Open AccessAssociation of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study
Author(s) -
Alireza Fatemi,
Seyed Hossein Ardehali,
Ghazaleh Eslamian,
Morvarid Noormohammadi,
Shirin Malek
Publication year - 2021
Publication title -
acute and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.345
H-Index - 4
eISSN - 2586-6060
pISSN - 2586-6052
DOI - 10.4266/acc.2021.00605
Subject(s) - medicine , interquartile range , vitamin d deficiency , vitamin d and neurology , hazard ratio , odds ratio , prospective cohort study , confounding , proportional hazards model , logistic regression , observational study , covid-19 , univariate analysis , multivariate analysis , disease , confidence interval , infectious disease (medical specialty)
Background: As the coronavirus disease 2019 (COVID-19) pandemic continues to escalate, it is important to identify the prognostic factors related to increased mortality and disease severity. To assess the possible associations of vitamin D level with disease severity and survival, we studied 248 hospitalized COVID-19 patients in a single center in a prospective observational study from October 2020 to May 2021 in Tehran, Iran. Methods: Patients who had a record of their 25-hydroxyvitamin D level measured in the previous year before testing positive with COVID-19 were included. Serum 25-hydroxyvitamin D level was measured upon admission in COVID-19 patients. The associations between clinical outcomes of patients and 25-hydroxyvitamin D level were assessed by adjusting for potential confounders and estimating a multivariate logistic regression model. Results: The median (interquartile range) age of patients was 60 years (44–74 years), and 53% were male. The median serum 25-hydroxyvitamin D level prior to admission decreased with increasing COVID-19 severity (P=0.009). Similar findings were obtained when comparing median serum 25-hydroxyvitamin D on admission between moderate and severe patients (P=0.014). A univariate logistic regression model showed that vitamin D deficiency prior to COVID-19 was associated with a significant increase in the odds of mortality (odds ratio, 2.01; P=0.041). The Multivariate Cox model showed that vitamin D deficiency on admission was associated with a significant increase in risk for mortality (hazard ratio, 2.35; P=0.019).Conclusions: Based on our results, it is likely that deficient vitamin D status is associated with increased mortality in COVID-19 patients. Thus, evaluating vitamin D level in COVID-19 patients is warranted.