Abstract
Purpose: Older adults are more likely to be vitamin D deficient. The aim of the study was to determine whether these patients have worse outcomes with COVID-19.
Methods: We conducted a prospective cohort study between 1 March and 30 April 2020 to assess the importance of vitamin D deficiency in older patients with COVID-19. The cohort consisted of patients aged ≥65 years presenting with symptoms consistent with COVID-19 (n=105). All patients were tested for serum 25-hydroxyvitamin D (25(OH)D) levels during acute illness. Diagnosis of COVID-19 was confirmed via viral reverse transcriptase PCR swab or supporting radiological evidence. COVID-19-positive arm (n=70) was sub-divided into vitamin D-deficient (≤30 nmol/L) (n=39) and -replete groups (n=35). Subgroups were assessed for disease severity using biochemical, radiological and clinical markers. Primary outcome was in-hospital mortality. Secondary outcomes were laboratory features of cytokine storm, thoracic imaging changes and requirement of non-invasive ventilation (NIV).
Results: COVID-19-positive arm demonstrated lower median serum 25(OH)D level of 27 nmol/L (IQR=20-47 nmol/L) compared with COVID-19-negative arm, with median level of 52 nmol/L (IQR=31.5-71.5 nmol/L) (p value=0.0008). Among patients with vitamin D deficiency, there was higher peak D-dimer level (1914.00 μgFEU/L vs 1268.00 μgFEU/L) (p=0.034) and higher incidence of NIV support and high dependency unit admission (30.77% vs 9.68%) (p=0.042). No increased mortality was observed between groups.
Conclusion: Older adults with vitamin D deficiency and COVID-19 may demonstrate worse morbidity outcomes. Vitamin D status may be a useful prognosticator.
Keywords: General medicine (see internal medicine); calcium & bone; diabetes & endocrinology; geriatric medicine.
【저자키워드】 diabetes &, endocrinology, geriatric medicine, general medicine (see internal medicine), calcium &, bone, 【초록키워드】 COVID-19, Cytokine storm, Vitamin D, Older adults, 25-hydroxyvitamin D, disease severity, cytokine, Symptom, diabetes, outcome, prospective cohort study, vitamin D deficiency, endocrinology, geriatric medicine, outcomes, serum, Cohort, Hospital mortality, older patient, Viral, morbidity, Patient, non-invasive ventilation, Swab, incidence, reverse transcriptase PCR, group, change, Admission, calcium, in-hospital mortality, Vitamin D status, bone, internal medicine, older patients, older adult, Thoracic, Laboratory features, reverse transcriptase, Support, deficiency, Primary outcome, biochemical, Secondary outcomes, subgroups, increased mortality, serum 25-hydroxyvitamin D, clinical markers, high dependency unit, acute illness, NIV, secondary, radiological, radiological evidence, tested, conducted, median, determine, demonstrated, groups, presenting, diabete, laboratory feature, peak D-dimer, were assessed, with COVID-19, 【제목키워드】 outcome, older patient, hospitalised, with COVID-19,