Department of Internal Medicine, Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
University of Cantabria, Santander, Spain.
J Clin Endocrinol Metab. 2021 Mar 8;106(3):e1343-e1353. doi: 10.1210/clinem/dgaa733.
The role of vitamin D status in COVID-19 patients is a matter of debate.
To assess serum 25-hydroxyvitamin D (25OHD) levels in hospitalized patients with COVID-19 and to analyze the possible influence of vitamin D status on disease severity.
Retrospective case-control study of 216 COVID-19 patients and 197 population-based controls. Serum 25OHD levels were measured in both groups. The association of serum 25OHD levels with COVID-19 severity (admission to the intensive care unit, requirements for mechanical ventilation, or mortality) was also evaluated.
Of the 216 patients, 19 were on vitamin D supplements and were analyzed separately. In COVID-19 patients, mean ± standard deviation 25OHD levels were 13.8 ± 7.2 ng/mL, compared with 20.9 ± 7.4 ng/mL in controls (P < .0001). 25OHD values were lower in men than in women. Vitamin D deficiency was found in 82.2% of COVID-19 cases and 47.2% of population-based controls (P < .0001). 25OHD inversely correlates with serum ferritin (P = .013) and D-dimer levels (P = .027). Vitamin D-deficient COVID-19 patients had a greater prevalence of hypertension and cardiovascular diseases, raised serum ferritin and troponin levels, as well as a longer length of hospital stay than those with serum 25OHD levels ≥20 ng/mL. No causal relationship was found between vitamin D deficiency and COVID-19 severity as a combined endpoint or as its separate components.
25OHD levels are lower in hospitalized COVID-19 patients than in population-based controls and these patients had a higher prevalence of deficiency. We did not find any relationship between vitamin D concentrations or vitamin deficiency and the severity of the disease.
维生素 D 状态在 COVID-19 患者中的作用仍存在争议。
评估住院 COVID-19 患者的血清 25-羟维生素 D(25OHD)水平,并分析维生素 D 状态对疾病严重程度的可能影响。
对 216 例 COVID-19 患者和 197 例基于人群的对照进行回顾性病例对照研究。两组均测量血清 25OHD 水平。还评估了血清 25OHD 水平与 COVID-19 严重程度(入住重症监护病房、需要机械通气或死亡)的关系。
在 216 例患者中,有 19 例正在服用维生素 D 补充剂并单独进行了分析。COVID-19 患者的平均±标准差 25OHD 水平为 13.8±7.2ng/mL,而对照组为 20.9±7.4ng/mL(P<0.0001)。男性的 25OHD 值低于女性。82.2%的 COVID-19 病例和 47.2%的基于人群的对照组存在维生素 D 缺乏(P<0.0001)。25OHD 与血清铁蛋白(P=0.013)和 D-二聚体水平(P=0.027)呈负相关。与血清 25OHD 水平≥20ng/mL 的 COVID-19 患者相比,维生素 D 缺乏的 COVID-19 患者更常见高血压和心血管疾病,血清铁蛋白和肌钙蛋白水平升高,住院时间更长。未发现维生素 D 缺乏与 COVID-19 严重程度作为综合终点或其单独组成部分之间存在因果关系。
与基于人群的对照组相比,住院 COVID-19 患者的 25OHD 水平较低,且这些患者维生素 D 缺乏的发生率更高。我们没有发现维生素 D 浓度或维生素缺乏与疾病严重程度之间存在任何关系。