Hospital Outcomes in Patients Hospitalized for COVID-19 Pneumonia: The Effect of SARS-CoV-2 Vaccination and Vitamin D Status
Nutrients 2023, 15(13), 2976; https://doi.org/10.3390/nu15132976
by Martyna Sanecka 1,Modar Youssef 2,Mohammad Abdulsalam 2,Syed F. Raza 2,Abdul Qadeer 2,Julia Ioana 2,Alya Aldoresi 2,Syed I. Shah 2,Abdul Al Lawati 2,Joseph Feely 3,William P. Tormey 3,Eoghan O’Neill 4,Liam J. Cormican 2,Eoin P. Judge 2,Daniel M. A. McCartney 1 andJohn L. Faul 2,5,6,*ORCID
SARS-CoV-2 vaccination promises to improve outcomes for patients with COVID-19 pneumonia (most notably those with advanced age and at high risk for severe disease). Here, we examine serum 25-Hydroxyvitamin D (25(OH)D) status and outcomes in both old (>70 years) and young vaccinated (n = 80) and unvaccinated (n = 91) subjects, who were hospitalized due to COVID-19 pneumonia in a single center (Connolly Hospital Dublin).
Outcomes included ICU admission and mortality. Serum 25(OH)D levels were categorized as D30 (<30 nmol/L), D40 (30–49.99 nmol/L) and D50 (≥50 nmol/L).
In multivariate analyses, D30 was independently associated with
- ICU admission (OR: 6.87 (95% CI: 1.13–41.85) (p = 0.036)) and
- mortality (OR: 24.81 (95% CI: 1.57–392.1) (p = 0.023))
in unvaccinated patients, even after adjustment for major confounders including age, sex, obesity and pre-existing diabetes mellitus. While mortality was consistently higher in all categories of patients over 70 years of age, the highest observed mortality rate of 50%, seen in patients over 70 years with a low vitamin D state (D30), appeared to be almost completely corrected by either vaccination, or having a higher vitamin D state, i.e., mortality was 14% for vaccinated patients over 70 years with D30 and 16% for unvaccinated patients over 70 years with a 25(OH)D level greater than 30 nmol/L. We observe that high mortality from COVID-19 pneumonia occurs in older patients, especially those who are unvaccinated or have a low vitamin D state. Recent vaccination or having a high vitamin D status are both associated with reduced mortality, although these effects do not fully mitigate the mortality risk associated with advanced age.
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