Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results
Meltzer DO, Best TJ, Zhang H, Vokes T, Arora V, Solway J
JAMA network open · 348 citations
How it was studied
- Design
- Cohort study (classified by our AI screen)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Independent funding
- University or hospital
- University of Chicago
- University or hospital
- Rush University
- Government
- National Center for Advancing Translational Sciences
- Government
- NCATS NIH HHS
- Grants
- National Center for Advancing Translational Sciences (UL1-TR002389)
Based on 4 listed funder(s).
Publication
- Published
- 2020-09-03 · JAMA Netw Open · vol. 3 · issue 9 · p. e2019722
- Publisher
- American Medical Association
- Cited
- 536 citations · more than 100% of similar papers · 63.0× the field average
- Impact
- Top 10% most cited in its field
- References
- 32 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Vitamin D Research Studies · Vitamin C and Antioxidants Research · COVID-19 Clinical Research Studies
- Keywords
- Medicine, Vitamin D and neurology, vitamin D deficiency, Incidence (geometry), Coronavirus disease 2019 (COVID-19), Retrospective cohort study, Internal medicine, Vitamin, Cohort study, Gastroenterology, Disease, Infectious disease (medical specialty)
- MeSH
- humans, pneumonia, viral, coronavirus infections, vitamin d deficiency, calcifediol, calcitriol, vitamins, vitamin d, clinical laboratory techniques, risk factors, retrospective studies, middle aged, united states, female, male, pandemics, betacoronavirus, covid-19, sars-cov-2, covid-19 testing
6 authors
From US
- David O. Meltzer · correspondingUniversity of Chicago
- Thomas J. BestUniversity of Chicago
- Zhang HuiUniversity of Chicago
- Tamara VokesUniversity of Chicago
- Vineet M. AroraUniversity of Chicago
- Julian SolwayUniversity of Chicago
Abstract
Importance
Vitamin D treatment has been found to decrease the incidence of viral respiratory tract infection, especially in patients with vitamin D deficiency. Whether vitamin D is associated with coronavirus disease 2019 (COVID-19) incidence is unknown.
Objective
To examine whether the last vitamin D status before COVID-19 testing is associated with COVID-19 test results.
Design, setting, and participants
This retrospective cohort study at an urban academic medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol level measured within 1 year before being tested for COVID-19 from March 3 to April 10, 2020.
Exposures
Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL before COVID-19 testing. Treatment changes were defined by changes in vitamin D type and dose between the date of the last vitamin D level measurement and the date of COVID-19 testing. Vitamin D deficiency and treatment changes were combined to categorize the most recent vitamin D status before COVID-19 testing as likely deficient (last level deficient and treatment not increased), likely sufficient (last level not deficient and treatment not decreased), and 2 groups with uncertain deficiency (last level deficient and treatment increased, and last level not deficient and treatment decreased).
Main outcomes and measures
The outcome was a positive COVID-19 polymerase chain reaction test result. Multivariable analysis tested whether vitamin D status before COVID-19 testing was associated with testing positive for COVID-19, controlling for demographic and comorbidity indicators.
Results
A total of 489 patients (mean [SD] age, 49.2 [18.4] years; 366 [75%] women; and 331 [68%] race other than White) had a vitamin D level measured in the year before COVID-19 testing. Vitamin D status before COVID-19 testing was categorized as likely deficient for 124 participants (25%), likely sufficient for 287 (59%), and uncertain for 78 (16%). Overall, 71 participants (15%) tested positive for COVID-19. In multivariate analysis, testing positive for COVID-19 was associated with increasing age up to age 50 years (relative risk, 1.06; 95% CI, 1.01-1.09; P = .02); non-White race (relative risk, 2.54; 95% CI, 1.26-5.12; P = .009), and likely deficient vitamin D status (relative risk, 1.77; 95% CI, 1.12-2.81; P = .02) compared with likely sufficient vitamin D status. Predicted COVID-19 rates in the deficient group were 21.6% (95% CI, 14.0%-29.2%) vs 12.2%(95% CI, 8.9%-15.4%) in the sufficient group.
Conclusions and relevance
In this single-center, retrospective cohort study, likely deficient vitamin D status was associated with increased COVID-19 risk, a finding that suggests that randomized trials may be needed to determine whether vitamin D affects COVID-19 risk.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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