Nutr Res Pract.  2021 Dec;15(S1):S32-40. 10.4162/nrp.2021.15.S1.S32.

25-Hydroxyvitamin D level is associated with mortality in patients with critical COVID-19: a prospective observational study in Mexico City

Affiliations
  • 1Auxiliary Diagnostic Services, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
  • 2Radiology and Imaging Service, General Zone Hospital 48, Instituto Mexicano del Seguro Social, Mexico City 02750, Mexico
  • 3Auxiliary Diagnostic Services, General Zone Hospital 48, Instituto Mexicano del Seguro Social, Mexico City 02750, Mexico
  • 4Analysis and Synthesis of the Evidence Research Unit, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
  • 5Facultad de Medicina Universidad Nacional Autónoma de México, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico

Abstract

BACKGROUND/OBJECTIVES
Considering the high number of deaths from coronavirus disease 2019 (COVID-19) in Latin American countries, together with multiple factors that increase the prevalence of vitamin D deficiency, we aimed to determine 25-hydroxyvitamin D (25[OH]D) levels and its association with mortality in patients with critical COVID-19.
SUBJECTS/METHODS
This was a prospective observational study including adult patients with critical COVID-19. Data, including clinical characteristics and 25(OH)D levels measured at the time of intensive care unit admission, were collected. All patients were followed until hospital discharge or in-hospital death. The patients were divided into those surviving and deceased patient groups, and univariate and multivariate logistic regression analyses were performed to determine independent predictors of in hospital mortality.
RESULTS
The entire cohort comprised 94 patients with critical COVID-19 (males, 59.6%; median age, 61.5 years). The median 25(OH)D level was 12.7 ng/mL, and 15 (16%) and 79 (84%) patients had vitamin D insufficiency and vitamin D deficiency, respectively. The median serum 25(OH)D level was significantly lower in deceased patients compared with surviving (12.1 vs. 18.7 ng/mL, P < 0.001). Vitamin D deficiency was present in 100% of the deceased patients. Multivariate logistic regression analysis revealed that age, body mass index, other risk factors, and 25(OH)D level were independent predictors of mortality.
CONCLUSIONS
Vitamin D deficiency was present in 84% of critical COVID-19 patients. Serum 25(OH)D was independently associated with mortality in critical patients with COVID-19.

Keyword

Vitamin D; COVID-19; SARS-CoV-2 virus; mortality; critical illness
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