Pneumonia acquired in hospital – 3X more likely to die if low vitamin D – June 2015

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• Hospital-acquired pneumonia treated by vitamin D if person was deficient – RCT Sept 2018
• Pneumonia patients 3 X more likely to die if low vitamin D – meta-analysis Sept 2017
• Search VitaminDWiki for community pneumonia 376 items as of Sept 2018
• Pneumonia and low vitamin D - many studies
• Pneumonia 2.6X more likely if low vitamin D – April 2013
• Pneumonia in seniors was 2.5X more likely if low vitamin D – June 2014

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Community-acquired pneumonia 3.7 X more likely if not < 30 ng vitamin D - Nov 2017

Association between serum concentration of 25-hydroxyvitamin D and community-acquired pneumonia: a case-control study.
Int J Gen Med. 2017 Nov 13;10:423-429. doi: 10.2147/IJGM.S149049. eCollection 2017.
Mamani M1,2, Muceli N2, Ghasemi Basir HR3, Vasheghani M4, Poorolajal J5.

BACKGROUND:
Community-acquired pneumonia (CAP) is a common disease with significant morbidity and mortality. There is evidence that vitamin D deficiency can be associated with infectious diseases. The aim of this study was to compare the levels of vitamin D between patients with CAP and healthy controls.

METHODS:
In a case-control study on 73 patients with CAP and 76 healthy controls, the serum concentration of 25-hydroxyvitamin D (25[OH]D) was measured. Severity and outcomes of disease and also duration of hospital stay were compared in patients with different levels of 25(OH)D. The severity of CAP was assessed using the CURB-65 score (confusion, uremia, respiratory rate, low blood pressure, age ≥65 years) and was also reflected by the length of hospital stay, admission to intensive care unit (ICU), and 30-day mortality.

RESULTS:
In total, 81.2% of the study population had vitamin D levels <30 ng/dL. The risk of pneumonia among subjects with deficient vitamin D levels was 3.69 (95% CI: 1.46, 9.31) times of those with sufficient vitamin D level (P=0.006). Prevalence of severe deficiency of vitamin D in scores three and four of CURB-65 (59.38%), was far more than scores one and two (31.71%). Also, results indicated patients with severe deficiency had a higher risk for ICU admission, 30-day mortality, and longer hospitalization stay, but these were not statistically significant.

CONCLUSION:
According to findings, a low level of 25(OH)D is associated with a higher incidence of CAP and more severe disease. It is recommended to pay more attention to vitamin D deficiency in infectious diseases, particularly in CAP patients.

PMID: 29180888 PMCID: PMC5692194 DOI: 10.2147/IJGM.S149049
 Download the PDF from VitaminDWiki

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Relationship between serum vitamin D concentrations and clinical outcome of community-acquired pneumonia. - 2015

Int J Tuberc Lung Dis. 2015 Jun;19(6):729-734.
Kim HJ1, Jang JG2, Hong KS2, Park JK3, Choi EY2.
1Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea.
2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Regional Respiratory Center, Yeungnam University Hospital, Daegu, South Korea.
3Department of Internal Medicine, The Catholic University of Korea College of Medicine, Uijeongbu St Mary's Hospital, Uijeongbu, South Korea.

SETTING: Hospitalised patients with community-acquired pneumonia (CAP) in a tertiary referral hospital in South Korea.

OBJECTIVE: To determine the burden of vitamin D deficiency in patients hospitalised with CAP and to investigate whether vitamin D deficiency affected clinical outcomes.

DESIGN: Serum 25-hydroxyvitamin D (25[OH]D) levels were measured at admission; vitamin D deficiency was defined as 25(OH)D <20 ng/ml. Data were retrospectively analysed for incidence of vitamin D deficiency. The primary outcome was the relationship between serum vitamin D concentration and 28-day all-cause mortality in CAP.

RESULTS: The mean age was 68.1 years (standard deviation [SD] ± 14.6), and the mean pneumonia severity index was 98.0 (±SD 28.6). Of the 797 patients (males 66.0%), 641 (80.4%) had vitamin D deficiency. Overall mean serum 25(OH)D level was 14.0 ± 7.4 ng/ml. The 28-day all-cause mortality rate in vitamin D-deficient patients was significantly higher than in non-deficient patients (8.3% vs. 2.6%, P = 0.01), and serum vitamin D level was negatively associated with risk of 28-day mortality in CAP after adjustment for pneumonia severity index and serum lactate levels (OR 0.94, 95%CI 0.90-0.99, P < 0.01).

CONCLUSION: The prevalence of vitamin D deficiency was ~80% in patients hospitalised with CAP. Vitamin D deficiency was also a significant predictor of increased 28-day all-cause mortality.

PMID: 25946368  Download the PDF from VitaminDWiki