Acute and Critical Care

Original Articles

Infection
Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study: Alireza Fatemi, Seyed Hossein Ardehali, Ghazaleh Eslamian, Morvarid Noormohammadi, Shirin Malek; Acute Crit Care. 2021;36(4):300-307. Published online November 29, 2021; DOI: https://doi.org/10.4266/acc.2021.00605

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Background
As the coronavirus disease 2019 (COVID-19) pandemic continues to escalate, it is important to identify the prognostic factors related to increased mortality and disease severity. To assess the possible associations of vitamin D level with disease severity and survival, we studied 248 hospitalized COVID-19 patients in a single center in a prospective observational study from October 2020 to May 2021 in Tehran, Iran.
Methods
Patients who had a record of their 25-hydroxyvitamin D level measured in the previous year before testing positive with COVID-19 were included. Serum 25-hydroxyvitamin D level was measured upon admission in COVID-19 patients. The associations between clinical outcomes of patients and 25-hydroxyvitamin D level were assessed by adjusting for potential confounders and estimating a multivariate logistic regression model.
Results
The median (interquartile range) age of patients was 60 years (44–74 years), and 53% were male. The median serum 25-hydroxyvitamin D level prior to admission decreased with increasing COVID-19 severity (P=0.009). Similar findings were obtained when comparing median serum 25-hydroxyvitamin D on admission between moderate and severe patients (P=0.014). A univariate logistic regression model showed that vitamin D deficiency prior to COVID-19 was associated with a significant increase in the odds of mortality (odds ratio, 2.01; P=0.041). The Multivariate Cox model showed that vitamin D deficiency on admission was associated with a significant increase in risk for mortality (hazard ratio, 2.35; P=0.019).
Conclusions
Based on our results, it is likely that deficient vitamin D status is associated with increased mortality in COVID-19 patients. Thus, evaluating vitamin D level in COVID-19 patients is warranted.

Citations

Citations to this article as recorded by

The close association of micronutrients with COVID-19
Aimin Zhang, Yue Yin, Jiashu Tian, Xialin Wang, Zhihong Yue, Lin Pei, Li Liu, Li Qin, Mei Jia, Hui Wang, Qingwei Ma, Wei-bo Gao, Lin-Lin Cao
Heliyon.2024; 10(7): e28629. CrossRef
The bounds of meta-analytics and an alternative method
Ramalingam Shanmugam, Mohammad Tabatabai, Derek Wilus, Karan P Singh
Epidemiology and Health.2024; : e2024016. CrossRef
Systematic Mendelian randomization study of the effect of gut microbiome and plasma metabolome on severe COVID-19
Han Yan, Si Zhao, Han-Xue Huang, Pan Xie, Xin-He Cai, Yun-Dan Qu, Wei Zhang, Jian-Quan Luo, Longbo Zhang, Xi Li
Frontiers in Immunology.2023;[Epub] CrossRef
Risk Factors Associated with Severity and Death from COVID-19 in Iran: A Systematic Review and Meta-Analysis Study
Ahmad Mehri, Sahar Sotoodeh Ghorbani, Kosar Farhadi-Babadi, Elham Rahimi, Zahra Barati, Niloufar Taherpour, Neda Izadi, Fatemeh Shahbazi, Yaser Mokhayeri, Arash Seifi, Saeid Fallah, Rezvan Feyzi, Koorosh Etemed, Seyed Saeed Hashemi Nazari
Journal of Intensive Care Medicine.2023; 38(9): 825. CrossRef
Vitamin D: A Role Also in Long COVID-19?
Luigi Barrea, Ludovica Verde, William B. Grant, Evelyn Frias-Toral, Gerardo Sarno, Claudia Vetrani, Florencia Ceriani, Eloisa Garcia-Velasquez, José Contreras-Briceño, Silvia Savastano, Annamaria Colao, Giovanna Muscogiuri
Nutrients.2022; 14(8): 1625. CrossRef

Endocrinology
Prevalence and Related Factors of Vitamin D Deficiency in Critically Ill Patients: Hyun Jung Kim, Min Su Sohn, Eun Young Choi; Korean J Crit Care Med. 2016;31(4):300-307. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00276

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Abstract PDF

Background
To identify the prevalence and related factors for vitamin D deficiency in the patients who admitted to the medical intensive care unit (ICU) of a Korean tertiary care hospital.
Methods
We retrospectively analyzed the data from ICU patients requiring mechanical ventilation (MV) for a period of > 48 h to identify the prevalence and associated factors for vitamin D deficiency. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] level < 20 ng/mL.
Results
Among 570 patients admitted to the ICU, 221 were enrolled in the study, 194 in the vitamin D deficient group and 27 in the non-deficient group. Prevalence of vitamin D deficiency in critically ill patients was 87.8%. The patient age was lower in the vitamin D deficient group compared with the non-deficient group (64.4 ± 15.4 vs. 71.0 ± 9.6 years, p = 0.049). A higher acute physiology and chronic health evaluation II (APACHE II) score (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.37) and chronic illness (OR 3.12, 95% CI 1.08-9.01) were associated with vitamin D deficiency after adjusting for age and body mass index. Clinical outcomes of duration of MV, ICU stay, and 28- and 90-day mortality rates were not significantly different between the vitamin D deficient and nondeficient groups.
Conclusions
Vitamin D deficiency was common in critically ill patients, particularly among younger patients. Higher APACHE II score and chronic illness were associated with vitamin D deficiency.

Citations

Citations to this article as recorded by

Vitamin D deficiency and mortality among critically ill surgical patients in an urban Korean hospital
Ji-hyun Lee, Seo-rin Doo, Dongha Kim, Yoo-kyoung Park, Eun-jeong Park, Jae-myeong Lee
International Journal for Vitamin and Nutrition Research.2022; 92(2): 101. CrossRef
Vitamin D Deficiency in Critically Ill Patients
Ji Hyun Lee, Jae-Myeong Lee
Surgical Metabolism and Nutrition.2017; 8(2): 17. CrossRef
Should We Measure Vitamin D Level?
Jae Hwa Cho
The Korean Journal of Critical Care Medicine.2016; 31(4): 369. CrossRef

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