Abstract
Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses an enormous challenge to health care systems throughout the world. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. To explore possible associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients diagnosed with coronavirus disease 2019 (COVID-19) and treated at our center. VitD status at first presentation was assessed retrospectively using accredited laboratory methods. VitD deficiency was defined as serum total 25-hydroxyvitamin D level < 12 ng/mL (<30 nM). Primary endpoint was severe course of disease (i.e., need for invasive mechanical ventilation and/or death, IMV/D). Within a median observation period of 66 days (range 2–92), 23 patients required IMV. A total of 28 patients had IMV/D, including 16 deaths. Ninety-three (50%) patients required hospitalization (inpatient subgroup). A total of 41 (22%) patients were VitD deficient. When adjusted for age, gender, and comorbidities, VitD deficiency was associated with higher risk of IMV/D and death (HR 6.12, 95% CI 2.79–13.42, p < 0.001 and HR 14.73, 95% CI 4.16–52.19, p < 0.001, respectively). Similar correlations were observed in the inpatient subgroup. Our study demonstrates an association between VitD deficiency and severity/mortality of COVID-19, highlighting the need for interventional studies on VitD supplementation in SARS-CoV-2 infected individuals.
Highlights
Infection with the viral pathogen severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)has reached pandemic status in 2020
2019 (COVID-19) at the time of writing [1], COVID-19 poses an enormous challenge to societies and health care systems throughout the world
Male gender, and underlying comorbidities were shown to be associated with severe COVID-19 [2,3,4]
Summary
Infection with the viral pathogen severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)has reached pandemic status in 2020. Infection with the viral pathogen severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). With more than 700,000 deaths attributed to coronavirus disease. 2019 (COVID-19) at the time of writing [1], COVID-19 poses an enormous challenge to societies and health care systems throughout the world. Clinical features of COVID-19 may vary from asymptomatic or mild upper respiratory tract symptoms to a severe acute lung injury with subsequent systemic inflammation, multiorgan failure, and fatal outcome. Male gender, and underlying comorbidities were shown to be associated with severe COVID-19 [2,3,4]. None of these risk factors are modifiable and little is known about the potential protective determinants
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