Department of Clinical Biochemistry, Black Country Pathology Services, Walsall Manor Hospital, Walsall, UK.
School of Medicine and Clinical Practice & Department of Biomedical Science and Physiology, Faculty of Science & Engineering, University of Wolverhampton, Wolverhampton, UK.
Int J Clin Pract. 2021 Jul;75(7):e14166. doi: 10.1111/ijcp.14166. Epub 2021 Apr 24.
Accumulating evidence links COVID-19 incidence and outcomes with vitamin D status. We investigated if an interaction existed between vitamin D levels and social deprivation in those with and without COVID-19 infection.
Upper or lower respiratory tract samples from 104 patients were tested for SARS-CoV-2 RNA in accordance with Public Health England criteria (January-May 2020) using RT-PCR. The latest serum total 25-hydroxyvitamin D(25-OHD) levels, quantified by LC-MS/MS, was obtained for each patient (September 2019-April 2020). Index of Multiple Deprivation (IMD) was generated for each patient. Univariate and logistic regression analyses examined associations between age, gender, 25-OHD, IMD score and SARS-CoV-2 result in the total cohort and subgroups.
In the total cohort, a positive SARS-CoV-2 test was significantly associated with lower 25-OHD levels and higher IMD. A positive test was associated with higher IMD in the male subgroup and with lower 25-OHD levels in those aged >72 years. Low 25-OHD and IMD quintile 5 were separately associated with positive COVID-19 outcome in the cohort. Patients in IMD quintile 5 with vitamin D levels ≤ 34.4 nmol/L were most likely to have a positive COVID-19 outcome, even more so if aged >72 years (OR: 19.07, 95%CI: 1.71-212.25; P = .016).
In this cohort, combined low vitamin D levels and higher social deprivation were most associated with COVID-19 infection. In older age, this combination was even more significant. Our data support the recommendations for normalising vitamin D levels in those with deficient / insufficient levels and in groups at high risk for deficiency.
越来越多的证据表明，COVID-19 的发病率和结果与维生素 D 状况有关。我们研究了维生素 D 水平与社会剥夺之间是否存在相互作用，以及这种相互作用在 COVID-19 感染者和非感染者中是否存在差异。
根据英国公共卫生署的标准（2020 年 1 月至 5 月），使用 RT-PCR 对 104 名患者的上呼吸道或下呼吸道样本进行了 SARS-CoV-2 RNA 检测。每位患者的最新血清总 25-羟基维生素 D（25-OHD）水平（通过 LC-MS/MS 定量）在 2019 年 9 月至 2020 年 4 月间获得。为每位患者生成了一个多因素剥夺指数（IMD）。单变量和逻辑回归分析检查了总队列和亚组中年龄、性别、25-OHD、IMD 评分和 SARS-CoV-2 结果之间的关联。
在总队列中，SARS-CoV-2 检测呈阳性与 25-OHD 水平较低和 IMD 较高显著相关。在男性亚组中，阳性检测结果与 IMD 较高相关，而在年龄>72 岁的患者中，阳性检测结果与 25-OHD 水平较低相关。在队列中，低 25-OHD 和 IMD 五分位数 5 分别与 COVID-19 阳性结果相关。IMD 五分位数 5 中维生素 D 水平≤34.4 nmol/L 的患者最有可能出现 COVID-19 阳性结果，尤其是年龄>72 岁的患者（OR：19.07，95%CI：1.71-212.25；P=0.016）。
在本队列中，维生素 D 水平低和社会剥夺程度高与 COVID-19 感染最相关。在老年患者中，这种组合更为显著。我们的数据支持在维生素 D 水平不足或缺乏的患者以及维生素 D 缺乏高危人群中补充维生素 D 的建议。
