Elsevier

Endocrine Practice

Volume 27, Issue 4, April 2021, Pages 271-278
Endocrine Practice

Original Article
Association of Vitamin D Status With Hospital Morbidity and Mortality in Adult Hospitalized Patients With COVID-19

https://doi.org/10.1016/j.eprac.2021.02.013Get rights and content

Abstract

Objective

To determine the association between vitamin D status and morbidity and mortality in adult hospitalized coronavirus disease 2019 (COVID-19) patients

Methods

We performed a retrospective chart review study in COVID-19 patients aged ≥18 year hospitalized at Boston University Medical Center between March 1 and August 4, 2020. All studied patients tested positive for COVID-19 and had serum levels of 25-hydroxyvitamin D (25[OH]D) results measured within 1 year prior to the date of positive tests. Medical information was retrieved from the electronic medical record and was analyzed to determine the association between vitamin D status and hospital morbidity and mortality.

Results

Among the 287 patients, 100 (36%) were vitamin D sufficient (25[OH]D >30 ng/mL) and 41 (14%) died during hospitalization. Multivariate analysis in patients aged ≥65 years revealed that vitamin D sufficiency (25[OH]D ≥30 ng/mL) was statistically significantly associated with decreased odds of death (adjusted OR 0.33, 95% CI, 0.12-0.94), acute respiratory distress syndrome (adjusted OR 0.22, 95% CI, 0.05-0.96), and severe sepsis/septic shock (adjusted OR 0.26, 95% CI, 0.08-0.88), after adjustment for potential confounders. Among patients with body mass index <30 kg/m2, vitamin D sufficiency was statistically significantly associated with a decreased odds of death (adjusted OR 0.18, 95% CI, 0.04-0.84). No significant association was found in the subgroups of patients aged <65 years or with body mass index ≥30 kg/m2.

Conclusion

We revealed an independent association between vitamin D sufficiency defined by serum 25(OH)D ≥30 ng/mL and decreased risk of mortality from COVID-19 in elderly patients and patients without obesity.

Key words

vitamin D
25-hydroxyvitamin D
COVID-19
morbidity
mortality
acute respiratory distress syndrome

Abbreviations

ARDS
acute respiratory distress syndrome
BMI
body mass index
CKD
chronic kidney disease
COPD
chronic obstructive pulmonary disease
COVID-19
coronavirus disease 2019
ESRD
end-stage renal disease
HIV
human immunodeficiency virus
HR
hazard ratio
ICU
intensive care unit
OR
odds ratio
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2

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