25 Hydroxyvitamin D Serum Concentration and COVID-19 Severity and Outcome—A Retrospective Survey in a Romanian Hospital

Topan et al., Nutrients, doi:10.3390/nu15051227

Feb 2023

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Retrospective 2,342 hospitalized COVID-19 patients in Romania with vitamin D levels measured on admission day, showing lower risk of mortality and severe/critical cases with vitamin D levels ≥ 20ng/mL.

This is the 159th 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, 30.6% lower, RR 0.69, p = 0.02, high D levels (≥20ng/mL) 61 of 1,148 (5.3%), low D levels (<20ng/mL) 118 of 1,194 (9.9%), adjusted per study, inverted to make RR<1 favor high D levels (≥20ng/mL), odds ratio converted to relative risk, multivariable.

risk of severe case, 10.9% lower, RR 0.89, p = 0.02, high D levels (≥20ng/mL) 432 of 1,148 (37.6%), low D levels (<20ng/mL) 560 of 1,194 (46.9%), NNT 11, adjusted per study, inverted to make RR<1 favor high D levels (≥20ng/mL), odds ratio converted to relative risk, severe/critical case, multivariable.

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Topan et al., 28 Feb 2023, retrospective, Romania, peer-reviewed, survey, 6 authors, study period April 2020 - May 2022.

Contact: mihaela.lupse@yahoo.com (corresponding author).

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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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