The effect of Vitamin D levels on the course of COVID-19 in hospitalized patients – a 1-year prospective cohort study

Siuka et al., F1000Research, doi:10.12688/f1000research.131730.1

Mar 2023

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Prospective study of 301 hospitalized patients in Slovenia, showing higher mortality with vitamin D deficiency, without statistical significance. Fewer patients with severe cases were deficient, which authors hypothesize was due to their recommendations for supplementation - many patients reported initiating supplementation after symptoms started but before hospitalization (while asymptomatic patients did not initiate supplementation).

This is the 162nd of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion).

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risk of death, 55.9% lower, RR 0.44, p = 0.24, high D levels (≥30nmol/L) 10 of 255 (3.9%), low D levels (<30nmol/L) 4 of 45 (8.9%), NNT 20.

risk of ICU admission, 58.8% higher, RR 1.59, p = 0.59, high D levels (≥30nmol/L) 27 of 255 (10.6%), low D levels (<30nmol/L) 3 of 45 (6.7%).

risk of severe case, 61.0% higher, RR 1.61, p = 0.009, high D levels (≥30nmol/L) 146 of 255 (57.3%), low D levels (<30nmol/L) 16 of 45 (35.6%).

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Siuka et al., 9 Mar 2023, prospective, Slovenia, peer-reviewed, 7 authors, study period December 2020 - December 2021.

Contact: josko.osredkar@kclj.si.

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The effect of Vitamin D levels on the course of COVID-19 in hospitalized patients – a 1-year prospective cohort study

Darko Siuka, Rajko Saletinger, Jure Uršič, Kristina Jevnikar, Rado Janša, David Štubljar, Joško Osredkar

F1000Research, doi:10.12688/f1000research.131730.1

Background: The aim of the current study was to assess the patients with COVID-19 and the impact of vitamin D supplementation on the course of COVID-19. Methods: This prospective cohort study included patients hospitalized due to COVID-19 between December 2020 and December 2021. Patients' demographic, clinical, and laboratory parameters were analysed. Results: 301 participants were enrolled in the study. 46 (15,3%) had moderate, and 162 (53,8%) had severe COVID-19. 14 (4,7%) patients died, and 30 (10,0%) were admitted to the ICU due to disease worsening. The majority needed oxygen therapy (n=224; 74,4%). Average vitamin 25(OH)D3 levels were below optimal at the admittance, and vitamin D deficiency was detected in 205 individuals. More male patients were suffering from vitamin D deficiency. Patients with the more severe disease showed lower levels of vitamin 25(OH)D3 in their blood. The most severe group of patients had more symptoms that lasted significantly longer with progressing disease severity. This group of patients also suffered from more deaths, ICU admissions, and treatments with dexamethasone, remdesivir, and oxygen. Conclusion: Patients with the severe course of COVID-19 were shown to have increased inflammatory parameters, increased mortality, and higher incidence of vitamin D deficiency. The results suggest that the vitamin D deficiency might represent a significant risk factor for a severe course of COVID-19.

Author contribution D.Si. and J.O. conceived of the idea for the project; D.Si. and J.O. wrote the draft version of the manuscript, R.S. supervised the patients invited to participate in the study; J.U. and K.J. compiled the clinical data on the patients involved; O.J. and D. St were responsible for completing laboratory data, and D.St. and R.J. performed the statistical calculations. All authors reviewed and agreed with the manuscript, and final approval was given by D.Si. and J.O. All authors have read and agreed to the published version of the manuscript.

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