25-hydroxyvitamin D is a predictor of COVID-19 severity of hospitalized patients
Nguyen NN, Raju MNP, da Graca B, Wang D, Mohamed NA, Mutnal MB, Rao A, Bennett M, Gokingco M, Pham H, Mohammad AA
PloS one · 10 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
Based on full-text disclosure statement.
Publication
- Published
- 2022-05-03 · PLoS One · vol. 17 · issue 5 · p. e0268038
- Publisher
- Public Library of Science
- Cited
- 48 citations · more than 98% of similar papers · 6.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 21 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Vitamin D Research Studies · COVID-19 Clinical Research Studies · Vitamin C and Antioxidants Research
- Keywords
- Medicine, Coronavirus disease 2019 (COVID-19), Vitamin D and neurology, Internal medicine, Logistic regression, Gastroenterology, Proportional hazards model, Odds ratio, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
- MeSH
- humans, calcifediol, 25-hydroxyvitamin d 2, vitamins, vitamin d, chromatography, liquid, tandem mass spectrometry, covid-19
11 authors
From US
- Nguyen N. Nguyen · correspondingBaylor Scott & White Medical Center - Temple
- Muppala N. P. RajuBaylor Scott & White Medical Center - Temple
- Briget da GracaBaylor Scott & White Health; Baylor Scott & White Research Institute
- Dapeng WangBaylor Scott & White Medical Center - Temple
- Nada MohamedBaylor Scott & White Medical Center - Temple
- Manohar B. MutnalBaylor Scott & White Medical Center - Temple
Abstract
Objectives
Studies investigating the association between vitamin D and severity of COVID-19 have mixed results perhaps due to immunoassay assessment of total 25-hydroxyvitamin D (tD) (the sum of 25-hydroxyvitamin-D2 [25-OH-D2] and 25-hydroxyvitamin-D3 [25-OH-D3]). Liquid chromatography tandem mass spectrometry (LC-MS/MS) has high analytical specificity and sensitivity for 25-OH-D2 and 25-OH-D3, and thus enables a more accurate assessment of impact on COVID-19 outcomes.
Methods
We established reference intervals for 25-OH-D3 and tD using LC-MS/MS. 25-OH-D2, 25-OH-D3 and tD were quantitated for 88 COVID-19 positive and 122 COVID-19 negative specimens. Chi-square or Fisher's exact tests were used to test associations in binary variables. T-Tests or Wilcoxon rank sum tests were used for continuous variables. Cox proportional hazards were used to test associations between 25-OH-D3 or tD levels and length of stay (LOS). For mortality and ventilation, logistic regression models were used.
Results
COVID-19 patients with deficient (<20 ng/mL) levels of 25-OH-D3 had significantly longer LOS by 15.3 days. COVID-19 P patients with deficient (<20 ng/mL) and insufficient (<30 ng/mL) of tD had significantly longer LOS by 12.1 and 8.2 days, respectively. Patients with insufficient levels of tD had significantly longer LOS by 13.7 days. COVID-19 patients with deficient serum 25-OH-D3 levels had significantly increased risk-adjusted odds of in-hospital mortality (OR [95% CI]: 5.29 [1.53-18.24]); those with insufficient 25-OH-D3 had significantly increased risk for requiring ventilation during hospitalization was found at LCMS insufficient cutoff (OR [95% CI]: 2.75 [1.10-6.90]).
Conclusions
There is an inverse relationship of 25-hydroxyvitamin D levels and hospital LOS for COVID-19 patients. Vitamin D status is a predictor for severity of outcomes. LCMS results are useful for assessing the odds of mortality and the need for ventilation during hospitalization.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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