Impact of Low Vitamin D Levels on COVID-19-Related Hospitalization and Mortality: Results From a National Cohort of Veterans Affairs Patients
2021 Integrative Medicine & Health Symposium Abstracts April 13
Karen Seal karen.seal at va.gov , Daniel Bertenthal and Evan Carey
1San Francisco VA Health Care System and University of California, San Francisco, San Francisco, California
2San Francisco VA Health Care System, San Francisco, California
3Center of Innovation for Veteran-Centered and Value-Driven Care, St. Louis, Missouri
4Saint Louis University Center for Health Outcomes Research, St. Louis, Missouri
This study investigated whether low vitamin D levels are independently associated with COVID-19-related hospitalization and mortality.
A retrospective cohort of 5,634 COVID-19+ patients with recent Vitamin D labs receiving care at US Department of Veteran Affairs (VA) health care facilities from February 20, 2020 to November 8, 2020, was identified. Vitamin D level was ascertained using the 25-hydroxyvitamin D3 or D2 + D3 test result within 90 days preceding the index positive COVID-19 test. Study outcomes were: (1) inpatient hospitalization requiring isolation and (2) 30-day mortality among those hospitalized. Poisson Generalized Linear Models with robust errors and adjusted for sociodemographics and comorbidities were used to estimate outcome probabilities conditional on the log of Vitamin D levels.
Of 5,634 veterans with a positive COVID-19 test, 707 (12.6%) were female, mean age was 62.5 (SD +/−15.1); 1,920 (34.1%) identified as non-White, and 623 (11.1%) as Latinx. Low vitamin D levels (<20 ng/ml) were found in 794 (14.1%) and 1,162 (20.6%) were hospitalized for COVID-19 infection. After adjusting for all covariates, the probability of hospitalization was 23.7% for those with Vitamin D levels of 15ng/ml, but decreased to 19.8% for patients with higher vitamin D levels of 40 ng/ml, [Adjusted Relative Risk (ARR) = 1.20 (1.06, 1.36, p = .004)]. Among 1,162 hospitalized patients, 186 (16.0%) died within 30 days. The adjusted mortality rate for patients with Vitamin D levels of 15 ng/ml was 22.3% and decreased to 14.4% for patients with higher vitamin D levels of 40 ng/ml, [ARR = 1.55 (1.11,2.18, p = .011)].
Vitamin D level may have a role in predicting COVID-19-related hospitalization and mortality; larger trials are needed to determine if vitamin D supplementation improves COVID-19-related clinical outcomes.
- COVID-19 deaths 1.5X less likely if more than 40 ng of vitamin D – US VA – April 2021
- Vitamin D supplementation and high levels reduce COVID-19 deaths in elderly – Review April 17, 2021
- Less COVID-19 infection, mortality in countries with higher Vitamin D (Asia in this case) – May 2021
- Risk of COVID-19 death was 4.9 X higher if very low vitamin D – March 31, 2021
- COVID-19 mortality 2X higher if low Vitamin D (Mexican hospital, preprint) - March 2021
- All COVID-19 patients had low vitamin D, the lowest were more likely to die – Feb 18, 2021
- 2.7 fewer COVID-19 hospital deaths in those having more than 30 ng of vitamin D – Mayo Jan 9, 2021
- Worse COVID-19 patients got 400,000 IU of vitamin D, deaths cut in half – Jan 14, 2021
- Iranians with COVID-19 were 2.3 X more likely to die if low vitamin D – Jan 2021
- Poor COVID-19 prognosis was 6 X more likely if low vitamin D – Jan 21, 2021
- 30 x fewer COVID-19 deaths in those getting 400,000 IU of Vitamin D - Jan 2021
- 2.8 X fewer COVID-19 nursing home deaths if add 10,000 IU Vitamin D daily for a week (small observation)- Jan 2021
- Italian nursing home COVID-19 – 4X less likely to die if taking Vitamin D– Dec 22, 2020
- Those getting intermittent vitamin D were 7 X less likely to die of COVID-19 - Dec 11, 2020
- COVID-19 male mortality increased 3.9 X if low vitamin D – observation Nov 25, 2020
- Hospital COVID-19 observation: 7X more likely to live if more than 20 ng of vitamin D– Nov 19, 2020
- COVID-19 lung death 4X more likely in Iran if less than 25 ng of vitamin D – Oct 30, 2020
- 9X COVID-19 survival in nursing home if had 80,000 IU dose of vitamin D in previous month – Oct 2020
- 14.7 X more likely to die of COVID-19 if less than 12 ng of Vitamin D (185 Germans) – Sept 10, 2020
- COVID ARDS deaths 2X more likely if less than 10 ng of Vitamin D – Aug 8, 2020
- COVID-19 mortality rate highest North of 35 degrees latitude (Vitamin D) – April 20, 2020