The effect of 1-hydroxy-vitamin D treatment in hospitalized patients with COVID-19: A retrospective study
Takashi Ogasawara, Yasuhisa Tajima, Naoto Nakamura, Hiroki Kanasaki, Wataru Matsuyama, Mitsuru Niwa, Yuichi Ozawa, Masayuki Sugiura, Masahito Ogiku, Jun Sato
Clinical Nutrition, doi:10.1016/j.clnu.2023.08.021
Background & aims: The efficacy of vitamin D supplementation in coronavirus disease 2019 remains unclear. This study aimed to evaluate the effect of 1-hydroxy-vitamin D on the prevention of severe disease and mortality in patients hospitalized for COVID-19. Methods: This retrospective study included 312 patients with COVID-19 who were admitted to our hospital between April 2021 and October 2021 (primarily the Delta variant) and between July 2022 and September 2022 (primarily Omicron variant). Serum 25-hydroxyvitamin D (25(OH)D) levels were measured at the time of admission and 1-hydroxy-vitamin D was prescribed by the treating physicians. The patients were divided into two groups: those administered 1-hydroxy-vitamin D (Vit D group) and those who were not (control group). The composite primary endpoint was the need for additional respiratory support, including high-flow oxygen therapy or invasive mechanical ventilation, and in-hospital mortality rate. Results: Of 312 patients, 122 (39%) received 1-hydroxy-vitamin D treatment. Although the median age was not significantly higher in the Vit D group than in the control group (66 vs. 58 years old, P ¼ 0.06) and there was no significant difference in the proportion of vitamin D deficiency (defined as serum 25(OH)D level less than 20 ng/mL, 77% vs. 65%, P ¼ 0.07), patients in the control group had a more severe baseline profile compared to the Vit D group according to the Japanese disease severity definition for COVID-19 (P ¼ 0.01). The proportion of those requiring more respiratory support and in-hospital mortality was significantly lower in the Vit D group than in the control group (6% vs. 14%, P ¼ 0.01 log-rank test). After propensity score matching, a statistically significant difference in the primary endpoint was observed (P ¼ 0.03 log-rank test). Conclusions: 1-hydroxy-vitamin treatment may improve outcomes in hospitalized patients with COVID-19, reducing composite outcomes including the need for additional respiratory support and in-hospital mortality.
Author contributions TO and YT conceived and designed this study. TO, YT, NN, HK, YO, MS, MN and WM did acquisition, analyses, and interpretation of data. TO drafted manuscript. TO, YT, NN, WM, MN, MO and JS contributed to reviewing or revising the paper. All authors read and approved the final manuscript.
Conflicts of interest None of the authors declared a conflict of interest.
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