A combined role for low vitamin D and low albumin circulating levels as strong predictors of worse outcome in COVID-19 patients

DOI record: { "DOI": "10.1007/s11845-022-02952-9", "ISSN": [ "0021-1265", "1863-4362" ], "URL": "http://dx.doi.org/10.1007/s11845-022-02952-9", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Purpose</jats:title>\n <jats:p>We aimed to assess the combined role of vitamin D and albumin serum levels as predictors of COVID-19 disease progression.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>We conducted a prospective observational study on adult patients hospitalized for SARS-CoV-2 pneumonia (March–September 2020). Vitamin D and albumin serum levels were measured on admission. These variables were categorized in albumin &lt; 3.5 or ≥ 3.5 g/dL and vitamin D &lt; 30 ng/mL or ≥ 30 ng/mL. We excluded patients with known bone diseases, renal failure, hypercalcemia and/or treated with antiepileptic drugs and steroids, and patients who received previous vitamin D supplementation. A composite outcome including any ventilatory support, PaO<jats:sub>2</jats:sub>/FiO<jats:sub>2</jats:sub> ratio, and 60-day mortality was defined.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>Sixty-nine patients were enrolled, of whom 50% received non-invasive (NIV) or invasive mechanical ventilation (IMV), 10% died, whereas 89% and 66% presented low albumin and low vitamin D serum levels, respectively. No correlation between vitamin D and albumin levels was found. In multivariable logistic regression analyses adjusted for sex and age-corrected comorbidities, patients having albumin &lt; 3.5 g/dL and vitamin D &lt; 30 ng/mL showed a significant increased risk for all study outcomes, namely NIV/IMV (<jats:italic>OR</jats:italic> 3.815; 95% <jats:italic>CI</jats:italic> 1.122–12.966; <jats:italic>p</jats:italic> = 0.032), NIV/IMV or death (<jats:italic>OR</jats:italic> 3.173; 95% <jats:italic>CI</jats:italic> 1.002–10.043; <jats:italic>p</jats:italic> = 0.049) and PaO<jats:sub>2</jats:sub>/FIO<jats:sub>2</jats:sub> ≤ 100 (<jats:italic>OR</jats:italic> 3.410; 95% <jats:italic>CI</jats:italic> 1.138–10.219; <jats:italic>p</jats:italic> = 0.029).</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>The measurement of both vitamin D and serum albumin levels on COVID-19 patients’ admission, and their combined evaluation, provides a simple prognostic tool that could be employed to guide prompt clinical decisions.</jats:p>\n 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