Objective Studies have demonstrated a potential correlation between low vitamin D status and both an increased risk of infection with SARS-CoV-2 and poorer clinical outcomes. This retrospective study examines if, and to what degree, a relationship exists between pre-infection serum 25-hydroxyvitamin D (25(OH)D) level and disease severity and mortality due to SARS-CoV-2. Participants The records of individuals admitted between April 7 th , 2020 and February 4 th , 2021 to the Galilee Medical Center (GMC) in Nahariya, Israel, with positive polymerase chain reaction (PCR) tests for SARS-CoV-2 (COVID-19) were searched for historical 25(OH)D levels measured 14 to 730 days prior to the positive PCR test. Design Patients admitted to GMC with COVID-19 were categorized according to disease severity and level of 25(OH)D. An association between pre-infection 25(OH)D levels, divided between four categories (deficient, insufficient, adequate, and high-normal), and COVID-19 severity was ascertained utilizing a multivariable regression analysis. To isolate the possible influence of the sinusoidal pattern of seasonal 25(OH)D changes throughout the year, a cosinor model was used. Results Of 1176 patients admitted, 253 had records of a 25(OH)D level prior to COVID-19 infection. A lower vitamin D status was more common in patients with the severe or critical disease (<20 ng/mL [87.4%]) than in individuals with mild or moderate disease (<20 ng/mL [34.3%] p < 0.001). Patients with vitamin D deficiency (<20 ng/mL) were 14 times more likely to have severe or critical disease than patients with 25(OH)D ≥40 ng/mL (odds ratio [OR], 14; 95% confidence interval [CI], 4 to 51; p < 0.001). Conclusions Among hospitalized COVID-19 patients, pre-infection deficiency of vitamin D was associated with increased disease severity and mortality.
【초록키워드】 COVID-19, SARS-CoV-2, Mortality, disease severity, COVID-19 severity, clinical outcomes, Retrospective study, PCR, COVID-19 infection, Patient, Mild, correlation, change, Critical disease, association, Vitamin D status, Odds ratio, regression analysis, deficiency, hospitalized COVID-19 patients, 95% confidence interval, increased risk, moderate disease, individual, positive PCR test, center, participant, serum 25-hydroxyvitamin D, positive, objective, GMC, polymerase chain, multivariable, Result, was used, searched, demonstrated, category, infection with SARS-CoV-2, with COVID-19, 【제목키워드】 severity of COVID-19, association, 25-hydroxyvitamin D3,