Coronavirus in HIP Fractures CHIP 2: Is Vitamin D Deficiency Associated with Increased Mortality from COVID-19 Infections in A Hip Fracture Population?
A Mahmood, F Rashid, D Hawkes, CHIP W J Harrison
European Journal of Medical and Health Sciences, doi:10.24018/ejmed.2021.3.6.1159
Purpose: There is controversy as to whether vitamin D deficiency is associated with increased mortality from coronavirus infection. The aim of the study was to assess the relationship between vitamin D levels and 30day mortality in hip fracture patients co-infected with COVID-19.
Methods : This was a national observational audit conducted between 23 March 2020 (start of UK lockdown) and 31 st December 2020. The cohort consisted of patients aged >60 years presenting with a hip fracture. Patients were included if they had a vitamin D level done during the admission episode, diagnosis of COVID-19 infection via a viral reverse transcriptase PCR swab, and a hip fracture. There were 517 patients included in the study from 43 different hospital trusts. The primary outcome measure was 30-day mortality. Secondary outcomes were the percentage of patients who had vitamin D deficiency, the percentage of patients who were prescribed Vitamin D, and the impact of vitamin D prescribing on mortality Results: Vitamin D deficiency was not associated with a higher 30-day mortality. Low serum vitamin D was observed in 56% of the patients on admission. Vitamin D was prescribed prior to admission in 28% and during admission in a further 49%. Pre-hospital vitamin D therapy reduced the chance of vitamin D deficiency. Starting vitamin D before or on admission did not affect the mortality rates. Conclusion: Vitamin D deficiency was common, but not associated with a higher 30-day mortality in the hip fracture population co-infected with COVID-19.
CONFLICT OF INTEREST All named authors hereby declare that they have no conflicts of interest to disclose.
References
Baktash, Hosack, Patel, Shah, Kandiah et al., Vitamin D status and outcomes for hospitalised older patients with COVID-19, Postgrad Med J
Beresford, Sexton, Nebhani, Liverpool University Foundation Trust
Boban, Novel coronavirus disease (COVID-19) update on epidemiology, pathogenicity, clinical course and treatments, Int J Clin Pract
Castillo, Costa, Barrios, Díaz, Miranda et al., Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study, J Steroid Biochem Mol Biol
Craveiro, Cabral, Araújo, Falcão, Guimarães et al., Association of Serum 25-Hydroxyvitamin D Concentration with Pulmonary Function in Young Adults, Nutrients
Ginde, Mansbach, Camargo, Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey, Arch Intern Med
Grant, Lahore, Mcdonnell, Baggerly, French et al., Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths, Nutrients
Hastie, Pell, Sattar, Vitamin D and COVID-19 infection and mortality in UK Biobank, Eur J Nutr
Ilie, Stefanescu, Smith, The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality, Aging Clin Exp Res
Kaufman, Niles, Kroll, Bi, Holick, SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels, PLoS One
Laird, Rhodes, Kenny, Vitamin D and Inflammation: Potential Implications for Severity of Covid-19, Ir Med J
Liu, Sun, Wang, Zhang, Zhao et al., Low vitamin D status is associated with coronavirus disease 2019 outcomes: a systematic review and meta-analysis, Int J Infect Dis
Mahmood, Rashid, Limb, Cash, Nagy et al., Coronavirus infection in hip fractures (CHIP) study, Bone Joint J
Martineau, Jolliffe, Hooper, Greenberg, Aloia et al., Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data, BMJ
Marufu, White, Griffiths, Moonesinghe, Moppett, Prediction of 30-day mortality after hip fracture surgery by the Nottingham Hip Fracture Score and the Surgical Outcome Risk Tool, Anaesthesia
Mccartney, Byrne, Optimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19, Ir Med J
Meltzer, Best, Zhang, Vokes, Arora et al., Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results, JAMA Netw Open
Mitchell, Vitamin-D and COVID-19: do deficient risk a poorer outcome?, Lancet Diabetes Endocrinol
Murai, Fernandes, Sales, Pinto, Goessler et al., Effect of a Single High Dose of Vitamin D3 on Hospital Length of Stay in Patients with Moderate to Severe COVID-19: A Randomized Clinical Trial, JAMA
Panagiotou, Tee, Ihsan, Athar, Marchitelli et al., Low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID-19 are associated with greater disease severity, Clin Endocrinol (Oxf)
Pizzini, Aichner, Sahanic, Böhm, Egger et al., Impact of Vitamin D Deficiency on COVID-19-A Prospective Analysis from the CovILD Registry, Nutrients
