Low 25(OH)D Level Is Associated with Severe Course and Poor Prognosis in COVID-19

Karonova et al., Nutrients, doi:10.3390/nu13093021

Aug 2021

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Retrospective 161 hospitalized patients in Russia, showing COVID-19 severity and mortality associated with vitamin D deficiency. Patients in this study may overlap with those in an earlier smaller study from some of the same authors.

This is the 94th of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion).

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risk of death, 77.8% lower, RR 0.22, p = 0.006, high D levels 8 of 96 (8.3%), low D levels 10 of 37 (27.0%), NNT 5.3, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >10ng/mL, logistic regression model 2.

risk of death, 84.8% lower, RR 0.15, p = 0.06, high D levels 1 of 43 (2.3%), low D levels 17 of 90 (18.9%), NNT 6.0, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >20ng/mL, logistic regression model 2.

risk of severe case, 67.3% lower, RR 0.33, p = 0.005, high D levels 12 of 96 (12.5%), low D levels 13 of 37 (35.1%), NNT 4.4, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >10ng/mL, logistic regression model 2.

risk of severe case, 53.2% lower, RR 0.47, p = 0.13, high D levels 4 of 43 (9.3%), low D levels 21 of 90 (23.3%), NNT 7.1, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >20ng/mL, logistic regression model 2.

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Karonova et al., 29 Aug 2021, retrospective, Russia, peer-reviewed, 8 authors, study period April 2020 - December 2020.

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Low 25(OH)D Level Is Associated with Severe Course and Poor Prognosis in COVID-19

Tatiana L Karonova, Alena T Andreeva, Ksenia A Golovatuk, Ekaterina S Bykova, Anna V Simanenkova, Maria A Vashukova, William B Grant, Evgeny V Shlyakhto

Nutrients, doi:10.3390/nu13093021

We evaluated associations between serum 25-hydroxyvitamin D [25(OH)D] level and severity of new coronavirus infection (COVID-19) in hospitalized patients. We assessed serum 25(OH)D level in 133 patients aged 21-93 years. Twenty-five (19%) patients had severe disease, 108 patients (81%) had moderate disease, and 18 (14%) patients died. 25(OH)D level ranged from 3.0 to 97.0 ng/mL (median, 13.5 [25%; 75%, 9.6; 23.3] ng/mL). Vitamin D deficiency was diagnosed in 90 patients, including 37 with severe deficiency. In patients with severe course of disease, 25(OH)D level was lower (median, 9.7 [25%; 75%, 6.0; 14.9] ng/mL), and vitamin D deficiency was more common than in patients with moderate course (median, 14.6 [25%; 75%, 10.6; 24.4] ng/mL, p = 0.003). In patients who died, 25(OH)D was 9.6 [25%; 75%, 6.0; 11.5] ng/mL, compared with 14.8 [25%; 75%, 10.1; 24.3] ng/mL in discharged patients (p = 0.001). Severe vitamin D deficiency was associated with increased risk of COVID-19 severity and fatal outcome. The threshold for 25(OH)D level associated with increased risk of severe course was 11.7 ng/mL. Approximately the same 25(OH)D level, 10.9 ng/mL, was associated with increased risk of mortality. Thus, most COVID-19 patients have vitamin D deficiency; severe vitamin D deficiency is associated with increased risk of COVID-19 severity and fatal outcome.

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