Vitamin D Status and Mortality from SARS CoV-2: A Prospective Study of Unvaccinated Caucasian Adults

• Published in: Nutrients Vol. 14; no. 16; p. 3252
• Main Authors: Barrett, Robert, Youssef, Modar, Shah, Irfan, Ioana, Julia, Lawati, Abdullah Al, Bukhari, Abdullah, Hegarty, Suzanne, Cormican, Liam J, Judge, Eoin, Burke, Conor M, Cody, Catriona, Feely, Joseph, Hutchinson, Katrina, Tormey, William, Neill, Eoghan O', Shea, Aoife O', Connolly, Meabh, McCartney, Daniel M A, Faul, John L
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.08.2022; MDPI
• Subjects: Adult; Adults; Age groups; Aged; Aged, 80 and over; Alfacalcidol; Automation; Bacterial pneumonia; Body mass index; Calcifediol; Calciferol; Clinical outcomes; Complications and side effects; Coronaviruses; COVID-19; Diabetes; Diabetes mellitus; Ethylenediaminetetraacetic acid; Health aspects; Hospital patients; Hospitalization; Humans; Inflammation; Ireland; Laboratories; Middle Aged; Mortality; Obesity; Pneumonia; Prospective Studies; Regression analysis; Risk analysis; Risk factors; Risk sharing; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Steroids; Variance analysis; Vitamin D; Vitamin D Deficiency; Vitamin deficiency; Vitamins; Ireland; United States > US; Germany; COVID-19; mortality; hospitalization; Ireland; vitamin D
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14163252

COVID-19 and a low vitamin D state share common risk factors, which might explain why vitamin D deficiency has been linked with higher COVID-19 mortality. Moreover, measures of serum vitamin D may become lower during systemic inflammatory responses, further confounding the association via reverse causality. In this prospective study (recruited over 12 months), we examined whether the association between a low vitamin D state and in-hospital mortality due to SARS-CoV-2 pneumonia in unvaccinated subjects is explained by (i) the presence of shared risk factors (e.g., obesity, advanced age) or (ii) a reduction in serum 25(OH)D due to COVID-19 (i.e., reverse causality). In this cohort of 232 (mean age = 56 years) patients (all had SARS-CoV-2 diagnosed via PCR AND required supplemental oxygen therapy), we failed to find an association between serum vitamin D and levels of CRP, or other inflammatory markers. However, the hazard ratio for mortality for subjects over 70 years of age (13.2) and for subjects with a serum 25(OH)D level less than 30 nmol·L−1 (4.6) remained significantly elevated even after adjustment for gender, obesity and the presence of diabetes mellitus. Subjects <70 years and >70 years had significantly higher mortality with a serum 25(OH)D less than 30 nmol·L−1 (11.8% and 55%), than with a serum 25(OH)D greater than 30 nmol·L−1 (2.2% and 25%). Unvaccinated Caucasian adults with a low vitamin D state have higher mortality due to SARS CoV-2 pneumonia, which is not explained by confounders and is not closely linked with elevated serum CRP.