Hospital Outcomes in Patients Hospitalized for COVID-19 Pneumonia: The Effect of SARS-CoV-2 Vaccination and Vitamin D Status

DOI record: { "DOI": "10.3390/nu15132976", "ISSN": [ "2072-6643" ], "URL": "http://dx.doi.org/10.3390/nu15132976", "abstract": "<jats:p>SARS-CoV-2 vaccination promises to improve outcomes for patients with COVID-19 pneumonia (most notably those with advanced age and at high risk for severe disease). Here, we examine serum 25-Hydroxyvitamin D (25(OH)D) status and outcomes in both old (&gt;70 years) and young vaccinated (n = 80) and unvaccinated (n = 91) subjects, who were hospitalized due to COVID-19 pneumonia in a single center (Connolly Hospital Dublin). Outcomes included ICU admission and mortality. Serum 25(OH)D levels were categorized as D30 (&lt;30 nmol/L), D40 (30–49.99 nmol/L) and D50 (≥50 nmol/L). In multivariate analyses, D30 was independently associated with ICU admission (OR: 6.87 (95% CI: 1.13–41.85) (p = 0.036)) and mortality (OR: 24.81 (95% CI: 1.57–392.1) (p = 0.023)) in unvaccinated patients, even after adjustment for major confounders including age, sex, obesity and pre-existing diabetes mellitus. While mortality was consistently higher in all categories of patients over 70 years of age, the highest observed mortality rate of 50%, seen in patients over 70 years with a low vitamin D state (D30), appeared to be almost completely corrected by either vaccination, or having a higher vitamin D state, i.e., mortality was 14% for vaccinated patients over 70 years with D30 and 16% for unvaccinated patients over 70 years with a 25(OH)D level greater than 30 nmol/L. We observe that high mortality from COVID-19 pneumonia occurs in older patients, especially those who are unvaccinated or have a low vitamin D state. Recent vaccination or having a high vitamin D status are both associated with reduced mortality, although these effects do not fully mitigate the mortality risk associated with advanced age.</jats:p>", "alternative-id": [ "nu15132976" ], "author": [ { "affiliation": [ { "name": "School of Biological, Health & Sports Sciences, Technological University Dublin, D07 XT95 Dublin, Ireland" } ], "family": "Sanecka", "given": "Martyna", "sequence": "first" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Youssef", "given": "Modar", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Abdulsalam", "given": "Mohammad", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Raza", "given": "Syed F.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Qadeer", "given": "Abdul", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Ioana", "given": "Julia", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Aldoresi", "given": "Alya", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Shah", "given": "Syed I.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Al Lawati", "given": "Abdul", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Biochemistry, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Feely", "given": "Joseph", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Biochemistry, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Tormey", "given": "William P.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Microbiology, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "O’Neill", "given": "Eoghan", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Cormican", "given": "Liam J.", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" } ], "family": "Judge", "given": "Eoin P.", "sequence": "additional" }, { "affiliation": [ { "name": "School of Biological, Health & Sports Sciences, Technological University Dublin, D07 XT95 Dublin, Ireland" } ], "family": "McCartney", "given": "Daniel M. A.", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-2538-0030", "affiliation": [ { "name": "Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland" }, { "name": "Department of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland" }, { "name": "Department of Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland" } ], "authenticated-orcid": false, "family": "Faul", "given": "John L.", "sequence": "additional" } ], "container-title": "Nutrients", "container-title-short": "Nutrients", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2023, 7, 3 ] ], "date-time": "2023-07-03T04:42:46Z", "timestamp": 1688359366000 }, "deposited": { "date-parts": [ [ 2023, 7, 3 ] ], "date-time": "2023-07-03T04:50:49Z", "timestamp": 1688359849000 }, "indexed": { "date-parts": [ [ 2023, 7, 4 ] ], "date-time": "2023-07-04T04:32:44Z", "timestamp": 1688445164314 }, "is-referenced-by-count": 0, "issue": "13", "issued": { "date-parts": [ [ 2023, 6, 30 ] ] }, "journal-issue": { "issue": "13", "published-online": { "date-parts": [ [ 2023, 7 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2023, 6, 30 ] ], "date-time": "2023-06-30T00:00:00Z", "timestamp": 1688083200000 } } ], "link": [ { "URL": "https://www.mdpi.com/2072-6643/15/13/2976/pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1968", "original-title": [], "page": "2976", "prefix": "10.3390", "published": { "date-parts": [ [ 2023, 6, 30 ] ] }, "published-online": { "date-parts": [ [ 2023, 6, 30 ] ] }, "publisher": "MDPI AG", "reference": [ { "DOI": "10.1056/NEJMoa2118691", "article-title": "Protection against SARS-CoV-2 after COVID-19 Vaccination and Previous Infection", "author": "Hall", "doi-asserted-by": "crossref", "first-page": "1207", "journal-title": "N. 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