Vitamin D Status and Mortality from SARS CoV-2: A Prospective Study of Unvaccinated Caucasian Adults
Abstract
:1. Introduction
2. Study Design and Methods
3. Statistical Analysis
4. Results
5. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Conflicts of Interest
Abbreviations
25(OH)D | 25-Hydroxyvitamin Vitamin D |
ARDS | Acute Respiratory Distress Syndrome |
BMI | Body Mass Index |
COVID-19 | Coronavirus Disease 2019 |
CRP | C-Reactive Protein |
HR | Hazard Ratio |
ICU | Intensive Care Unit |
n | Total number of cases |
O2 | Oxygen |
OR | Odds Ratio |
PaO2 RXR | Partial Pressure of Oxygen Retinoid X Receptor |
SARS-CoV-2 | Severe Acute Respiratory Syndrome Coronavirus-2 |
WBC | White Blood Cell |
μg | Microgram |
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Male | 60 (%) | |
---|---|---|
BMI (kg/m2) (%) <18.5 kg/m2 18.5–24.9 kg/m2 25–29.9 kg/m2 ≥30 kg/m2 | (%) 4 36 22 38 | |
Current Smoker | 2% | |
Comorbidity Diabetes Mellitus Hypertension Hyperlipidaemia Renal Disease Respiratory Disease Malignancy Other Comorbidity | n (%) 16 35 15 5 23 10 49 | |
Serum 25(OH)D (nmol·L−1) (%) Deficient (<30 nmol·L−1) Insufficient (30–49.9 nmol·L−1) Sufficient (>50 nmol·L−1) | (%) 38 26 36 | |
Mortality (%) Survivors Non-survivors | n (%) 85 15 | |
ICU Admission (%) Admitted to ICU > 24 h | n (%) 19 | |
Extended O2 Requirement > 24 h (%) Yes | n (%) 69 |
Parameter Biochemistry | 25(OH)D Concentration < 30 nmol·L−1 (Deficient) | 25(OH)D Concentration 30–49.9 nmol·L−1 (Insufficient) | 25(OH)D Concentration > 50 nmol·L−1 (Sufficient) | p Value |
---|---|---|---|---|
CRP (mg/L) (median (IQR)) | 114 (182) | 158 (153) | 91 (148) | 0.390 |
WBC (C/mL) (mean (SD)) | 7.43 × 109 (3.89 × 109) | 6.42 × 109 (2.84 × 109) | 7.74 × 109 (2.74 × 109) | 0.409 |
Lymphocytes (C/mL) (median (IQR)) | 1.00 × 109 (0.63 × 109) | 0.68 × 109 (0.47 × 109) | 1.00 × 109 (0.56 × 109) | 0.036 |
Eosinophils (C/mL) (median (IQR)) | 0.00 × 109 (0.30 × 109) | 0.00 × 109 (0.01 × 109) | 0.00 × 109 (0.05 × 109) | 0.554 |
Neutrophils (C/mL) (mean (SD)) | 5.62 × 109 (3.5 × 109) | 5.12 × 109 (2.76 × 109) | 5.83 × 109 (2.49 × 109) | 0.739 |
Ferritin (ng/mL) (median (IQR)) | 894 (1250) | 814 (1944) | 1068 (1663) | 0.929 |
D-Dimer (ng/mL) (median (IQR)) | 895 (3039) | 902 (806) | 768 (1513) | 0.453 |
Platelets (109/L) (mean SD)) | 216 (88) | 219 (119) | 222 (70) | 0.965 |
Troponin (ng/mL) (median (IQR)) | 6.5 (13.2) | 6.7 (11.2) | 7.0 (9.7) | 0.923 |
ACE-2 (ng/mL) (median (IQR)) | 35 (25) | 32 (12) | 35 (48) | 0.788 |
Calcium (mmol/L) (median (IQR)) | 2.19 (0.18) | 2.20 (0.19) | 2.20 (0.2) | 0.180 |
Magnesium (mmol/L) (median (IQR)) | 0.86 (0.16) | 0.82 (0.11) | 0.83 (0.13) | 0.119 |
Parameter | 25(OH)D Concentration <30 nmol/L (n = 88) | 25(OH)D Concentration 30–50 nmol/L (n = 60) | 25(OH)D Concentration >50 nmol/L (n = 84) | p Value |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
O2 Requirement >24 h | 36 (75) | 14 (70) | 14 (56.0) | 0.249 |
ICU Admission >24 h | 19 (21.6) | 17 (28.3) | 8 (9.5) | 0.013 |
Mortality Non-survivors | 19 (22) | 4 (7) | 11 (13) | 0.037 |
Category | Beta Coefficient | Standard Error (SE) | OR (95% CI) | p Value |
---|---|---|---|---|
Gender | 0.069 | 0.277 | 1.071 (0.622–1.844) | 0.804 |
Age | −0.653 | 0.308 | 0.520 (0.285–0.951) | 0.034 |
Diabetes Mellitus | 0.053 | 0.373 | 1.055 (0.508–2.189) | 0.886 |
Renal Disease | 0.338 | 0.937 | 1.402 (0.223–8.801) | 0.718 |
BMI (≥30 kg/m2) | 0.382 | 0.358 | 1.465 (0.726–2.959) | 0.286 |
Outcome Measure | Covariate | OR (95% CI) | p Value |
---|---|---|---|
Mortality | 25(OH)D Concentration <30 nmol/L | 4.63 (1.53–13.97) | 0.006 |
Age ≥70 years Diabetes Mellitus Male Gender Obesity | 13.32 (4.24–41.81) 1.59 (0.43–5.86) 0.90 (0.33–2.41) 2.03 (0.744–5.57) | <0.001 0.484 0.836 0.166 | |
ICU Admission | 25(OH)D Concentration < 30 nmol/L | 1.18 (0.58–2.39) | 0.632 |
Age ≥70 years | 0.29 (0.11–0.73) | 0.009 | |
Male Gender | 2.90 (1.29–6.51) | 0.010 | |
Diabetes Mellitus | 2.82 (1.21–6.53) | 0.016 | |
Extended O2 Requirement >24 h | 25(OH)D Concentration < 30 nmol/L | 2.11 (0.83–5.39) | 0.116 |
Male Gender | 3.22 (1.26–8.22) | 0.014 |
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Barrett, R.; Youssef, M.; Shah, I.; Ioana, J.; Lawati, A.A.; Bukhari, A.; Hegarty, S.; Cormican, L.J.; Judge, E.; Burke, C.M.; et al. Vitamin D Status and Mortality from SARS CoV-2: A Prospective Study of Unvaccinated Caucasian Adults. Nutrients 2022, 14, 3252. https://doi.org/10.3390/nu14163252
Barrett R, Youssef M, Shah I, Ioana J, Lawati AA, Bukhari A, Hegarty S, Cormican LJ, Judge E, Burke CM, et al. Vitamin D Status and Mortality from SARS CoV-2: A Prospective Study of Unvaccinated Caucasian Adults. Nutrients. 2022; 14(16):3252. https://doi.org/10.3390/nu14163252
Chicago/Turabian StyleBarrett, Robert, Modar Youssef, Irfan Shah, Julia Ioana, Abdullah Al Lawati, Abdullah Bukhari, Suzanne Hegarty, Liam J. Cormican, Eoin Judge, Conor M. Burke, and et al. 2022. "Vitamin D Status and Mortality from SARS CoV-2: A Prospective Study of Unvaccinated Caucasian Adults" Nutrients 14, no. 16: 3252. https://doi.org/10.3390/nu14163252