scholarly journals Vitamin D Status in Hospitalized Patients with SARS-CoV-2 Infection

Author(s):  
José L Hernández ◽  
Daniel Nan ◽  
Marta Fernandez-Ayala ◽  
Mayte García-Unzueta ◽  
Miguel A Hernández-Hernández ◽  
...  

Abstract Background The role of vitamin D status in COVID-19 patients is a matter of debate. Objectives To assess serum 25-hydroxyvitamin D (25OHD) levels in hospitalized patients with COVID-19 and to analyze the possible influence of vitamin D status on disease severity. Methods Retrospective case–control study of 216 COVID-19 patients and 197 population-based controls. Serum 25OHD levels were measured in both groups. The association of serum 25OHD levels with COVID-19 severity (admission to the intensive care unit, requirements for mechanical ventilation, or mortality) was also evaluated. Results Of the 216 patients, 19 were on vitamin D supplements and were analyzed separately. In COVID-19 patients, mean ± standard deviation 25OHD levels were 13.8 ± 7.2 ng/mL, compared with 20.9 ± 7.4 ng/mL in controls (P < .0001). 25OHD values were lower in men than in women. Vitamin D deficiency was found in 82.2% of COVID-19 cases and 47.2% of population-based controls (P < .0001). 25OHD inversely correlates with serum ferritin (P = .013) and D-dimer levels (P = .027). Vitamin D-deficient COVID-19 patients had a greater prevalence of hypertension and cardiovascular diseases, raised serum ferritin and troponin levels, as well as a longer length of hospital stay than those with serum 25OHD levels ≥20 ng/mL. No causal relationship was found between vitamin D deficiency and COVID-19 severity as a combined endpoint or as its separate components. Conclusions 25OHD levels are lower in hospitalized COVID-19 patients than in population-based controls and these patients had a higher prevalence of deficiency. We did not find any relationship between vitamin D concentrations or vitamin deficiency and the severity of the disease.


2021 ◽  
Vol 12 ◽  
pp. 215013272110412
Author(s):  
Jennifer L. Pecina ◽  
Stephen P. Merry ◽  
John G. Park ◽  
Tom D. Thacher

Background: Vitamin D deficiency may increase the risk of severe COVID-19 disease. Objectives: To determine if 25-hydroxyvitamin D [25(OH)D] levels in patients hospitalized for COVID-19 were associated with the clinical outcomes of days on oxygen, duration of hospitalization, ICU admission, need for assisted ventilation, or mortality. Methods: We conducted a retrospective study of 92 patients admitted to the hospital with SARS-CoV-2 infection between April 16, 2020 and October 17, 2020. Multivariable regression was performed to assess the independent relationship of 25(OH)D values on outcomes, adjusting for significant covariates and the hospitalization day the level was tested. Results: About 15 patients (16.3%) had 25(OH)D levels <20 ng/mL. Only 1 patient (3.4%) who had documented vitamin D supplementation prior to admission had 25(OH)D <20 ng/mL. Serum 25(OH)D concentrations were not significantly associated with any of our primary outcomes of days on oxygen, duration of hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, or mortality in any of the adjusted multivariable models. Adjusting for the hospital day of 25(OH)D sampling did not alter the relationship of 25(OH)D with any outcomes. Conclusion: Vitamin D status was not related to any of the primary outcomes reflecting severity of COVID-19 in hospitalized patients. However, our sample size may have lacked sufficient power to demonstrate a small effect of vitamin D status on these outcomes.



2020 ◽  
Vol 24 (11) ◽  
pp. 1412-1418
Author(s):  
Hanna Augustin ◽  
Sinead Mulcahy ◽  
Inez Schoenmakers ◽  
Maria Bullarbo ◽  
Anna Glantz ◽  
...  

Abstract Objectives The aim of this prospective cohort study was to investigate the associations between maternal vitamin D status in late pregnancy and emergency caesarean section (EMCS) and birth asphyxia, in a population based sample of women in Sweden. Methods Pregnant women were recruited at the antenatal care in Sweden and 1832 women were included after exclusion of miscarriages, terminated pregnancies and missing data on vitamin D status. Mode of delivery was retrieved from medical records. EMCS was defined as caesarean section after onset of labour. Birth asphyxia was defined as either 5 min Apgar score < 7 or arterial umbilical cord pH < 7.1. Serum was sampled in the third trimester of pregnancy (T3) and 25-hydroxyvitamin D (25OHD) was analysed by liquid chromatography tandem mass spectrometry. Vitamin D deficiency was defined as 25OHD < 30 nmol/L, and associations were studied using logistic regression analysis and expressed as adjusted odds ratios (AOR). Results In total, 141 (7.7%) women had an EMCS and 58 (3.2%) children were born with birth asphyxia. Vitamin D deficiency was only associated with higher odds of EMCS in women without epidural anaesthesia (AOR = 2.01, p = 0.044). Vitamin D deficiency was also associated with higher odds of birth asphyxia (AOR = 2.22, p = 0.044). Conclusions for Practice In this Swedish prospective population-based cohort study, vitamin D deficiency in late pregnancy was associated with doubled odds of birth asphyxia and with EMCS in deliveries not aided by epidural anaesthesia. Prevention of vitamin D deficiency among pregnant women may reduce the incidence of EMCS and birth asphyxia. The mechanism behind the findings require further investigation.



2018 ◽  
Vol 40 (4) ◽  
pp. 1109-1151 ◽  
Author(s):  
Roger Bouillon ◽  
Claudio Marcocci ◽  
Geert Carmeliet ◽  
Daniel Bikle ◽  
John H White ◽  
...  

AbstractThe etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor of 25-hydroxyvitamin D and other metabolites, including 1,25(OH)2D, the ligand for the vitamin D receptor (VDR). The effects of the vitamin D endocrine system on bone and its growth plate are primarily indirect and mediated by its effect on intestinal calcium transport and serum calcium and phosphate homeostasis. Rickets and osteomalacia can be prevented by daily supplements of 400 IU of vitamin D. Vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) accelerates bone turnover, bone loss, and osteoporotic fractures. These risks can be reduced by 800 IU of vitamin D together with an appropriate calcium intake, given to institutionalized or vitamin D–deficient elderly subjects. VDR and vitamin D metabolic enzymes are widely expressed. Numerous genetic, molecular, cellular, and animal studies strongly suggest that vitamin D signaling has many extraskeletal effects. These include regulation of cell proliferation, immune and muscle function, skin differentiation, and reproduction, as well as vascular and metabolic properties. From observational studies in human subjects, poor vitamin D status is associated with nearly all diseases predicted by these extraskeletal actions. Results of randomized controlled trials and Mendelian randomization studies are supportive of vitamin D supplementation in reducing the incidence of some diseases, but, globally, conclusions are mixed. These findings point to a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health. Vitamin D deficiency enhances the risk of osteoporotic fractures and is associated with many diseases. We review what is established and what is plausible regarding the health effects of vitamin D.



2015 ◽  
Vol 4 ◽  
Author(s):  
Michiel G. J. Balvers ◽  
Elske M. Brouwer-Brolsma ◽  
Silvia Endenburg ◽  
Lisette C. P. G. M. de Groot ◽  
Frans J. Kok ◽  
...  

AbstractVitamin D is a fat-soluble hormone that traditionally has been linked to bone health. Recently, its involvement has been extended to other (extra-skeletal) disease areas, such as cancer, CVD, energy metabolism and autoimmune diseases. Vitamin D deficiency is a worldwide problem, and several recommendation-setting bodies have published guidelines for adequate vitamin D intake and status. However, recommendations from, for example, the Health Council of the Netherlands do not provide advice on how to treat vitamin D deficiency, a condition that is often encountered in the clinic. In addition, these recommendations provide guidelines for the maintenance of ‘minimum levels’, and do not advise on ‘optimum levels’ of vitamin D intake/status to further improve health. The NutriProfiel project, a collaboration between the Gelderse Vallei Hospital (Ede, the Netherlands) and the Division of Human Nutrition of Wageningen University (Wageningen, the Netherlands), was initiated to formulate a protocol for the treatment of vitamin deficiency and for the maintenance of optimal vitamin D status. To discuss the controversies around treatment of deficiency and optimal vitamin D status and intakes, a workshop meeting was organised with clinicians, scientists and dietitians. In addition, a literature review was conducted to collect recent information on optimal intake of vitamins, their optimal circulating concentrations, and effective dosing regimens to treat deficiency. This information has been translated into the NutriProfiel advice, which is outlined in this article.



2019 ◽  
Vol 23 (7) ◽  
pp. 1179-1183 ◽  
Author(s):  
Madhava Vijayakumar ◽  
Vijayalakshmi Bhatia ◽  
Biju George

AbstractObjectiveTo study plasma 25-hydroxyvitamin D (25(OH)D) status of children in Kerala, southern India, and its relationship with sociodemographic variables.DesignCross-sectional observational study.SettingTertiary government hospital.ParticipantsChildren (n 296) with trivial acute illness were enrolled. Sun exposure and Ca and vitamin D intakes (7 d dietary recall) were documented. Serum Ca, P, alkaline phosphatase, plasma 25(OH)D and parathyroid hormone (PTH) were measured.ResultsPrevalence of vitamin D deficiency (plasma 25(OH)D <30 nmol/l) was 11·1% (median, interquartile range (IQR): 52·6, 38·4–65·6 nmol/l). Children who ate fish daily had significantly higher plasma 25(OH)D than those who did not (median, IQR: 52·5, 40·8–68·9 v. 49·1, 36·2–60·7 nmol/l; P = 0·02). Those investigated in the months of March–May showed highest 25(OH)D v. those enrolled during other times (median, IQR: 58·7, 45·6–81·4 v. 45·5, 35·6–57·4 nmol/l; P <0·001). Plasma 25(OH)D correlated positively with serum P (r = 0·24, P <0·001) and Ca intake (r = 0·16, P 0·03), negatively with age (r = −0·13, P 0·03) and PTH (r = −0·22, P <0·001.). On linear regression, summer season (March–May), lower age, daily fish intake and higher Ca intake were independently associated with plasma 25(OH)D.ConclusionsPrevalence of vitamin D deficiency is low in Kerala. The natural fish diet of coastal Kerala and the latitude may be protective. Public health policy in India should take account of this geographical diversity.



2012 ◽  
Vol 109 (5) ◽  
pp. 928-935 ◽  
Author(s):  
Stig Andersen ◽  
Peter Laurberg ◽  
Bodil Hvingel ◽  
Kent Kleinschmidt ◽  
Lene Heickendorff ◽  
...  

Vitamin D status as measured by plasma 25-hydroxyvitamin D (25(OH)D) is important to human health. Circumpolar people rely on dietary sources and societal changes in the Arctic are having profound dietary effects. The objective of the present study was to determine plasma 25(OH)D status and factors important to plasma 25(OH)D in populations in Greenland. Inuit and non-Inuit aged 50–69 years in the capital in West Greenland (latitude 64°15′N) and in a major town and remote settlements in East Greenland (latitude 65°35′N) were surveyed. Supplement use and lifestyle factors were determined by questionnaires. Inuit food scores were computed from a FFQ of seven traditional Inuit and seven imported food items. 25(OH)D2 and 25(OH)D3 levels were measured in the plasma. We invited 1 % of the population of Greenland, and 95 % participated. 25(OH)D3 contributed 99·7 % of total plasma 25(OH)D. Non-Inuit had the lowest median plasma 25(OH)D of 41 (25th–75th percentile 23–53) nmol/l compared with 64 (25th–75th percentile 51–81) nmol/l in Inuit (P< 0·001). Plasma 25(OH)D was below 20 and 50 nmol/l in 13·8 and 60·1 % of participants, respectively, with Inuit food item scores below 40 % (P< 0·001), and in 0·2 and 25·0 % of participants, respectively, with higher scores (P< 0·001). The Inuit diet was an important determinant of plasma 25(OH)D (P< 0·001) and its effect was modified by ethnicity (P= 0·005). Seal (P= 0·005) and whale (P= 0·015) were major contributors to plasma 25(OH)D. In conclusion, a decrease in the intake of the traditional Inuit diet was associated with a decrease in plasma 25(OH)D levels, which may be influenced by ethnicity. The risk of plasma 25(OH)D deficiency in Arctic populations rises with the dietary transition of societies in Greenland. Vitamin D intake and plasma 25(OH)D status should be monitored.



2012 ◽  
Vol 1 (1) ◽  
pp. 13-21 ◽  
Author(s):  
Ranganathan R Rao ◽  
Harpal S Randeva ◽  
Sailesh Sankaranarayanan ◽  
Murthy Narashima ◽  
Matthias Möhlig ◽  
...  

Introduction/backgroundVitamin D deficiency further increases circulating parathyroid hormone (PTH) levels in patients with primary hyperparathyroidism (pHPT), with potential detrimental effects on bone mass.MethodsThis was an observational clinical study in consecutive conservatively treated postmenopausal women (n=40) with pHPT and coexistent 25-hydroxyvitamin D deficiency (25OHD ≤50 nmol/l (≤20 ng/ml)). Patients who showed an increase in serum 25OHD above the threshold of vitamin D deficiency (>50 nmol/l; n=28) using treatment with various commonly prescribed vitamin D preparations were, for the purposes of statistical analyses, allocated to the treatment group. Patients who were retrospectively identified as having received no treatment with vitamin D and/or remained vitamin D deficient were considered as non-responders/controls (n=12). Adjusted calcium (adjCa), PTH and 25OHD concentrations were monitored in all subjects up to 54 months (mean observation period of 18±2 months).ResultsProlonged increased vitamin D intake, regardless of the source (serum 25OHD, increase from 32.2±1.7 nmol/l at baseline to 136.4±11.6 nmol/l, P<0.0001), significantly reduced serum PTH (13.3±1.1 vs 10.5±1.0 pmol/l, P=0.0001), with no adverse effects on adjCa levels (2.60±0.03 vs 2.60±0.02 mmol/l, P=0.77) and renal function tests (P>0.73). In contrast, serum PTH remained unchanged (15.8±2.6 vs 16.3±1.9 pmol/l, P=0.64) in patients who remained vitamin D deficient, with a significant difference between groups in changes of PTH (P=0.0003). Intrapartial correlation analyses showed an independent negative correlation of changes in 25OHD with PTH levels (ric=−0.41, P=0.014).ConclusionsProlonged treatment with vitamin D in various commonly prescribed preparations appeared to be safe and significantly reduced PTH levels by 21%.



2008 ◽  
Vol 93 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Marian T. Hannan ◽  
Heather J. Litman ◽  
Andre B. Araujo ◽  
Christine E. McLennan ◽  
Robert R. McLean ◽  
...  

Abstract Context: Although racial and ethnic differences in vitamin D status and bone mineral density (BMD) are recognized, less is known about how differences in vitamin D status impact BMD, especially among men. Objective: Our objective was to examine the relation between serum 25-hydroxyvitamin D [25(OH)D] and BMD by race and ethnic group. Design: We conducted a population-based, observational survey. Participants: Participants included 1114 Black, Hispanic, and White men, 30–79 yr of age. Outcomes: We assessed 25(OH)D by a competitive protein binding assay and BMD by dual-energy x-ray absorptiometry. Results: Mean age ± sd of the 331 Black, 362 Hispanic, and 421 White men was 48 ± 12.8 yr. Mean 25(OH)D was lower among Black (25.0 ± 14.7 ng/ml) and Hispanic (32.9 ± 13.9 ng/ml) men compared with White men (37.4 ± 14.0 ng/ml, P &lt; 0.01). A higher percentage of both Black (44%) and Hispanic (23%) men had levels of 25(OH)D in the lowest quartile, compared with 11% of White men (P &lt; 0.001). After adjusting for age, height, and weight, only White men showed significant positive correlation between 25(OH)D and BMD (range of correlations, 0.00–0.14). Serum 25(OH)D was not associated with BMD in Black or Hispanic men at any bone site. Results were similar when adjusted for age only. Conclusions: Our findings confirm substantial racial and ethnic group differences in BMD and serum 25(OH)D in men. Serum 25(OH)D and BMD are significantly related to one another in White men only. This may have implications for evaluation of bone health and supplementation in men with low levels of 25(OH)D. Further understanding of the biological mechanisms for these differences between race and ethnic groups is needed.



2019 ◽  
Vol 110 (1) ◽  
pp. 150-157 ◽  
Author(s):  
Kirsten A Herrick ◽  
Renee J Storandt ◽  
Joseph Afful ◽  
Christine M Pfeiffer ◽  
Rosemary L Schleicher ◽  
...  

ABSTRACT Background Vitamin D is important for bone health; in 2014 it was the fifth most commonly ordered laboratory test among Medicare Part B payments. Objectives The aim of this study was to describe vitamin D status in the US population in 2011–2014 and trends from 2003 to 2014. Methods We used serum 25-hydroxyvitamin D data from NHANES 2011–2014 (n = 16,180), and estimated the prevalence at risk of deficiency (&lt;30 nmol/L) or prevalence at risk of inadequacy (30–49 nmol/L) by age, sex, race and Hispanic origin, and dietary intake of vitamin D. We also present trends between 2003 and 2014. Results In 2011–2014, the percentage aged ≥1 y at risk of vitamin D deficiency or inadequacy was 5.0% (95% CI: 4.1%, 6.2%) and 18.3% (95% CI: 16.2%, 20.6%). The prevalence of at risk of deficiency was lowest among children aged 1–5 y (0.5%; 95% CI: 0.3%, 1.1%), peaked among adults aged 20–39 y (7.6%; 95% CI: 6.0%, 9.6%), and fell to 2.9% (95% CI: 2.0%, 4.0%) among adults aged ≥60 y; the prevalence of at risk of inadequacy was similar. The prevalence of at risk of deficiency was higher among non-Hispanic black (17.5%; 95% CI: 15.2%, 20.0%) than among non-Hispanic Asian (7.6%; 95% CI: 5.9%, 9.9%), non-Hispanic white (2.1%; 95% CI: 1.5%, 2.7%), and Hispanic (5.9%; 95% CI: 4.4%, 7.8%) persons; the prevalence of at risk of inadequacy was similar. Persons with higher vitamin D dietary intake or who used supplements had lower prevalences of at risk of deficiency or inadequacy. From 2003 to 2014 there was no change in the risk of vitamin D deficiency; the risk of inadequacy declined from 21.0% (95% CI: 17.9%, 24.5%) to 17.7% (95% CI: 16.0%, 19.7%). Conclusion The prevalence of at risk of vitamin D deficiency in the United States remained stable from 2003 to 2014; at risk of inadequacy declined. Differences in vitamin D status by race and Hispanic origin warrant additional investigation.



Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 25 ◽  
Author(s):  
Andrius Bleizgys ◽  
Jevgenij Kurovskij

Aim: Data on the prevalence of vitamin D deficiency in Lithuania are scarce. The aim was to assess the reserves of vitamin D in different age groups of out-patients, regarding the season of the year. Methods: Data on serum 25-hydroxyvitamin D (25(OH)D) levels from blood tests made in 2012–2014 were obtained from one laboratory, and a retrospective cross-sectional analysis was performed. Results: A total of 9581 subjects were included. The mean age of the participants was 33 ± 23 years. The mean levels of vitamin D were higher in males than in females (p < 0.001). The highest mean 25(OH)D levels were in 0–9-year-old group, the lowest were in the 10–19-year-old group and in the group of participants that were 70 years and older (p < 0.001). The lowest vitamin D status was found in January, February, March, and April. The highest status was found in August and September. Overall, vitamin D deficiency, sufficiency, and hypervitaminosis were detected in 67%, 21%, and 12% of cases, respectively. Most cases with hypervitaminosis were in the group of children up to 2 years of age. Conclusion: Vitamin D status demonstrated clear seasonality. Significant sex-related differences of vitamin D statuses were also determined. Vitamin D deficiency was very prevalent in almost all age groups. Young children (aged up to 2 years) are of special interest for further research involving other types of 25(OH)D assays, such as those based on high-performance liquid chromatography (HPLC), since the real prevalence of “true” vitamin D hypervitaminosis in Lithuania’s children is still to be determined.



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