Endocrine Abstracts

Recently, vitamin D deficiency has been considered as a risk factor for the morbidity and the severity of acute respiratory infections. The aim of this study was to evaluate the interlinks between serum 25(OH)D level and severity of new coronavirus infection (COVID-19) in hospitalized patients.

Methods

We included 131 patients aged 21 to 93 y.o. (mean age 51.7 ± 13.8 years), 76 (57.1%) men, hospitalized following COVID-19 infection. We assessed serum 25(OH)D level for all of them using Abbott Architect i2000 with immunochemiluminescent assay.

Results

Twenty-five (19.1%) patients (15 males) had severe disease, and 108 subjects (80.9%) (61 males) had a moderate one. Fatal outcome was registered in 18 (13.7%) patients and 15 (83.3%) of them had severe course of disease. Half of the severely ill patients were obese. Also, obesity was seen in 64.0% of deceased patients, and was significantly more often than in the discharged ones – 21.3% (P < 0.001). Diabetes mellitus and cardiovascular diseases occurred with the same frequency, regardless of the disease severity. Serum 25(OH)D level ranged from 3.0 to 97.0 ng/ml (13.5 [9.6;23.3] ng/ml). Vitamin D deficiency was diagnosed in 90 (68.7%) patients including 37 with severe deficiency (25(OH)D level < 10 ng/ml). It was found that in patients with severe course, serum 25(OH)D level was significantly lower (9.7 [6.0;14.9] ng/ml) and vitamin D deficiency was more common than in patients with moderate course of the disease (14.6 [10.6;24.4] ng/ml, P = 0.003). The same pattern was revealed in patients with fatal outcome, where 25(OH)D level was 9.6 [6.0;11.5] ng/ml, compared to levels seen in discharged patients (14.8 [10.1;24.3] ng/ml) (P = 0.001). We found that severe vitamin D deficiency was associated with increased risk of COVID-19 severity (OR = 3.79 [95% CI:1.53–9.39]; P = 0.005) and fatal outcome (OR = 4.07 [95% CI: 1.46–11.35], v0.009). The threshold for 25(OH)D level that was associated with an increased risk of severe course in this population was 11.7 ng/ml (AUCarea = 0.693; sensitivity 71.3% and specificity 68.0%, P = 0.003). Approximately the same 25(OH)D level was associated with an increased risk of mortality – 10.9 ng/ml (AUC_area = 0.746; sensitivity 73.9% and specificity 72.2%, P = 0.001).

Conclusions

COVID-19 patients have Vitamin D deficiency in most cases and severe vitamin D deficiency has been found to be associated with an increased risk of severity and fatal outcome of new coronavirus infection.