维生素D水平对老年新冠疫苗接种患者死亡率的影响。

Impact of vitamin D levels on mortality in older covid-19 vaccinated patients.

作者信息

Ceolin Chiara, Vergadoro Margherita, Simonato Cristina, Cazzavillan Sara, Papa Mario Virgilio, Trapella Giulia Salerno, Di Marzio Benedetta, Sermasi Riccardo, Zanforlini Bruno Micael, Curreri Chiara, Bertocco Anna, Devita Maria, Coin Alessandra, Spiezia Luca, Sergi Giuseppe, De Rui Marina

机构信息

Department of Medicine (DIMED) Geriatrics Division, University of Padua, Via Giustiniani 2, Padua, 35128, Italy.

Department of Medicine, First Chair of Internal Medicine, Padova University Hospital, Padua, Italy.

出版信息

BMC Geriatr. 2025 Apr 10;25(1):240. doi: 10.1186/s12877-025-05873-1.

DOI:10.1186/s12877-025-05873-1

PMID:40211163

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11983984/

Abstract

BACKGROUND

Vitamin D plays a key role in regulating the immune system and vaccine response, and hypovitaminosis D is a known risk factor for mortality. However, its potential influence on mortality in SARS-CoV-2 vaccinated older adults remains underexplored. This study aims to examine survival differences between unvaccinated and vaccinated older adults with varying vitamin D levels, and to assess the impact of vitamin D on mortality.

METHODS

We recruited patients aged 65 and over from the Geriatrics Unit of Azienda Ospedale - Università Padova. Clinical, pharmacological data, including vaccination status and vitamin D levels, were collected at admission, alongside mortality data 12 months post-hospitalization. Participants were divided into three groups: unvaccinated, vaccinated with vitamin D levels of 25-50 nmol/L, and vaccinated with levels > 50 nmol/L.

RESULTS

A total of 126 participants were included (56% women, mean age 83 years). No significant differences were found in COVID-19 severity among the three groups. After 12 months, 24 deaths were recorded: 17% in unvaccinated, 19% in vaccinated with low vitamin D, and 20% in vaccinated with high vitamin D (p = 0.94). Kaplan-Meier curves showed that mortality risk for vaccinated individuals with low vitamin D was similar to unvaccinated patients but significantly higher than vaccinated individuals with high vitamin D (p = 0.04). Vitamin D levels of 25-50 nmol/L were associated with a threefold increased risk of 12-month mortality (HR: 3.79, p < 0.001).

CONCLUSIONS

Vitamin D levels can impact mortality in older vaccinated individuals. Early correction of vitamin D deficiency could potentially enhance outcomes.

摘要

背景

维生素D在调节免疫系统和疫苗反应中起关键作用，维生素D缺乏是已知的死亡风险因素。然而，其对接种SARS-CoV-2疫苗的老年人死亡率的潜在影响仍未得到充分研究。本研究旨在探讨不同维生素D水平的未接种疫苗和接种疫苗的老年人之间的生存差异，并评估维生素D对死亡率的影响。

方法

我们从帕多瓦大学医院老年病科招募了65岁及以上的患者。入院时收集临床、药理学数据，包括疫苗接种状况和维生素D水平，以及住院后12个月的死亡率数据。参与者分为三组：未接种疫苗组、维生素D水平为25 - 50 nmol/L的接种疫苗组和维生素D水平>50 nmol/L的接种疫苗组。

结果

共纳入126名参与者（56%为女性，平均年龄83岁）。三组之间的新冠严重程度无显著差异。12个月后，记录了24例死亡：未接种疫苗组为17%，低维生素D水平接种疫苗组为19%，高维生素D水平接种疫苗组为20%（p = 0.94）。Kaplan-Meier曲线显示，低维生素D水平的接种疫苗个体的死亡风险与未接种疫苗的患者相似，但显著高于高维生素D水平的接种疫苗个体（p = 0.04）。25 - 50 nmol/L的维生素D水平与12个月死亡率增加三倍相关（风险比：3.79，p < 0.001）。