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0 0.5 1 1.5 2+ Mortality 57% Improvement Relative Risk ICU admission -20% Vitamin D for COVID-19  Neves et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 115 patients in Brazil (July - December 2020) Lower mortality with higher vitamin D levels (p=0.046) Neves et al., Clinical Nutrition ESPEN, Jun 2022 Favors vitamin D Favors control

Vitamin D deficiency predicts 30-day hospital mortality of adults with COVID-19

Neves et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2022.05.027
Jun 2022  
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Retrospective 115 hospitalized patients in Brazil, showing lower mortality with higher vitamin D levels. Adjusted results are only provided for vitamin D as a continuous variable.
This is the 136th of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion). This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups.
risk of death, 57.1% lower, RR 0.43, p = 0.046, high D levels (≥50nmol/L) 12 of 87 (13.8%), low D levels (<50nmol/L) 9 of 28 (32.1%), NNT 5.4.
risk of ICU admission, 19.5% higher, RR 1.20, p = 0.81, high D levels (≥50nmol/L) 26 of 87 (29.9%), low D levels (<50nmol/L) 7 of 28 (25.0%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Neves et al., 14 Jun 2022, retrospective, Brazil, peer-reviewed, mean age 62.1, 7 authors, study period July 2020 - December 2020.
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This PaperVitamin DAll
Vitamin D deficiency predicts 30-day hospital mortality of adults with COVID-19
Fabio Fernandes Neves, Henrique Pott-Junior, Sigrid De Sousa Santos, Marcia Regina Cominetti, Caio Cesar De Melo Freire, Anderson Ferreira Da Cunha, Alceu Afonso Jordão Júnior
Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2022.05.027
Background & aims: Several studies have shown conflicting results for the relationship between vitamin D deficiency and COVID-19 outcomes. Here, we aimed to evaluate whether plasma 25(OH)D levels predict mortality in adults admitted with COVID-19, considering potential confounders. Methods: We conducted a retrospective cohort study that included 115 adults (age 62.1 ± 17.6 years, 65 males) admitted to a Brazilian public hospital for severely symptomatic COVID-19. Subjects were classified into two groups according to their plasma levels of 25(OH)D: sufficiency (50 nmol/L) and the deficiency (<50 nmol/L). The diagnosis of COVID-19 was performed using real-time polymerase chain reaction (qPCR). In addition, direct competitive chemiluminescence immunoassay assessed serum 25(OH)D levels. Results: The all-cause 30-day mortality was 13.8% (95% CI: 6.5%e21%) in the group of patients with sufficient plasma 25(OH)D levels and 32.1% (95% CI: 14.8%e49.4%) among those with deficient plasma 25(OH)D levels. Cox regression showed that plasma 25(OH)D levels remained a significant predictor of mortality even after adjusting for the covariates sex, age, length of the delay between symptom onset and hospitalization, and disease severity (HR ¼ 0.98, 95% CI: 0.96e1.00; p ¼ 0.02). Conclusion: Vitamin D deficiency predicts higher mortality risk in adults with COVID-19.
Author contributions Conceptualization, F.F.N. and H.P-J.; data curation, F.F.N., H.P-J. and S.S.S; formal analysis, F.F.N. and H.P-J.; funding acquisition, F.F.N.; investigation, F.F.N., H.P-J. and S.S.S; methodology, F.F.N., H.P-J., C.C.M.F, A.F.C. and A.A.J-J; resources, M.R.C., C.C.M.F, A.F.C. and A.A.J-J; software, H.P-J.; supervision, F.F.N. and H.P-J.; writing original draft, F.F.N. and H.P-J.; final approval: all authors. Declaration of competing interest The authors declare no conflicts of interest. Appendix A. Supplementary data Supplementary data to this article can be found online at
Akbar, Wibowo, Pranata, Setiabudiawan, Low serum 25-hydroxyvitamin D (vitamin D) level is associated with susceptibility to COVID-19, severity, and mortality: a systematic review and meta-analysis, Front Nutr
Ali, Role of vitamin D in preventing of COVID-19 infection, progression and severity, J Infect Public Health
Banerjee, Ganguly, Saha, Chakrabarti, Saini et al., Vitamin D and immuno-pathology of COVID-19: many interactions but uncertain therapeutic benefits, Expert Rev Anti Infect Ther
Bui, Zhu, Hawkins, Cortez-Resendiz, Bellon, Vitamin D regulation of the immune system and its implications for COVID-19: a mini review, SAGE Open Med
Dissanayake, Silva, Sumanatilleke, De Silva, Gamage et al., Prognostic and therapeutic role of vitamin D in COVID-19: systematic review and meta-analysis, J Clin Endocrinol Metab
Holick, Binkley, Bischoff-Ferrari, Gordon, Hanley et al., Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline, J Clin Endocrinol Metab
Huang, Wang, Li, Ren, Zhao et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet Lond Engl
Neves, Pott-Junior, De Sousa Santos, None, Clinical Nutrition ESPEN
Neves, Pott-Junior, De Sousa Santos, None, Clinical Nutrition ESPEN
Tay, Poh, Macary, Ng, The trinity of COVID-19: immunity, inflammation and intervention, Nat Rev Immunol
Tentolouris, Samakidou, Eleftheriadou, Tentolouris, Jude, The effect of vitamin D supplementation on mortality and Intensive Care Unit admission of COVID-19 patients. A systematic review, meta-analysis and meta-regression, Diabetes Metab Res Rev
Yisak, Ewunetei, Kefale, Mamuye, Teshome et al., Effects of vitamin D on COVID-19 infection and prognosis: a systematic review, Risk Manag Healthc Pol
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