Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.
Aging Clin Exp Res. 2021 May;33(5):1415-1422. doi: 10.1007/s40520-021-01831-0. Epub 2021 Mar 31.
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.
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.
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].
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.
随着全球继续谨慎应对 2019 年冠状病毒病（COVID-19）大流行，目前正在开发和研究几种治疗方法和疫苗的突破。因此，对于严重急性呼吸冠状病毒 2（SARS-CoV-2）预防的替代疗法，如维生素 D 补充剂，虽然具有理论上的前景，但需要受 COVID-19 影响的国家提供大量证据。本回顾性病例对照研究旨在确定筛查 SARS-CoV-2 的住院患者的维生素 D 状况和临床特征差异，并确定维生素 D 水平与 COVID-19 风险增加和死亡率之间的关联。
2020 年 5 月至 7 月，从沙特阿拉伯利雅得的沙特国王大学医疗城-哈立德国王大学医院（KSUMC-KKUH）筛查 SARS-CoV-2 并收治的 550 名住院成年患者中，共纳入 222 名（SARS-CoV-2（+）N=150[97 名男性；53 名女性]；SARS-CoV-2（-）N=72[38 名男性，34 名女性]）。分析了临床、放射学和血清学数据，包括 25（OH）D 水平。
所有患者中维生素 D 缺乏（25（OH）D<50 nmol/L）的发生率为 75%。调整年龄、性别和体重指数（BMI）后，SARS-CoV-2（+）患者的血清 25（OH）D 水平明显低于 SARS-CoV-2（-）患者（35.8±1.5 nmol/L 与 42.5±3.0 nmol/L；p=0.037）。多变量回归分析显示，年龄>60 岁和既往疾病是 SARS-CoV-2 的显著预测因素（p<0.05）。调整协变量后，死亡率的显著预测因素包括男性[优势比，OR 3.3（95%置信区间，CI 1.2-9.2）；p=0.02]、慢性肾脏病[OR 3.5（95%CI 1.4-8.7）；p=0.008]和严重的 25（OH）D 缺乏症（<12.5 nmol/L），但具有边缘显著性[OR 4.9（95%CI（0.9-25.8）；p=0.06]。
在医院环境中，25（OH）D 缺乏与 SARS-CoV-2 感染无关，但可能会增加严重缺乏症患者的死亡风险。需要进行临床试验以确定维生素 D 状态纠正是否对 COVID-19 结局产生保护作用。
