Vitamin D deficiency, secondary hyperparathyroidism and respiratory insufficiency in hospitalized patients with COVID-19

• Published in: Journal of endocrinological investigation Vol. 44; no. 10; pp. 2285 - 2293
• Main Authors: Mazziotti, G., Lavezzi, E., Brunetti, A., Mirani, M., Favacchio, G., Pizzocaro, A., Sandri, M. T., Di Pasquale, A., Voza, A., Ciccarelli, M., Lania, A. G.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2021; Springer Nature B.V
• Subjects: 25-Hydroxyvitamin D; Adult; Aged; Aged, 80 and over; Blood pressure; Calcium; Calcium (blood); Coronaviruses; COVID-19; COVID-19 - blood; COVID-19 - complications; COVID-19 - therapy; Endocrinology; Female; Humans; Hyperparathyroidism; Hyperparathyroidism - blood; Hyperparathyroidism - complications; Inflammation; Internal Medicine; Male; Mechanical ventilation; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Nutrient deficiency; Original; Original Article; Oxygen; Parathyroid; Parathyroid hormone; Patients; Respiratory Insufficiency - blood; Respiratory Insufficiency - complications; Respiratory Insufficiency - therapy; Retrospective Studies; Risk factors; Severe acute respiratory syndrome coronavirus 2; Treatment Outcome; Ventilation; Vitamin D; Vitamin D Deficiency - blood; Vitamin D Deficiency - complications; Vitamin deficiency; COVID-19; Vitamin D deficiency; Pneumonia; Vitamin D; PTH; SARS-CoV-2 infection; Hyperparathyroidism
• ISSN: 1720-8386; 0391-4097; 1720-8386
• DOI: 10.1007/s40618-021-01535-2

Purpose Hypovitaminosis D has emerged as potential risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the general population with variable effects on the outcome of the coronavirus disease-19 (COVID-19). The aim of this retrospective single-center study was to investigate the impact of hypovitaminosis D and secondary hyperparathyroidism on respiratory outcomes of COVID-19. Methods Three-hundred-forty-eight consecutive patients hospitalized for COVID-19 at the IRCCS Humanitas Research Hospital, Rozzano, Milan (Italy) were evaluated for arterial partial pressure oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio, serum 25hydroxy-vitamin D [25(OH)D], parathyroid hormone (PTH) and inflammatory parameters at study entry and need of ventilation during the hospital stay. Results In the entire population, vitamin D deficiency (i.e., 25(OH)D values < 12 ng/mL) was significantly associated with acute hypoxemic respiratory failure at the study entry [adjusted odds ratio (OR) 2.48, 95% confidence interval 1.29–4.74; P  = 0.006], independently of age and sex of subjects, serum calcium and inflammatory parameters. In patients evaluated for serum PTH (97 cases), secondary hyperparathyroidism combined with vitamin D deficiency was significantly associated with acute hypoxemic respiratory failure at study entry ( P  = 0.001) and need of ventilation during the hospital stay ( P  = 0.031). Conclusion This study provides evidence that vitamin D deficiency, when associated with secondary hyperparathyroidism, may negatively impact the clinical outcome of SARS-CoV-2-related pneumonia.