Association of vitamin D status with hospital morbidity and mortality in adult hospitalized COVID-19 patients

Charoenngam, Nipith; Shirvani, Arash; Reddy, Niyoti; Vodopivec, Danica M.; Apovian, Caroline M.; Holick, Michael F.

OBJECTIVE: To determine the association between vitamin D status and morbidity and mortality in adult hospitalized COVID-19 patients METHODS: We performed a retrospective chart review study in COVID-19 patients aged ≥18 years old hospitalized at Boston University Medical Center between March 1 – August 4, 2020. All studied patients were tested positive for COVID-19 and had serum levels of 25-hydroxyvitamin D results measured within one year prior to the date of positive tests. Medical information was retrieved from the electronic medical record and were analyzed to determine the association between vitamin D status and hospital morbidity and mortality. RESULTS: Among the 287 patients, 100 (36%) patients were vitamin D-sufficient [25(OH)D >30 ng/mL] and 41 (14%) patients died during the hospitalization. Multivariate analysis in patients aged ≥65 years old revealed that vitamin D sufficiency [25(OH)D ≥30 ng/mL] was statistically significantly associated with decreased odds of death (adjusted OR 0.33, 95%CI, 0.12–0.94), acute respiratory distress syndrome (adjusted OR 0.22, 95%CI, 0.05–0.96), and severe sepsis/septic shock (adjusted OR 0.26, 95%CI, 0.08–0.88), after adjustement for potential confounders. Among patients with body mass index <30 kg/m(2), vitamin D sufficiency was statistically significantly associated with a decreased odds of death (adjusted OR 0.18, 95%CI, 0.04–0.84). No significant association was found in the subgroups of patients aged <65 years old or BMI ≥30 kg/m(2). CONCLUSION: We revealed an independent association between vitamin D sufficiency defined by serum 25(OH)D ≥30 ng/mL and decreased risk of mortality from COVID-19 in elderly patients and patients without obesity.