Hospital Outcomes in Patients Hospitalized for COVID-19 Pneumonia: The Effect of SARS-CoV-2 Vaccination and Vitamin D Status

• Published in: Nutrients Vol. 15; no. 13; p. 2976
• Main Authors: Sanecka, Martyna, Youssef, Modar, Abdulsalam, Mohammad, Raza, Syed F, Qadeer, Abdul, Ioana, Julia, Aldoresi, Alya, Shah, Syed I, Al Lawati, Abdul, Feely, Joseph, Tormey, William P, O'Neill, Eoghan, Cormican, Liam J, Judge, Eoin P, McCartney, Daniel M A, Faul, John L
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.06.2023; MDPI
• Subjects: 25-Hydroxyvitamin D; 25-Hydroxyvitamin D (25(OH)D); Age; Aged; Aged, 80 and over; Alfacalcidol; Analysis; Antibodies; Bacterial pneumonia; Body mass index; Calcifediol; Calciferol; Clinical outcomes; COVID-19; COVID-19 - prevention & control; COVID-19 Vaccines; Cytotoxicity; Diabetes; Diabetes mellitus; Drug dosages; Health risks; hospitalization; Hospitals; Humans; Hypertension; Infections; Ireland; Mortality; Overweight; Patient outcomes; Pneumonia; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Statistical significance; Vaccination; Ventilators; Vitamin D; Vitamins; Ireland; COVID-19; 25-Hydroxyvitamin D (25(OH)D); SARS-CoV-2; hospitalization; vitamin D; mortality; unvaccinated; vaccinated
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15132976

SARS-CoV-2 vaccination promises to improve outcomes for patients with COVID-19 pneumonia (most notably those with advanced age and at high risk for severe disease). Here, we examine serum 25-Hydroxyvitamin D (25(OH)D) status and outcomes in both old (>70 years) and young vaccinated ( = 80) and unvaccinated ( = 91) subjects, who were hospitalized due to COVID-19 pneumonia in a single center (Connolly Hospital Dublin). Outcomes included ICU admission and mortality. Serum 25(OH)D levels were categorized as D30 (<30 nmol/L), D40 (30-49.99 nmol/L) and D50 (≥50 nmol/L). In multivariate analyses, D30 was independently associated with ICU admission (OR: 6.87 (95% CI: 1.13-41.85) ( = 0.036)) and mortality (OR: 24.81 (95% CI: 1.57-392.1) ( = 0.023)) in unvaccinated patients, even after adjustment for major confounders including age, sex, obesity and pre-existing diabetes mellitus. While mortality was consistently higher in all categories of patients over 70 years of age, the highest observed mortality rate of 50%, seen in patients over 70 years with a low vitamin D state (D30), appeared to be almost completely corrected by either vaccination, or having a higher vitamin D state, i.e., mortality was 14% for vaccinated patients over 70 years with D30 and 16% for unvaccinated patients over 70 years with a 25(OH)D level greater than 30 nmol/L. We observe that high mortality from COVID-19 pneumonia occurs in older patients, especially those who are unvaccinated or have a low vitamin D state. Recent vaccination or having a high vitamin D status are both associated with reduced mortality, although these effects do not fully mitigate the mortality risk associated with advanced age.