Associations of vitamin D levels and clinical parameters with COVID‐19 infection, severity and mortality in hemodialysis patients: A cohort study

{ 'indexed': { 'date-parts': [[2024, 12, 23]], 'date-time': '2024-12-23T08:10:10Z', 'timestamp': 1734941410883, 'version': '3.32.0'}, 'reference-count': 27, 'publisher': 'Wiley', 'license': [ { 'start': { 'date-parts': [[2024, 12, 22]], 'date-time': '2024-12-22T00:00:00Z', 'timestamp': 1734825600000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'http://onlinelibrary.wiley.com/termsAndConditions#vor'}], 'content-domain': {'domain': ['onlinelibrary.wiley.com'], 'crossmark-restriction': True}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Vitamin ' 'D deficiency is prevalent among patients undergoing hemodialysis. This study aimed to ' 'investigate the associations between vitamin D levels and clinical parameters with the risk ' 'of COVID‐19 infection, severity, and mortality in hemodialysis patients with end‐stage kidney ' 'disease (ESKD).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This ' 'retrospective cohort study included 198 hemodialysis patients from a single center. Vitamin D ' 'deficiency was defined by the last measurement of 25‐hydroxycholecalciferol less than 20\u2009' 'ng/mL. Vitamin D deficiency and vitamin D supplements were combined to categorize patients ' 'into three groups: deficiency, uncertain deficiency, and likely sufficient. COVID‐19 ' 'infection status, severity, and outcomes were recorded. Statistical analyses were performed ' 'to assess the associations between vitamin D levels and COVID‐19 severity and ' 'mortality.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>Among the ' '198 patients, 73 patients (37%) were in the deficiency group, 29 patients (15%) had uncertain ' 'deficiency, and 96 patients (48%) were likely sufficient. The overall COVID‐19 infection rate ' 'was 59%. The deficiency group had a similar infection rate (60.3%) compared to those with ' 'likely sufficient levels (54.2%). However, the severity and mortality rates of vitamin D ' 'deficiency group had a significantly higher rate than those with likely sufficient levels. ' 'Multivariate logistic regression analysis showed that vitamin D deficiency and uncertain ' 'deficiency group were significantly associated with an increased risk of COVID‐19 severity ' '(OR\u2009=\u200922.57, <jats:italic>p</jats:italic>\u2009=\u20090.01 and OR\u2009=\u200915.8, ' '<jats:italic>p</jats:italic>\u2009=\u20090.03, respectively). Uncertain deficiency group was ' 'significantly associated with an increased risk of COVID‐19 mortality (OR\u2009=\u200912.93, ' '<jats:italic>p</jats:italic>\u2009=\u20090.04), while the deficiency group should similarly ' 'trend but did not reach statistical ' 'significance.</jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p>Vitamin ' 'D deficiency is associated with an increased risk of COVID‐19 severity in hemodialysis ' 'patients with ESKD. These findings suggest that monitoring and managing vitamin D levels may ' 'be important in reducing the risk of COVID‐19 severity in this vulnerable ' 'population.</jats:p></jats:sec>', 'DOI': '10.1111/hdi.13194', 'type': 'journal-article', 'created': { 'date-parts': [[2024, 12, 23]], 'date-time': '2024-12-23T07:41:58Z', 'timestamp': 1734939718000}, 'update-policy': 'https://doi.org/10.1002/crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Associations of vitamin D levels and clinical parameters with <scp>COVID</scp>‐19 infection, ' 'severity and mortality in hemodialysis patients: A cohort study', 'prefix': '10.1111', 'author': [ { 'ORCID': 'https://orcid.org/0009-0001-4924-0078', 'authenticated-orcid': False, 'given': 'Yanhua', 'family': 'You', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Nephrology West China Xiamen Hospital of Sichuan ' 'University Xiamen China'}, { 'name': 'Department of Nephrology Army 73rd Group Military Hospital ' 'Xiamen China'}]}, { 'given': 'Chun', 'family': 'Xu', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Nephrology Army 73rd Group Military Hospital ' 'Xiamen China'}]}, { 'given': 'Yuqing', 'family': 'Hu', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Nephrology Army 73rd Group Military Hospital ' 'Xiamen China'}]}, { 'given': 'Meng', 'family': 'Liang', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Nephrology Army 73rd Group Military Hospital ' 'Xiamen China'}]}, { 'given': 'Qi', 'family': 'Sun', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Nephrology Army 73rd Group Military Hospital ' 'Xiamen China'}]}], 'member': '311', 'published-online': {'date-parts': [[2024, 12, 22]]}, 'reference': [ { 'issue': '7', 'key': 'e_1_2_8_2_1', 'doi-asserted-by': 'crossref', 'first-page': '1911', 'DOI': '10.1210/jc.2011-0385', 'article-title': 'Evaluation, treatment, and prevention of vitamin D deficiency: an ' 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