Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study

• Published in: European journal of nutrition Vol. 60; no. 4; pp. 2249 - 2257
• Main Authors: Abrishami, Alireza, Dalili, Nooshin, Mohammadi Torbati, Peyman, Asgari, Reyhaneh, Arab-Ahmadi, Mehran, Behnam, Behdad, Sanei-Taheri, Morteza
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2021; Springer Nature B.V
• Subjects: acute respiratory distress syndrome; Adult; Aged; blood serum; Chemistry; Chemistry and Materials Science; chest; Computed tomography; Coronaviruses; COVID-19; COVID-19 infection; disease course; Female; hazard ratio; hospitals; Humans; Infectious diseases; Inflammation; Lung; lungs; Male; males; Middle Aged; mortality; Nutrition; Original Contribution; Patients; regression analysis; Respiratory distress syndrome; Respiratory tract diseases; Retrospective Studies; risk; sample size; SARS-CoV-2; Statistical analysis; Vitamin D; Vitamin D Deficiency - epidemiology; Vitamin deficiency; COVID-19; Computed tomography; Vitamin D; Outcome
• ISSN: 1436-6207; 1436-6215; 1436-6215
• DOI: 10.1007/s00394-020-02411-0

Purpose Vitamin D deficiency has been reported as a key factor in the development of infectious diseases such as respiratory tract infections and inflammatory processes like acute respiratory distress syndrome. However, the impact of vitamin D on the severity and outcome of COVID-19 is still not fully known. Herein, we aimed to evaluate the prognostic role of serum vitamin D concentration on the extent of lung involvement and final outcome in patients with COVID-19. Methods Seventy-three subjects with confirmed diagnosis of COVID-19 were investigated in this study. The patients had been admitted to our academic hospital from February 28, 2020 to April 19, 2020. Demographic and clinical data, serum 25(OH)D levels, and findings of initial chest computed tomography were recorded. Linear and binary logistic regression, cox regression and ROC curve tests were used for statistical analysis. Results The mean age of patients was 55.18 ± 14.98 years old; 46.4% were male. Mean serum 25(OH)D concentration was significantly lower in the deceased (13.83 ± 12.53 ng/ mL compared with discharged patients (38.41 ± 18.51 ng/mL) ( P  < 0.001). Higher levels of 25(OH)D were associated with significantly less extent of total lung involvement ( β  = − 0.10, P  = 0.004). In addition, vitamin D deficiency [25(OH) D < 25 ng/mL] was associated with a significant increase in the risk of mortality (hazard ratio = 4.15, P  = 0.04). Conclusion This study suggests that serum vitamin D status might provide useful information regarding the clinical course, extent of lung involvement and outcome of patients with COVID-19. However, further studies with larger sample size are needed to confirm these findings.