Department of Medicine, Federal University of São Carlos - UFSCar, São Carlos, Brazil.
Department of Medicine, Federal University of São Carlos - UFSCar, São Carlos, Brazil.
Clin Nutr ESPEN. 2022 Aug;50:322-325. doi: 10.1016/j.clnesp.2022.05.027. Epub 2022 Jun 14.
BACKGROUND & AIMS: Several studies have shown conflicting results for the relationship between vitamin D deficiency and COVID-19 outcomes. Here, we aimed to evaluate whether plasma 25(OH)D levels predict mortality in adults admitted with COVID-19, considering potential confounders.
We conducted a retrospective cohort study that included 115 adults (age 62.1 ± 17.6 years, 65 males) admitted to a Brazilian public hospital for severely symptomatic COVID-19. Subjects were classified into two groups according to their plasma levels of 25(OH)D: sufficiency (≥50 nmol/L) and the deficiency (<50 nmol/L). The diagnosis of COVID-19 was performed using real-time polymerase chain reaction (qPCR). In addition, direct competitive chemiluminescence immunoassay assessed serum 25(OH)D levels.
The all-cause 30-day mortality was 13.8% (95% CI: 6.5%-21%) in the group of patients with sufficient plasma 25(OH)D levels and 32.1% (95% CI: 14.8%-49.4%) among those with deficient plasma 25(OH)D levels. Cox regression showed that plasma 25(OH)D levels remained a significant predictor of mortality even after adjusting for the covariates sex, age, length of the delay between symptom onset and hospitalization, and disease severity (HR = 0.98, 95% CI: 0.96-1.00; p = 0.02).
Vitamin D deficiency predicts higher mortality risk in adults with COVID-19.
几项研究表明,维生素 D 缺乏与 COVID-19 结局之间的关系存在矛盾的结果。在这里,我们旨在评估血浆 25(OH)D 水平是否可以预测患有 COVID-19 的成年人的死亡率,同时考虑潜在的混杂因素。
我们进行了一项回顾性队列研究,纳入了 115 名(年龄 62.1±17.6 岁,65 名男性)因严重症状性 COVID-19 而入住巴西公立医院的成年人。根据其血浆 25(OH)D 水平,将受试者分为两组:充足(≥50 nmol/L)和缺乏(<50 nmol/L)。COVID-19 的诊断采用实时聚合酶链反应(qPCR)进行。此外,直接竞争化学发光免疫分析法评估血清 25(OH)D 水平。
在血浆 25(OH)D 水平充足的患者组中,全因 30 天死亡率为 13.8%(95%CI:6.5%-21%),而在血浆 25(OH)D 水平缺乏的患者组中为 32.1%(95%CI:14.8%-49.4%)。Cox 回归分析表明,即使在调整了性别、年龄、症状出现与住院之间的延迟时间和疾病严重程度等混杂因素后,血浆 25(OH)D 水平仍然是死亡率的显著预测因子(HR=0.98,95%CI:0.96-1.00;p=0.02)。
维生素 D 缺乏症可预测 COVID-19 成年患者的死亡率更高。