Vitamin D Deficiency and Outcome of COVID-19 Patients
Radujkovic et al.
, Vitamin D Deficiency and Outcome of COVID-19 Patients
, Nutrients 2020, 12:9, 2757, doi:10.3390/nu12092757
Observational study 185 patients in Germany shows an association between vitamin D status and severity and mortality. Adjusted hazard ratio of vitamin D sufficiency for combined mechanical ventilation and death was HR 0.16, p < 0.001, and for death HR 0.068, p < 0.001.
risk of death, 93.2% lower, HR 0.07, p = 0.001, high D levels 144, low D levels 12, >30nmol/L.
risk of death/intubation, 84.0% lower, HR 0.16, p < 0.001, high D levels 144, low D levels 12, >30nmol/L.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Radujkovic et al., 10 Sep 2020, prospective, Germany, peer-reviewed, 6 authors.
Vitamin D Deficiency and Outcome of
Aleksandar Radujkovic 1 , Theresa Hippchen 2 , Shilpa Tiwari-Heckler 2 , Saida Dreher 2 ,
Monica Boxberger 2 and Uta Merle 2, *
Department of Internal Medicine V, University of Heidelberg, 69121 Heidelberg, Germany;
Department of Internal Medicine IV, University of Heidelberg, 69121 Heidelberg, Germany;
firstname.lastname@example.org (T.H.); email@example.com (S.T.-H.);
firstname.lastname@example.org (S.D.); email@example.com (M.B.)
Correspondence: firstname.lastname@example.org; Tel.: +49-6221-568705
Received: 9 August 2020; Accepted: 9 September 2020; Published: 10 September 2020
Abstract: Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses
an enormous challenge to health care systems throughout the world. Without causal treatment,
identification of modifiable prognostic factors may help to improve outcomes. To explore possible
associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients
diagnosed with coronavirus disease 2019 (COVID-19) and treated at our center. VitD status at first
presentation was assessed retrospectively using accredited laboratory methods. VitD deficiency
was defined as serum total 25-hydroxyvitamin D level < 12 ng/mL (<30 nM). Primary endpoint
was severe course of disease (i.e., need for invasive mechanical ventilation and/or death, IMV/D).
Within a median observation period of 66 days (range 2–92), 23 patients required IMV. A total of
28 patients had IMV/D, including 16 deaths. Ninety-three (50%) patients required hospitalization
(inpatient subgroup). A total of 41 (22%) patients were VitD deficient. When adjusted for age,
gender, and comorbidities, VitD deficiency was associated with higher risk of IMV/D and death
(HR 6.12, 95% CI 2.79–13.42, p < 0.001 and HR 14.73, 95% CI 4.16–52.19, p < 0.001, respectively).
Similar correlations were observed in the inpatient subgroup. Our study demonstrates an association
between VitD deficiency and severity/mortality of COVID-19, highlighting the need for interventional
studies on VitD supplementation in SARS-CoV-2 infected individuals.
Keywords: vitamin D; SARS-CoV-2; COVID-19; outcome; severity; retrospective
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