SFEBES2021 Oral Poster Presentations Bone and Calcium (4 abstracts)
1Translational & Clinical Research Institute, University of Newcastle, Newcastle, United Kingdom; 2Department of Metabolic Medicine, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, United Kingdom; 3Department of Respiratory Medicine, Royal Victoria Infirmary, Newcastle, United Kingdom; 4Department of Endocrinology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom
Background: Vitamin D deficiency (VDD) has been implicated in the pathophysiology of respiratory infections, including Coronavirus Disease 2019 (COVID-19). We assessed vitamin D levels of patients who died from COVID-19 during or following admission to Newcastle-upon-Tyne Hospitals.
Methods: We performed a retrospective survey of electronic patient records for 2,355 patients admitted to our institution between 04/02/2020 and 19/01/2021, who had a positive SARS-CoV-2 PCR on nasopharyngeal swab. 308 patients died and had COVID-19 included on their death certificate (mortality rate=13%). 136 patients (44%) also had a serum 25-hydroxyvitamin D (25OHD) measurement within 3 months prior to admission and were included in the analysis.
Results: The median 25OHD was 34nmol/l (interquartile range 19-69.5nmol/l). 60% (n = 81) of patients who died from COVID-19 had 25OHD levels <50nmol/l (local laboratory definition of VDD, Table). 68% (n = 93) of patients who died would have been deemed as having sufficient vitamin D levels (≥25nmol/l) according to UK Scientific Advisory Committee on Nutrition (SACN) recommendations. Conversely, only 29 (21%) patients who died had 25OHD levels ≥75nmol/l, which is the definition of vitamin D adequacy used in Endocrine Society guidance. The prevalence of VDD was higher in male deaths compared to female deaths: 67% of males and 46% of females who died had 25OHD levels <50nmol/l (P = 0.0185 using Fishers exact test).
Admission 25OHD, nmol/l | Number of deaths (%) | Age at death, median (IQR) |
<25 | 43 (32%) | 83 (7289) |
2549 | 38 (28%) | 77.5 (73.7584.25) |
5074 | 26 (19%) | 80 (76.7584.5) |
≥75 | 29 (21%) | 86 (8089.5) |
Discussion: VDD was highly prevalent in patients who died from COVID-19 in Newcastle-upon-Tyne. Although our study is limited by the lack of a control group, we recommend that vitamin D supplementation aiming for levels of ≥75nmol/l is a safe and cost-effective intervention to mitigate COVID-19s morbidity and mortality.