Abstract
Background and aims: Despite reports on the impact of vitamin D status on coronavirus disease 2019 (COVID-19) severity, the association between low vitamin D status and severe COVID-19 remains unclear. Moreover, researchers have not determined the aforementioned association in Japanese patients. This study aimed to investigate the association between 25-hydroxyvitamin D [25(OH)D] levels and COVID-19 severity in Japanese patients.
Methods: This retrospective observational study included 117 consecutive patients with COVID-19 admitted to the Kobe City Medical Center General Hospital between October 01, 2020, and January 31, 2021. We measured the serum 25(OH)D levels using blood specimens collected within 5 days of hospital admission using liquid chromatography-tandem mass spectrometry.
Results: There were 21 (17.9%), 73 (62.4%), 19 (16.2%) and 4 (3.4%) patients with severe deficiency (<10 ng/mL), deficiency (10-<20 ng/mL), insufficiency (20-<30 ng/mL), and sufficiency (≥30 ng/mL) of vitamin D, respectively. In univariate logistic regression analyses, lower serum 25(OH)D levels [odds ratio (OR) 1.18 per 1 ng/mL decrease, 95% confidence interval (CI) 1.04-1.33, p = 0.007] were significantly associated with invasive mechanical ventilation (IMV) or death. In a multivariate logistic regression analysis, low serum 25(OH)D levels [OR 1.22 per 1 ng/mL decrease, 95% CI 1.06-1.40, p = 0.005] were significantly associated with IMV or death. The cut-off value of serum 25(OH)D levels was 10.4 ng/mL, calculated by the receiver operating characteristic curve to detect the requirement for IMV or death.
Conclusions: To the best of our knowledge, this is the first study to assess the association between vitamin D status and COVID-19 severity in Japanese patients. Low serum 25(OH)D level was detected as an independent risk factor for severe COVID-19 among Japanese patients.
Keywords: COVID-19; Japanese; SARS-CoV-2; Vitamin D.
【저자키워드】 COVID-19, SARS-CoV-2, Japanese, vitamin D., 【초록키워드】 coronavirus disease, severe COVID-19, Vitamin D, knowledge, 25-hydroxyvitamin D, severity, COVID-19 severity, serum, Patient, death, Logistic regression, Hospital admission, characteristic, patients, Blood, association, Vitamin D status, retrospective, Invasive mechanical ventilation, Analysis, deficiency, 95% CI, 95% confidence interval, city, multivariate logistic regression, specimen, center, cut-off value, independent risk factor, researcher, Kobe, IMV, decrease, severe deficiency, detect, collected, significantly, calculated, analyses, consecutive patient, with COVID-19, 【제목키워드】 25-hydroxyvitamin D, COVID-19 severity,