Vitamin D Deficiency Is Associated With Higher Hospitalization Risk From COVID-19: A Retrospective Case-control Study
Edward B Jude, Stephanie F Ling, Rebecca Allcock, Beverly X Y Yeap, Joseph M Pappachan
The Journal of Clinical Endocrinology & Metabolism, doi:10.1210/clinem/dgab439
Context: One risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-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.
Abbreviations: 25(OH)D, 25-hydroxyvitamin D; IQR, interquartile range.
Additional Information Correspondence: Professor Edward Jude, MD, DNB, MRCP, Tameside and Glossop Integrated Care NHS Foundation Trust, Fountain Street, Ashton-under-Lyne, OL6 9RW, UK. Email: Edward. jude@tgh.nhs.uk. Disclosures: None to declare in relation to this work. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Data Availability: Full data of this research work is available with the corresponding author and can be viewed by interested parties on request.
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'abstract': '<jats:title>Abstract</jats:title>\n'
' <jats:sec>\n'
' <jats:title>Context</jats:title>\n'
' <jats:p>One risk factor for severe acute respiratory syndrome coronavirus 2 '
'(SARS-CoV-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.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Objective</jats:title>\n'
' <jats:p>To examine whether hospitalization with COVID-19 is more prevalent '
'in individuals with lower vitamin D levels.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Methods</jats:title>\n'
' <jats:p>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.</jats:p>\n'
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' <jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>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\u2005'
'&lt;\u20050.005). 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-, '
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'deficiency may reduce this risk.</jats:p>\n'
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