47.1 nmol/L (IQR, 31.8-64.7) in
nonhospitalized vs 33.0 nmol/L (IQR, 19.4-54.1) in hospitalized patients. Age-, sex-, and
season-adjusted odds ratios for hospital admission were 2.3 to 2.4 times higher among
participants with serum 25(OH)D <50 nmol/L compared with those with normal serum
25(OH)D levels, without excess mortality risk.
ISSN Print 0021-972X
ISSN Online 1945-7197
Printed in USA
© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved.
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Vitamin D Deficiency Is Associated With
Higher Hospitalization Risk From COVID-19:
A Retrospective Case-Control Study
The Journal of Clinical Endocrinology & Metabolism, 2021, Vol. 106, No. 11
Conclusion: Vitamin D deficiency is associated with higher risk of COVID-19 hospitalization.
Widespread measurement of serum 25(OH)D and treatment of insufficiency or deficiency
may reduce this risk.
Key Words: vitamin D deficiency, COVID-19, hospitalization, severe acute respiratory syndrome coronavirus..
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