Low 25-Hydroxyvitamin D Levels on Admission to the Intensive Care Unit May Predispose COVID-19 Pneumonia Patients to a Higher 28-Day Mortality Risk: A Pilot Study on a Greek ICU Cohort
Nutrients 2020,12, 3773; doi:10.3390/nu12123773
Alice G. Vassiliou , Edison Jahaj1®, Maria Pratikaki 2, Stylianos E. Orfanos 1,3,
Ioanna Dimopoulou 1® and Anastasia Kotanidou *
First Department of Critical Care Medicine & Pulmonary Services, School of Medicine,
National and Kapodistrian University of Athens, Evangelismos Hospital, 106 76 Athens, Greece; alvass75@gmail.com (A.G.V.); edison.jahaj@gmail.com (E.J.); sorfanos@med.uoa.gr (S.E.O.); idimo@otenet.gr (I.D.)
Biochemical Department, Evangelismos Hospital, 106 76 Athens, Greece; marypratik@icloud.com
Second Department of Critical Care, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 124 62 Athens, Greece
- Correspondence: akotanid@med.uoa.gr or akotanid@gmail.com; Tel.: +30-2107243320
Low Vitamin D was defined by this study as < 15.2 ng
Every pneumonia patient in the ICU with COVID-19 had < 30 ng
Previous (non-COVID-19) studies found:
- Pneumonia elderly death 12X more likely when vitamin D less than 12 ng – 2011
- Pneumonia 6X more likely if very low vitamin D – meta-analysis Sept 2019
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We aimed to examine whether low intensive care unit (ICU) admission 25-hydroxyvitamin D (25(OH)D) levels are associated with worse outcomes of COVID-19 pneumonia. This was a prospective observational study of SARS-CoV2 positive critically ill patients treated in a multidisciplinary ICU. Thirty (30) Greek patients were included, in whom 25(OH)D was measured on ICU admission. Eighty (80%) percent of patients had vitamin D deficiency, and the remaining insufficiency. Based on 25(OH)D levels, patients were stratified in two groups: higher and lower than the median value of the cohort (15.2 ng/mL). The two groups did not differ in their demographic or clinical characteristics. All patients who died within 28 days belonged to the low vitamin D group. Survival analysis showed that the low vitamin D group had a higher 28-day survival absence probability (log-rank test, p = 0.01). Critically ill COVID-19 patients who died in the ICU within 28 days appeared to have lower ICU admission 25(OH)D levels compared to survivors. When the cohort was divided at the median 25(OH)D value, the low vitamin D group had an increased risk of 28-day mortality. It seems plausible, therefore, that low 25(OH)D levels may predispose COVID-19 patients to an increased 28-day mortality risk.