Vitamin D deficient patients are 14 times more likely to get severe COVID-19

Patients deficient in vitamin D are more likely to become severe COVID-19[female[feminine and die compared to those with sufficient levels of the vitamin

People who are deficient in vitamin D have been shown to be much more likely to suffer from severe COVID-19 and die compared to those with normal or sufficient levels of the vitamin. This was an important finding by researchers from the Department of Otorhinolaryngology, Head and Neck Surgery, Galilee Medical Center, Israel.

Previous research has shown how vitamin D has a protective effect against respiratory tract infections when taken once daily. Additionally, a 2021 systematic review that included 46 randomized controlled trials with 48,488 people, reaffirmed the benefits of daily supplementation with 400 to 1000 IU of vitamin D for reduce the risk of acute respiratory tract infections compared to placebo. Several studies undertaken during the COVID-19 pandemic have suggested that a state of vitamin D deficiency is associated with increased risk of COVID-19. In addition, other data showed how the vitamin D level is markedly low in patients with severe COVID-19 although this was measured once in the hospital. However, what is less clear is the extent to which pre-infection or baseline vitamin D levels impact clinical outcomes once patients are infected with COVID-19.

For the current study, the Israeli team set out to determine whether COVID-19 disease severity correlated with the patient’s most recent vitamin D levels, as documented in their medical records. They undertook a retrospective study of adult patients hospitalized with PCR-confirmed COVID-19 infection. The team defined the severity of COVID-19 disease as the point of highest severity. For example, if a patient was admitted with mild illness and then deteriorated, this would be classified as severe illness. They used the most recent medical record for vitamin D status, then categorized patients as vitamin D deficient (<20 ng/ml), insufficient (20 to 29.9 ng/ml), adequate (30 to 39.9 ng/ml) and high-normal. (40ng/ml). They used multivariate analysis to examine the relationship between vitamin D status and COVID-19 disease severity.

Vitamin D deficiency status and severity of COVID-19

A total of 253 people with an average age of 63.3 years (56.9% women) were included in the analysis. Among the cohort, 52.5% were vitamin D deficient, 14.2% had levels between 20 and 30 ng/ml and 15.8% had a level of 40 ng/ml or more.

Mortality from COVID-19 occurred in 2.3% of people with adequate vitamin D levels and 25.6% of people with vitamin D deficiency (p < 0.001). When stratifying COVID-19 disease severity with vitamin D status, among those with the lowest vitamin D levels, a higher proportion (87.4%) developed severe COVID-19 or critical versus mild to moderate disease, 34.3% (p < 0.001). In regression analysis, patients with vitamin D deficiency compared to those with high normal levels (40 ng/ml) were 14 times more likely to develop severe or critical disease (odds ratio, OR = 14 , 95% CI 4 - 51, p < 0.001). Overall, when comparing prehospital vitamin D levels with COVID-19 disease severity, there was a clear inverse relationship such that as vitamin D levels reduced, disease severity COVID-19 was increasing.

Further analysis revealed that age was an independent risk factor for more severe disease, and that the strongest correlation between vitamin D status and COVID-19 severity occurred in people aged 50 years and over (r = – 0.74, p < 0.001). However, this correlation remains significant in the under 50s (r = -0.66, p < 0.001).

The authors described how, at the start of the current pandemic, there was much debate about the role of vitamin D in protection against COVID-19. They suggested their study provided further evidence of how vitamin D-deficient patients were at much higher risk of more severe COVID-19 infection and called for further studies to determine if and when vitamin D supplementation. vitamin D in those who are deficient, impacts COVID-19. 19 related results.

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Dror AA et al. 25-Hydroxyvitamin D3 levels before infection and association with COVID-19 disease severity PloS One 2022