25 Hydroxyvitamin D Serum Concentration and COVID-19 Severity and Outcome—A Retrospective Survey in a Romanian Hospital
Adriana Topan, Mihaela Lupse, Mihai Calin, Cristian Jianu, Daniel-Corneliu Leucuta, Violeta Briciu
Nutrients, doi:10.3390/nu15051227
Interest in the immunomodulatory function of vitamin D has grown since the COVID-19 pandemic started. Our study investigated the possible association between vitamin D deficiency and COVID-19 severity, intensive care needs, and mortality in patients hospitalized with COVID-19. A prospective cohort study was performed on 2342 COVID-19 hospitalized patients between April 2020 and May 2022 in a Romanian tertiary hospital for infectious diseases. A multivariate generalized linear model for binary data was fit with dependent variables: severe/critical form of COVID-19, intensive care need, and fatal outcome as a function of vitamin D deficiency, controlling for age, comorbidities, and vaccination status. More than half of the patients (50.9%) were classified with vitamin D deficiency based on a serum concentration of less than 20 ng/mL. There was a negative association between vitamin D and age. Vitamin D-deficient patients presented with more cardiovascular, neurological, and pulmonary diseases, as well as diabetes, and cancer. In multivariate logistic regression models, vitamin D-deficient patients had higher odds of severe/critical forms of COVID-19 [OR = 1.23 (95% CI 1.03-1.47), p = 0.023] and higher odds of death [OR = 1.49 (95% CI 1.06-2.08), p = 0.02]. Vitamin D deficiency was associated with disease severity and death outcome in hospitalized COVID-19 patients.
Supplementary Materials: The following supporting information can be downloaded at https://www.mdpi.com/article/10.3390/nu15051227/s1, Table S1 : Patients characteristics according to deficient, insufficient, and sufficient 25(OH)D; Table S2 : Multivariate logistic regression with dependent variable severe/critical form of COVID-19 adjusted for 25(OH)D (deficient, insufficient, and sufficient) and all the other variables; Table S3 : Multivariate logistic regression with dependent variable (evolution to death) adjusted for 25(OH)D (deficient, insufficient, and sufficient) and all the other variables; Table S4 : Multivariate logistic regression with dependent variable evolution to intensive care need adjusted for 25(OH)D (deficient, insufficient, and sufficient) and all the other variables; Figure S1 : Smoothing spline graphical representation of the relationship between 25(OH)D as a continuous variable and the log odds of severe/critical form in the multiple logistic regression model adjusted for Age ≥ 65 years, cardiovascular, diabetes, obesity, pulmonary diseases, renal diseases, hepatic diseases, rheumatic diseases, neurological diseases, cancer, vaccine doses; Figure S2 Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.
Conflicts of Interest: The authors declare no conflict of interest.
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"abstract": "<jats:p>Interest in the immunomodulatory function of vitamin D has grown since the COVID-19 pandemic started. Our study investigated the possible association between vitamin D deficiency and COVID-19 severity, intensive care needs, and mortality in patients hospitalized with COVID-19. A prospective cohort study was performed on 2342 COVID-19 hospitalized patients between April 2020 and May 2022 in a Romanian tertiary hospital for infectious diseases. A multivariate generalized linear model for binary data was fit with dependent variables: severe/critical form of COVID-19, intensive care need, and fatal outcome as a function of vitamin D deficiency, controlling for age, comorbidities, and vaccination status. More than half of the patients (50.9%) were classified with vitamin D deficiency based on a serum concentration of less than 20 ng/mL. There was a negative association between vitamin D and age. Vitamin D-deficient patients presented with more cardiovascular, neurological, and pulmonary diseases, as well as diabetes, and cancer. In multivariate logistic regression models, vitamin D-deficient patients had higher odds of severe/critical forms of COVID-19 [OR = 1.23 (95% CI 1.03–1.47), p = 0.023] and higher odds of death [OR = 1.49 (95% CI 1.06–2.08), p = 0.02]. Vitamin D deficiency was associated with disease severity and death outcome in hospitalized COVID-19 patients.</jats:p>",
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