Vitamin D and Lung Outcomes in Elderly COVID-19 Patients

• Published in: Nutrients Vol. 13; no. 3; p. 717
• Main Authors: Sulli, Alberto, Gotelli, Emanuele, Casabella, Andrea, Paolino, Sabrina, Pizzorni, Carmen, Alessandri, Elisa, Grosso, Marco, Ferone, Diego, Smith, Vanessa, Cutolo, Maurizio
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 24.02.2021; MDPI
• Subjects: Age; Age Factors; Aged; Aged, 80 and over; Blood; C-reactive protein; Calciferol; Computed tomography; Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - diagnostic imaging; COVID-19 - mortality; COVID-19 - physiopathology; disease severity; Female; Health risks; Hospitalization; Humans; Infections; Laboratories; Lung - diagnostic imaging; Lung - physiopathology; Lung diseases; lung involvement; Lungs; Male; Middle Aged; Older people; Patients; Proteins; Regression analysis; Risk analysis; Risk Factors; SARS-CoV-2; SARS-CoV-2 - metabolism; Serum levels; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Sulfur dioxide; Tomography, X-Ray Computed; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - blood; Vitamin D Deficiency - diagnostic imaging; Vitamin D Deficiency - mortality; Vitamin D Deficiency - physiopathology; Vitamin deficiency; COVID-19; SARS-CoV-2; Vitamin D; disease severity; lung involvement
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13030717

Vitamin D deficiency is frequently reported in patients with SARS-CoV-2 infection. The aim of this study was to correlate the 25OH-Vitamin D serum concentrations with clinical parameters of lung involvement, in elderly patients hospitalized for SARS-CoV-2 infection. Sixty-five consecutive COVID-19 patients (mean age 76 ± 13 years) and sixty-five sex- and age-matched control subjects (CNT) were analyzed. The following clinical parameters, including comorbidities, were collected at admission: type of pulmonary involvement, respiratory parameters (PaO , SO , PaCO , PaO /FiO ), laboratory parameters (including 25OH-vitamin D, D-dimer, C-reactive protein). Significantly lower vitamin D serum levels were found in COVID-19 patients than in CNT (median 7.9 vs 16.3 ng/mL, = 0.001). Interestingly, a statistically significant positive correlation was observed between vitamin D serum levels and PaO ( = 0.03), SO ( = 0.05), PaO /FiO ( = 0.02), while a statistically significant negative correlation was found between vitamin D serum levels and D-dimer ( = 0.04), C-reactive protein ( = 0.04) and percentage of O in a venturi mask ( = 0.04). A negative correlation was also observed between vitamin D serum levels and severity of radiologic pulmonary involvement, evaluated by computed tomography: in particular, vitamin D was found significantly lower in COVID-19 patients with either multiple lung consolidations ( = 0.0001) or diffuse/severe interstitial lung involvement than in those with mild involvement ( = 0.05). Finally, significantly lower vitamin D serum levels were found in the elderly COVID-19 patients who died during hospitalization, compared to those who survived (median 3.0 vs 8.4 ng/mL, = 0.046). This study confirms that 25OH-vitamin D serum deficiency is associated with more severe lung involvement, longer disease duration and risk of death, in elderly COVID-19 patients. The detection of low vitamin D levels also in younger COVID-19 patients with less comorbidities further suggests vitamin D deficiency as crucial risk factor at any age.