Severe vitamin D deficiency is not related to SARS-CoV-2 infection but may increase mortality risk in hospitalized adults: a retrospective case-control study in an Arab Gulf country
Aging Clin Exp Res. 2021 Mar 31. doi: 10.1007/s40520-021-01831-0
Abdullah M Alguwaihes # 1, Shaun Sabico # 2, Rana Hasanato 3, Mohammed E Al-Sofiani 4 5 6, Maram Megdad 7, Sakhar S Albader 8, Mohammad H Alsari 8, Ali Alelayan 8, Ebtihal Y Alyusuf 4, Saad H Alzahrani 9, Nasser M Al-Daghri 2, Anwar A Jammah 4
- 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
Purpose: As the world continues to cautiously navigate its way through the coronavirus disease 2019 (COVID-19) pandemic, several breakthroughs in therapies and vaccines are currently being developed and scrutinized. Consequently, alternative therapies for severe acute respiratory coronavirus 2 (SARS-CoV-2) prevention, such as vitamin D supplementation, while hypothetically promising, require substantial evidence from countries affected by COVID-19. The present retrospective case-control study aims to identify differences in vitamin D status and clinical characteristics of hospitalized patients screened for SARS-CoV-2, and determine associations of vitamin D levels with increased COVID-19 risk and mortality.
Methods: A total of 222 [SARS-CoV-2 (+) N = 150 (97 males; 53 females); SARS-CoV-2 (-) N = 72 (38 males, 34 females)] out of 550 hospitalized adult patients screened for SARS-CoV-2 and admitted at King Saud University Medical City-King Khalid University Hospital (KSUMC-KKUH) in Riyadh, Saudi Arabia from May-July 2020 were included. Clinical, radiologic and serologic data, including 25(OH)D levels were analyzed.
Results: Vitamin D deficiency (25(OH)D < 50 nmol/l) was present in 75% of all patients. Serum 25(OH)D levels were significantly lower among SARS-CoV-2 (+) than SARS-CoV-2 (-) patients after adjusting for age, sex and body mass index (BMI) (35.8 ± 1.5 nmol/l vs. 42.5 ± 3.0 nmol/l; p = 0.037). Multivariate regression analysis revealed that significant predictors for SARS-CoV-2 include age > 60 years and pre-existing conditions (p < 0.05). Statistically significant predictors for mortality adjusted for covariates include male sex [Odds ratio, OR 3.3 (95% confidence interval, CI 1.2-9.2); p = 0.02], chronic kidney disease [OR 3.5 (95% CI 1.4-8.7); p = 0.008] and severe 25(OH)D deficiency (< 12.5 nmol/l), but at borderline significance [OR 4.9 (95% CI (0.9-25.8); p = 0.06].
Conclusion: In hospital settings, 25(OH)D deficiency is not associated with SARS-CoV-2 infection, but may increase risk for mortality in severely deficient cases. Clinical trials are warranted to determine whether vitamin D status correction provides protective effects against worse COVID-19 outcomes.