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COVID-19 deaths 1.5X less likely if more than 40 ng of vitamin D – US VA – April 2021

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

Objective
This study investigated whether low vitamin D levels are independently associated with COVID-19-related hospitalization and mortality.

Methods
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.

Results
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)].

Conclusion
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.


Mortality and Virus studies


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