Department of Internal Medicine, Wayne State University, Detroit, Michigan.
Wayne State University, Detroit, Michigan.
Am J Physiol Endocrinol Metab. 2021 Mar 1;320(3):E520-E526. doi: 10.1152/ajpendo.00517.2020. Epub 2021 Jan 6.
The immunomodulating role of vitamin D might play a role in COVID-19 disease. We studied the association between vitamin D and clinical outcomes in COVID-19 patients. This is a retrospective cohort study on COVID-19 patients with documented vitamin D levels within the last year. Vitamin D levels were grouped as ≥ 20 ng/mL or < 20 ng/mL. Main outcomes were mortality, need for mechanical ventilation, new DVT or pulmonary embolism, and ICU admission. A total of 270 patients (mean ± SD) age, 63.81 (14.69) years); 117 (43.3%) males; 216 (80%) Blacks; 139 (51.5%) in 65 and older age group were included. Vitamin D levels were less than 20 ng/mL in 95 (35.2%) patients. During admission, 72 patients (26.7%) died, 59 (21.9%) needed mechanical ventilation, and 87 (32.2%) required ICU. Vitamin D levels showed no significant association with mortality (OR = 0.69; 95% CI, 0.39-1.24; = 0.21), need for mechanical ventilation (OR = 1.23; 95% CI, 0.68-2.24; = 0.49), new DVT or PE(OR= 0.92; 95% CI, 0.16-5.11; = 1.00) or ICU admission (OR = 1.38; 95% CI, 0.81-2.34; = 0.23). We did not find any significant association of vitamin D levels with mortality, the need for mechanical ventilation, ICU admission and the development of thromboembolism in COVID-19 patients. Low vitamin D has been associated with increased frequency and severity of respiratory tract infections in the past. Current literature linking clinical outcomes in COVID-19 with low vitamin D is debatable. This study evaluated the role of vitamin D in severe disease outcomes among COVID-19 patients and found no association of vitamin D levels with mortality, the need for mechanical ventilation, ICU admission, and thromboembolism in COVID-19.
维生素 D 的免疫调节作用可能在 COVID-19 疾病中发挥作用。我们研究了维生素 D 与 COVID-19 患者临床结局之间的关系。这是一项回顾性队列研究,纳入了过去一年有记录的维生素 D 水平的 COVID-19 患者。将维生素 D 水平分为≥20ng/mL 或<20ng/mL。主要结局为死亡率、需要机械通气、新发深静脉血栓形成或肺栓塞以及入住 ICU。共纳入 270 例患者(平均±标准差)年龄 63.81(14.69)岁;117 例(43.3%)男性;216 例(80%)黑人;139 例(51.5%)年龄在 65 岁及以上。95 例(35.2%)患者的维生素 D 水平<20ng/mL。住院期间,72 例(26.7%)患者死亡,59 例(21.9%)需要机械通气,87 例(32.2%)需要入住 ICU。维生素 D 水平与死亡率无显著相关性(OR=0.69;95%CI,0.39-1.24;=0.21)、机械通气需求(OR=1.23;95%CI,0.68-2.24;=0.49)、新发深静脉血栓形成或肺栓塞(OR=0.92;95%CI,0.16-5.11;=1.00)或 ICU 入院(OR=1.38;95%CI,0.81-2.34;=0.23)。我们没有发现维生素 D 水平与 COVID-19 患者的死亡率、机械通气需求、ICU 入院和血栓栓塞的发生有任何显著关联。过去,维生素 D 水平较低与呼吸道感染的频率和严重程度增加有关。目前将维生素 D 与 COVID-19 临床结局联系起来的文献存在争议。本研究评估了维生素 D 在 COVID-19 患者严重疾病结局中的作用,结果发现维生素 D 水平与死亡率、机械通气需求、COVID-19 患者 ICU 入院和血栓栓塞无关联。