The relationship between serum 25-hydroxyvitamin D levels and the severity of COVID-19 disease and its mortality
Vasheghani et al.
, The relationship between serum 25-hydroxyvitamin D levels and the severity of COVID-19 disease and its..
, Scientific Reports, doi:10.1038/s41598-021-97017-9 (date from earlier preprint) (Preprint)
Retrospective 508 hospitalized COVID-19 patients in Iran showing lower mortality with vitamin D supplementation (not reaching statistical significance), and an association between lower vitamin D levels and disease severity, ICU admission, and increased mortality. Details of supplementation are not provided. The multivariate result for vitamin D deficiency is in the preprint, the journal version only contains the multivariate result for serum level.
risk of death, 30.4% lower, RR 0.70, p = 0.45, treatment 7 of 88 (8.0%), control 48 of 420 (11.4%), NNT 29, vitamin D supplementation.
risk of ICU admission, 63.8% lower, RR 0.36, p = 0.009, treatment 13 of 185 (7.0%), control 53 of 323 (16.4%), NNT 11, adjusted per study, inverted to make RR<1 favor treatment, vitamin D levels >30ng/mL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Vasheghani et al., 18 Jan 2021, retrospective, Iran, preprint, 6 authors, dosage not specified.
The relationship between serum
25‑hydroxyvitamin D levels
and the severity of COVID‑19
disease and its mortality
Maryam Vasheghani1, Nasrin Jannati2, Parvaneh Baghaei3, Mitra Rezaei4*,
Roqayeh Aliyari1,5 & Majid Marjani6
Supplemental vitamin D can reduce the risk and mortality of viral pneumonia. The relationship
between 25 hydroxyvitamin D [25(OH)D] levels and the severity and mortality of Coronavirus
disease 2019 (COVID-19) was evaluated. In this cross-sectional study, the admitted patients with
COVID-19 were categorized as mild, moderate, severe, and critical based on clinical and radiologic
characteristics. Calcium, phosphorus, albumin, creatinine, and serum 25(OH)D were measured and
their correlation with the severity of disease and mortality were analyzed. During 2 months, 508
patients (442 patients in general wards and 66 patients in the intensive care unit (ICU)) were included.
The participants were 56 ± 17 years old (52% male, 37% with comorbidity). Concerning severity, 13%,
42%, 36%, and 9% had mild, moderate, severe, and critical diseases, respectively. The mortality rate
was 10.8%. Admission to ICU, severity of disease and mortality decreased significantly across quartiles
of 25(OH)D. According to multivariate logistic regression analysis, disease mortality had a positive
correlation with age and had a negative correlation with the serum level of 25(OH)D, calcium, and
albumin. In hospitalized patients with COVID-19, low 25(OH)D was associated with severe disease and
increased ICU admission and mortality rate.
In late 2019, a new coronavirus was identified as a cause of a cluster of pneumonia cases in China which is
named COVID-19 d
isease1. Currently, COVID-19 is p
andemic2. In Iran, 612,772 people as the definitive cases
of COVID-19 have been reported by November 10, 2020, and 34,864 people have d
ied3. Manifestations of the
COVID-19 range from asymptomatic carriers to acute respiratory failure and d
eath4. Complications include
acute respiratory failure, cytokine release syndrome, increased coagulation factors, and multi-organ damage
which are associated with poor prognosis5,6. The overall mortality rate until November 18, 2020, is about 2.4%
(1,333,742 deaths between 55,326,907 patients)7. Old age, cardiovascular disease, diabetes, high blood pressure,
chronic lung disease, cancer, chronic kidney disease, people with defective or suppressed immune systems,
obesity, and chronic liver disease have been identified as risk factors for severe disease or mortality4,6,8,9. There
is currently no specific treatment against COVID-19 d
isease10. Currently, the most important way to deal with
this disease is prevention and control of the conditions that are considered as a risk factor for the more severe
course, and complications.
There is evidence from influenza A and severe acute respiratory syndrome (SARS) epidemics suggesting a role
for vitamin D in these d
iseases11. Previous studies have suggested an association between vitamin D deficiency
and an increased chance of developing bacterial and/or viral pneumonia due to viruses such as SARS, MERS,
and Influenza A. COVID-19 disease is more prevalent and severe in winter and is more common in people who
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases
(NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2Internal Medicine Department, School..
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