Department of Respiratory Medicine, Hamamatsu Medical Center, Japan.
Department of Infectious Disease, Hamamatsu Medical Center, Japan.
Clin Nutr. 2023 Oct;42(10):2045-2050. doi: 10.1016/j.clnu.2023.08.021. Epub 2023 Sep 1.
BACKGROUND & AIMS: The efficacy of vitamin D supplementation in coronavirus disease 2019 (COVID-19) remains unclear. This study aimed to evaluate the effect of 1-hydroxy-vitamin D on the prevention of severe disease and mortality in patients hospitalized for COVID-19.
This retrospective study included 312 patients with COVID-19 who were admitted to our hospital between April 2021 and October 2021 (primarily the Delta variant) and between July 2022 and September 2022 (primarily Omicron variant). Serum 25-hydroxyvitamin D (25(OH)D) levels were measured at the time of admission and 1-hydroxy-vitamin D was prescribed by the treating physicians. The patients were divided into two groups: those administered 1-hydroxy-vitamin D (Vit D group) and those who were not (control group). The composite primary endpoint was the need for additional respiratory support, including high-flow oxygen therapy or invasive mechanical ventilation, and in-hospital mortality rate.
Of 312 patients, 122 (39%) received 1-hydroxy-vitamin D treatment. Although the median age was not significantly higher in the Vit D group than in the control group (66 vs. 58 years old, P = 0.06) and there was no significant difference in the proportion of vitamin D deficiency (defined as serum 25(OH)D level less than 20 ng/mL, 77% vs. 65%, P = 0.07), patients in the control group had a more severe baseline profile compared to the Vit D group according to the Japanese disease severity definition for COVID-19 (P = 0.01). The proportion of those requiring more respiratory support and in-hospital mortality was significantly lower in the Vit D group than in the control group (6% vs. 14%, P = 0.01 log-rank test). After propensity score matching, a statistically significant difference in the primary endpoint was observed (P = 0.03 log-rank test).
1-hydroxy-vitamin treatment may improve outcomes in hospitalized patients with COVID-19, reducing composite outcomes including the need for additional respiratory support and in-hospital mortality.
维生素 D 补充剂在 2019 年冠状病毒病（COVID-19）中的疗效尚不清楚。本研究旨在评估 1-羟维生素 D 在预防 COVID-19 住院患者发生重症疾病和死亡方面的效果。
这是一项回顾性研究，纳入了 2021 年 4 月至 2021 年 10 月（主要为德尔塔变异株）和 2022 年 7 月至 2022 年 9 月（主要为奥密克戎变异株）期间因 COVID-19 住院的 312 例患者。在入院时测量血清 25-羟维生素 D（25(OH)D）水平，并由主治医生开具 1-羟维生素 D 处方。患者被分为两组：接受 1-羟维生素 D 治疗的组（Vit D 组）和未接受治疗的组（对照组）。复合主要终点是需要额外的呼吸支持，包括高流量氧疗或有创机械通气，以及住院死亡率。
312 例患者中，122 例（39%）接受了 1-羟维生素 D 治疗。尽管 Vit D 组的中位年龄与对照组无显著差异（66 岁比 58 岁，P=0.06），维生素 D 缺乏的比例也无显著差异（定义为血清 25(OH)D 水平<20ng/mL，77%比 65%，P=0.07），但根据 COVID-19 的日本疾病严重程度定义，对照组患者的基线特征比 Vit D 组更严重（P=0.01）。Vit D 组需要更多呼吸支持和住院死亡率的比例明显低于对照组（6%比 14%，P=0.01，对数秩检验）。在进行倾向评分匹配后，主要终点的差异具有统计学意义（P=0.03，对数秩检验）。
1-羟维生素 D 治疗可能改善 COVID-19 住院患者的结局，降低包括需要额外呼吸支持和住院死亡率在内的复合结局。
