Association of Vitamin D levels on the Clinical Outcomes of Patients Hospitalized for COVID-19 in a Tertiary Hospital
Margarita Katrina Amor Tan, Rebecca Lim Alba, Kingbherly Li
Journal of the ASEAN Federation of Endocrine Societies, doi:10.15605/jafes.038.01.07
Objectives. This study aimed to compare the severity of COVID-19, inflammatory parameters and clinical outcomes among patients with normal and subnormal levels of Vitamin D. Methodology. This is a retrospective cohort study of 135 patients admitted in a tertiary hospital for COVID-19. Patients were grouped according to their Vitamin D level. Primary outcome measure was the composite of all-cause mortality and morbidity. Other outcome measures determined were the comparison among the groups on the severity of COVID-19 infection, changes in inflammatory parameters, length of hospital stay and duration of respiratory support. Results. There was a significant trend of higher ICU admission (p-value=0.024), mortality (p-value=0.006) and poor clinical outcome (p-value=0.009) among the Vitamin D deficient group. No significant difference was found for most of the inflammatory parameters, duration of hospital stay and respiratory support. Overall, patients with deficient, but not insufficient Vitamin D level had 6 times higher odds of composite poor outcome than those with normal Vitamin D (crude OR=5.18, p-value=0.003; adjusted OR =6.3, p-value=0.043).
Conclusion. The inverse relationship between Vitamin D level and poor composite outcome observed in our study suggests that low Vitamin D may be a risk factor for poor prognosis among patients admitted for COVID-19.
CONCLUSION The high occurrence of hypovitaminosis D in severe and critical COVID-19 patients implies a potential relation to poor prognosis. Overall, patients with deficient, but not insufficient Vitamin D level had 6 times higher odds of composite poor outcome than those with normal Vitamin D after adjusting for potential confounders (Crude OR = 5.18; adjusted OR = 6.3). The inverse association between serum 25(OH)D levels and composite poor outcome (ICU admission, in-hospital mortality and morbidity) observed in our retrospective study suggests that a lower Vitamin D status upon admission may be an independent risk factor for poor prognosis in COVID-19.
Statement of Authorship The authors certified fulfillment of ICMJE authorship criteria.
CRediT Author
Author Disclosure The authors declared no conflict of interest.
Funding Source None. Authors are required to accomplish, sign and submit scanned copies of the JAFES Author Form consisting of: (1) Authorship Certification, that authors contributed substantially to the work, that the manuscript has been read and approved by all authors, and that the requirements for authorship have been met by each author; (2) the Author Declaration, that the article represents original material that is not being considered for publication or has not been published or accepted for publication elsewhere, that the article does not infringe or violate any copyrights or intellectual property rights, and that no references have been made..
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