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.
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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.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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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
doi:10.1210/clinem/dgab439
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
1
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.
Abstract
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
e4708 https://academic.oup.com/jcem
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.
For permissions, please e-mail: journals.permissions@oup.com
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
e4709
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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