Abstract
Background: Accumulating evidence links COVID-19 incidence and outcomes with vitamin D status. We investigated if an interaction existed between vitamin D levels and social deprivation in those with and without COVID-19 infection.
Methods: Upper or lower respiratory tract samples from 104 patients were tested for SARS-CoV-2 RNA in accordance with Public Health England criteria (January-May 2020) using RT-PCR. The latest serum total 25-hydroxyvitamin D(25-OHD) levels, quantified by LC-MS/MS, was obtained for each patient (September 2019-April 2020). Index of Multiple Deprivation (IMD) was generated for each patient. Univariate and logistic regression analyses examined associations between age, gender, 25-OHD, IMD score and SARS-CoV-2 result in the total cohort and subgroups.
Results: In the total cohort, a positive SARS-CoV-2 test was significantly associated with lower 25-OHD levels and higher IMD. A positive test was associated with higher IMD in the male subgroup and with lower 25-OHD levels in those aged >72 years. Low 25-OHD and IMD quintile 5 were separately associated with positive COVID-19 outcome in the cohort. Patients in IMD quintile 5 with vitamin D levels ≤ 34.4 nmol/L were most likely to have a positive COVID-19 outcome, even more so if aged >72 years (OR: 19.07, 95%CI: 1.71-212.25; P = .016).
Conclusions: In this cohort, combined low vitamin D levels and higher social deprivation were most associated with COVID-19 infection. In older age, this combination was even more significant. Our data support the recommendations for normalising vitamin D levels in those with deficient / insufficient levels and in groups at high risk for deficiency.
【초록키워드】 SARS-CoV-2, Vitamin D, 25-hydroxyvitamin D, Infection, Gender, outcome, RT-PCR, serum, Cohort, COVID-19 infection, male, Patient, Older age, Logistic regression, age, SARS-CoV-2 RNA, group, association, Vitamin D status, Evidence, Combination, Interaction, Analysis, Deprivation, Lower respiratory tract, criteria, high risk, Support, COVID-19 incidence, deficiency, index, subgroups, vitamin D level, vitamin D levels, Positive test, Logistic regression analyses, positive, Public Health England, SARS-CoV-2 test, Multiple, positive COVID-19, upper, social deprivation, recommendation, tested, examined, significantly, investigated, was obtained, quantified, with COVID-19, 【제목키워드】 Deprivation, vitamin D level,