Vitamin D on admission and disease severity in patients with COVID-19 in the Intensive Care Unit
DOI:
https://doi.org/10.35454/rncm.v6n2.485Keywords:
coronavirus disease 2019, vitamin D, mechanical ventilation, Intensive Care UnitsAbstract
Introduction: 25-hydroxy vitamin D (25(OH)D) would decrease the incidence of viral respiratory infections, due to its pleiotropic effect on immunomodulation.
Objective: to examine the potential association between severe 25(OH)D deficiency on admission to the intensive care unit (ICU) and disease severity in patients diagnosed with COVID-19. Determine whether there is an association between severe 25(OH)D deficiency on admission and the need for invasive mechanical ventilation, co-morbidities, and mortality.
Methods: retrospective observational study of 164 patients with a diagnosis of COVID-19 admitted to the intensive care unit in whom plasma 25(OH)D values were measured within the first 72 hours of hospitalization.
Results: 136 (83%) patients exhibited 25(OH)D deficiency (<30 ng/mL) and 35 (21%) had 25(OH)D ≤ 12 ng/m. Patients with severe 25(OH)D deficiency were significantly more likely to have severe COVID-19 (OR 2.2, 95% CI 1.02 to 5.06, p= 0.049) and were more likely to need invasive ventilatory support (OR 2.4, 95% CI 1.09 to 5.58, p=0.036). Mortality was significantly higher in the severe 25(OH)D deficiency group (40% vs 22%, p=0.03; OR 2.4, 95% CI 1.07 to 5.32, p=0.031). In the multivariate model, history of cardiovascular disease, severe 25(OH)D deficiency, PaO2/FiO2 and invasive ventilatory support remained significant.
Conclusion: This study confirms that severe vitamin D deficiency is associated with more severe lung compromise, increased disease severity and risk of death in patients with COVID-19.
TRANSLATE with x English Arabic Hebrew Polish Bulgarian Hindi Portuguese Catalan Hmong Daw Romanian Chinese Simplified Hungarian Russian Chinese Traditional Indonesian Slovak Czech Italian Slovenian Danish Japanese Spanish Dutch Klingon Swedish English Korean Thai Estonian Latvian Turkish Finnish Lithuanian Ukrainian French Malay Urdu German Maltese Vietnamese Greek Norwegian Welsh Haitian Creole Persian TRANSLATE with COPY THE URL BELOW Back EMBED THE SNIPPET BELOW IN YOUR SITE Enable collaborative features and customize widget: Bing Webmaster Portal BackDownloads
References
Arboleda JF, Urcuqui-Inchima S. Vitamin D Supplementation: A Potential Approach for Coronavirus/COVID-19 Therapeutics? Front Immunol. 2020;11:1523. doi: 10.3389/fimmu.2020.01523
Beardb JA, Beardena A, Strikera R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50(3):194-200. doi: 10.1016/j.jcv.2010.12.006
Hewison M. Antibacterial effects of vitamin D. Nat. Rev. Endocrinol. 2011;7(6):337-45. doi: 10.1038/nrendo.2010.226
Aranow C. Vitamin D and the Immune System. J Investig Med. 2011;59(6):881-86. doi: 10.2310/JIM.0b013e31821b8755
Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020;13(10):1373-380. doi: 10.1016/j.jiph.2020.06.021
Daneshkhah A, Agrawal V, Eshein A, Subramanian H, Roy HK, Backman V. The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. medRxiv. doi: 10.1101/2020.04.08.20058578
Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):988. doi: 10.3390/nu12040988
Martineau AR, Jolliffe DA, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, et al. Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis. Health Technol Assess. 2019;23(2):1-44. doi: 10.3310/hta23020
Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010;91(5):1255-60. doi: 10.3945/ajcn.2009.29094
Loeb M, Duc Dang A, Dinh Thiem V, Hanabalan V, Wang B, Binh Nguyenet N, et al. Effect of Vitamin D supplementation to reduce respiratory infections in children and adolescents in Vietnam: A randomized controlled trial. Influenza Other Respir Viruses. 2019;13(2):176–83. doi: 10.1111/irv.12615
Ginde AA, Mansbach JM, Camargo Jr CA. Association Between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009;169(4):384–90. doi: 10.1001/archinternmed.2008.560
Lau, FH, Majumder R, Torabi R, Saeg F, Hoffman R, Cirillo JD, et al. Vitamin D insufficiency is prevalent in severe COVID-19. medRxiv. doi: 10.1101/2020.04.24.20075838
De Smet D, De Smet K, Herroelen P, Gryspeerdts S, Martens GA. Vitamin D deficiency as risk factor for severe COVID-19: a convergence of two pandemics. medRxiv. doi: 10.1101/2020.05.01.20079376
Hastie CE, Mackay DF, Ho F, Celis-Morales CA, Katikireddi SV, Niedzwiedz CL, et al. Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes Metab Syndr. 2020;14(4):561-65. doi: 10.1016/j.dsx.2020.04.050
Darling AL, Ahmadi KR, Ward KA, Harvey NC, Alves AC, Dunn-Walters DK, et al. Vitamin D status, body mass index, ethnicity and COVID-19: Initial analysis of the first-reported UK Biobank COVID-19 positive cases (n 580) compared with negative controls (n 723). medRxiv. doi: 10.1101/2020.04.29.20084277
Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, et al., editors. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US);2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56070/ doi: 10.17226/13050
Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253.
Amrein K, Zajic P, Schnedl C, Waltensdorfer A, Fruhwald S, Holl A, et al. Vitamin D status and its association with season, hospital and sepsis mortality in critical illness. Crit Care. 2014;18(2):R47. doi: 10.1186/cc13790
Carpagnano GE, Di Lecce V, Quaranta VN, Zito A, Buonamico E, Capozza E, et al. Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. J Endocrinol Invest. 2021;44(4):765-71. doi: 10.1007/s40618-020-01370-x
Herrera-Quintana L, Gamarra-Morales Y, Vázquez-Lorente H, Molina-López J, Castaño-Pérez J, Machado-Casas JF, et al. Bad Prognosis in Critical Ill Patients with COVID-19 during Short-Term ICU Stay regarding Vitamin D Levels. Nutrients. 2021;13(6):1988. doi: 10.3390/nu13061988
AlSafar H, Grant WB, Hijazi R, Uddin M, Alkaabi N, Tay G, et al. COVID-19 Disease Severity and Death in Relation to Vitamin D Status among SARS-CoV-2-Positive UAE Residents. Nutrients. 2021;13(5):1714. doi: 10.3390/nu13051714
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-062. doi: 10.1016/S0140-6736(20)30566-3
Alipio M. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with coronavirus-2019 (COVID-2019). SSRN Electronic Journal. 2020. doi: 10.2139/ssrn.3571484
Sulli A, Gotelli E, Casabella A, Paolino S, Pizzorni C, Alessandri E, et al. Vitamin D and Lung Outcomes in Elderly COVID-19 Patients. Nutrients. 2021;13(3):717. doi: 10.3390/nu13030717
Quraishi SA, McCarthy C, Blum L, Cobb JP, Camargo CA Jr. Plasma 25-Hydroxyvitamin D Levels at Initiation of Care and Duration of Mechanical Ventilation in Critically Ill Surgical Patients. JPEN J Parenter Enteral Nutr. 2016;40(2):273-8. doi: 10.1177/0148607114566276
Janssen HC, Samson MM, Verhaar HJ. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr. 2002;75(4):611-5. doi: 10.1093/ajcn/75.4.611
Mercola J, Grant WB, Wagner CL. Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity. Nutrients. 2020;12(11):3361. doi: 10.3390/nu12113361
Garvin MR, Alvarez C, Miller JI, Prates ET, Walker AM, Amos BK, et al. A mechanistic model and therapeutic interventions for COVID-19 involving a RAS-mediated bradykinin storm. Elife. 2020;9:e59177. doi: 10.7554/eLife.59177
Mason RJ. Thoughts on the alveolar phase of COVID-19. Am J Physiol Lung Cell Mol Physiol. 2020;319(1):L115-L120. doi: 10.1152/ajplung.00126.2020
Rehan VK, Torday JS, Peleg S, Gennaro L, Vouros P, Padbury J, et al. 1Alpha,25-dihydroxy-3-epi-vitamin D3, a natural metabolite of 1alpha, 25-dihydroxy vitamin D3: production and biological activity studies in pulmonary alveolar type II cells. Mol Genet Metab. 2002;76(1):46-56. doi: 10.1016/s1096-7192(02)00022-7
Amrein K, Schnedl C, Holl A, Riedl R, Christopher KB, Pachler C, et al. Effect of high-dose vitamin D3 on hospital length of stay in critically ill patients with vitamin D deficiency: the VITdAL-ICU randomized clinical trial. JAMA. 2014;312(15):1520-30. doi: 10.1001/jama.2014.13204
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Victoria Gonzalez, Cayetano Galletti, Romina Alvarez Vizzoni, Yanina Saldivar, Nicolás Kessler, Francisco Irades, Estefanía Minoldo, Pablo Calcagno, Antonella Aliscioni, Ursula Zaya
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
