Up to 40% of COVID-19 Critically Ill Patients Have Vitamin D Deficiency

Background: Coronavirus disease (COVID-19) has caused more than 745,000 deaths worldwide. Vitamin D has been identified as a potential strategy to prevent or treat this disease. The purpose of the study was to measure vitamin D at hospital admission of COVID-19; Methods: We included critically ill patients with the polymerase chain reaction positive test for COVID-19, from March to April, 2020. Statistical significance was defined as P &lt; .05. All tests were 2-tailed; Results: A total of 35 patients (median age, 60 years; 26 [74.3%] male) were included. Vitamin D levels were categorized as deficient for 14 participants (40%). Vitamin D deficiency was associated with vitamin A (P= 0.003) and Zinc (P= 0.019) deficiency and lower levels of albumin (P= 0.026) and prealbumin (P= 0.009). Overall, none of the studied variables were associated with vitamin D status: mortality, intensive care unit (ICU) or hospital stay, necessity of vasoactive agents, intubation, prone position, C reactive protein (CRP), Dimer-D, Interleukin 6 levels (IL-6), ferritin levels, or bacterial superinfection; Conclusions: In this single-center, retrospective cohort study, deficient vitamin D status was found in 40% in COVID-19 critically ill patients. However, deficient vitamin D status was not associated with inflammation or outcome.

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Vitamin D status and its influence on outcomes following major burn injury and critical illness

Burns & Trauma ◽

10.1186/s41038-018-0113-4 ◽

2018 ◽

Vol 6 ◽

Cited By ~ 9

Author(s):

Khaled Al-Tarrah ◽

Martin Hewison ◽

Naiem Moiemen ◽

Janet M. Lord

Keyword(s):

Vitamin D ◽

Critical Illness ◽

Vitamin D Deficiency ◽

Critically Ill ◽

Critically Ill Patients ◽

Thermal Injury ◽

Burn Injury ◽

Vitamin D Supplementation ◽

Burn Patients ◽

Vitamin D Status

Abstract Vitamin D deficiency is common among the general population. It is also observed in up to 76% of critically ill patients. Despite the high prevalence of hypovitaminosis D in critical illness, vitamin D is often overlooked by medical staff as the clinical implications and consequences of vitamin D deficiency in acute contexts remain to be fully understood. Vitamin D has a broad range of pleotropic effects on various processes and systems including the immune-inflammatory response. 1α,25-dihydroxyvitamin D (1,25(OH)2D), has been shown to promote a tolerogenic immune response limiting deleterious inflammatory effects, modulation of the innate immune system, and enhancement of anti-microbial peptides. Vitamin D deficiency is frequently observed in critically ill patients and has been related to extrinsic causes (i.e., limited sunlight exposure), magnitude of injury/illness, or the treatment started by medical doctors including fluid resuscitation. Low levels of vitamin D in critically ill patients have been associated with sepsis, organ failure, and mortality. Despite this, there are subpopulations of critical illness, such as burn patients, where the literature regarding vitamin D status and its influence on outcomes remain insufficient. Thermal injury results in damage to both burned and non-burned tissues, as well as induces an exaggerated and persistent immune-inflammatory and hypermetabolic response. In this review, we propose potential mechanisms in which burn injury affects the vitamin D status and summarizes current literature investigating the influence of vitamin D status on outcomes. In addition, we reviewed the literature and trials investigating vitamin D supplementation in critically ill patients and discuss the therapeutic potential of vitamin D supplementation in burn and critically ill patients. We also highlight current limitations of studies that have investigated vitamin D status and supplementation in critical illness. Thermal injury influences vitamin D status. More studies investigating vitamin D depletion in burn patients and its influence on prognosis, via standardized methodology, are required to reach definitive conclusions and influence clinical practice.

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Prevalence of Vitamin D Deficiency and Associated Factors in Critically Ill Patients: A Multicenter Observational Study

Frontiers in Nutrition ◽

10.3389/fnut.2021.768804 ◽

2021 ◽

Vol 8 ◽

Author(s):

Kuo-Wei Chen ◽

Chung-Wei Chen ◽

Kuo-Ching Yuan ◽

I-Ting Wang ◽

Fang-Ming Hung ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Critically Ill ◽

Critically Ill Patients ◽

Associated Factors ◽

Albumin Level ◽

Icu Stay ◽

Vitamin D Levels ◽

Group 2

Background: Vitamin D deficiency is common in the general population worldwide, and the prevalence and severity of vitamin D deficiency increase in critically ill patients. The prevalence of vitamin D deficiency in a community-based cohort in Northern Taiwan was 22.4%. This multicenter cohort study investigated the prevalence of vitamin D deficiency and associated factors in critically ill patients in Northern Taiwan.Methods: Critically ill patients were enrolled and divided into five groups according to their length of stay at intensive care units (ICUs) during enrolment as follows: group 1, <2 days with expected short ICU stay; group 2, <2 days with expected long ICU stay; group 3, 3-7 days; group 4, 8-14 days; and group 5, 15-28 days. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) level < 20 ng/ml, and severe vitamin D deficiency was defined as a 25(OH)D level < 12 ng/ml. The primary analysis was the prevalence of vitamin D deficiency. The exploratory analyses were serial follow-up vitamin D levels in group 2, associated factors for vitamin D deficiency, and the effect of vitamin D deficiency on clinical outcomes in critically ill patients.Results: The prevalence of vitamin D deficiency was 59% [95% confidence interval (CI) 55-62%], and the prevalence of severe vitamin D deficiency was 18% (95% CI 15-21%). The median vitamin D level for all enrolled critically ill patients was 18.3 (13.7-23.9) ng/ml. In group 2, the median vitamin D levels were <20 ng/ml during the serial follow-up. According to the multivariable analysis, young age, female gender, low albumin level, high parathyroid hormone (PTH) level, and high sequential organ failure assessment (SOFA) score were significantly associated risk factors for vitamin D deficiency. Patients with vitamin D deficiency had longer ventilator use duration and length of ICU stay. However, the 28- and 90-day mortality rate were not associated with vitamin D deficiency.Conclusions: This study demonstrated that the prevalence of vitamin D deficiency is high in critically ill patients. Age, gender, albumin level, PTH level, and SOFA score were significantly associated with vitamin D deficiency in these patients.

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Association Between Low Serum Vitamin D Levels and Sepsis: A Single-Center Study in Tehran, Iran

Archives of Clinical Infectious Diseases ◽

10.5812/archcid.102926 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Masume Bayat ◽

Latif Gachkar ◽

Mahya Zahirnia ◽

Fahimeh Hadavand

Keyword(s):

Vitamin D ◽

Severe Sepsis ◽

Vitamin D Deficiency ◽

Critically Ill ◽

Critically Ill Patients ◽

Plasma Concentrations ◽

Serum Vitamin ◽

Vitamin D Insufficiency ◽

Serum Vitamin D ◽

Vitamin D Levels

Background: Vitamin D insufficiency is common in critically ill patients. It is hypothesized that vitamin D deficiency would be associated with sepsis in the critically ill. Thus, the present study aimed to investigate the association between vitamin D and sepsis severity. Method: In this cross-sectional study, patients with sepsis referring to a university hospital in Tehran, Iran, from February 2018 to March 2019 were included. Plasma concentrations of vitamin D in critically ill subjects admitted were assessed. Data were analyzed using SPSS version 20.0. P-values less than 0.05 were considered statistically significant. Results: Among the investigated patients, the mean serum level of vitamin D3 was 19.03 ± 13.08 ng/mL. The prevalence of vitamin D insufficiency in critically ill subjects with sepsis was 100% (150/150). Only sex (P = 0.01) indicated a significant association with vitamin D. Patients suffering from severe sepsis had lower levels of vitamin D compared to the patients with non-severe sepsis (P = 0.07). Conclusions: The present study showed that all critically ill patients studied had vitamin D insufficiency. In line with the biological evidence, the present study suggests that vitamin D deficiency may predispose patients to sepsis. Further studies are needed to establish the causes and mechanisms underlying these interpretations.

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CORRELATION OF SERUM VITAMIN D LEVEL WITH MORTALITY IN PATIENTS WITH SEPSIS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i4.206 ◽

2019 ◽

Vol 3 (4) ◽

Author(s):

Pramod Sood ◽

Manpreet Kaur

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Critically Ill ◽

Critically Ill Patients ◽

Tertiary Care ◽

Serum Vitamin ◽

Medical Emergency ◽

Serum Vitamin D ◽

Increased Risk ◽

Vitamin D Levels

Background: Vitamin D insufficiency is a common global phenomenon. Its insufficiency is also reported to be common in hospitalized patients and particularly in critically ill patients. Methods: Following ethical approval, consent will be sought from either the patient or assent from a near relative. Successive patients admitted to the medical emergency and ICU at tertiary care health center who fulfill the following criteria for sepsis, within a 24 h time window, were included in the study. Results: A total of 50 patients were enrolled in the study, 37 (74.00%) were discharged whereas 13(26.00%) patients expired. The majority of patients, irrespective of outcome had Vitamin D deficiency. Although normal Vitamin D levels were observed in relatively higher proportion of patients who were discharged (29 patients) as compared to those who expired (12 patients) yet this difference was not significant statistically (P = 0.481). Conclusion: Vitamin D deficiency leads to increased risk of mortality in the critically ill patients. Keywords: Sepsis, Vitamin D deficiency, Mortality.

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Vitamin D deficiency in critically ill patients diagnosed with COVID -19. Are we doing enough? A retrospective analysis of 226 patients.

10.21203/rs.3.rs-30390/v1 ◽

2020 ◽

Cited By ~ 2

Author(s):

Tomás Cuñat ◽

Antonio Ojeda ◽

Andrea Calvo

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Critically Ill ◽

Critically Ill Patients ◽

Distress Syndrome ◽

Renin Angiotensin System ◽

Angiotensin System ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

25 Hydroxyvitamin D

Abstract Vitamin D deficiency is common in critically ill patients, and its role in COVID-19 patients could be important. Its deficiency has been associated with respiratory distress syndrome, pulmonary fibrosis (through activation of the renin-angiotensin system), increased levels of IL-2, and cardiovascular adverse events. Various scientific societies recommend the screening of vitamin D in individuals at risk for deficiency. Despite that, the demographics of Vitamin D levels amongst critically ill patients with a confirmed diagnosis of COVID-19 are currently unknown. We propose a study to determine the prevalence of vitamin D deficiency in a consecutive population of COVID-19 patients admitted to intensive care units and to evaluate its relationship with clinical outcomes. We study 226 COVID-19 patients between March 16 and April 26, 2020. The prevalence of vitamin D deficiency could not be determined because the value of 25-hydroxyvitamin D was obtained in a few patients (17 patients, 7,5%). However, all patients with serum determinations of 25-hydroxyvitamin D presented a level lower than 20 ng/ml and thirteen patients (76,5%) levels < 12,5 ng/ml. We conclude that undiagnosed vitamin D deficiency is common in critically ill COVID-19 patients, and physicians should be conscious of the relevance of its monitoring and supplementation.

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Effect Of Vitamin D Deficiency In Critically Ill Patients

10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a2556 ◽

2012 ◽

Author(s):

Michael Agustin ◽

Vera A. De Palo

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Critically Ill ◽

Critically Ill Patients

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Vitamin D status in pregnant women and their newborns in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184969 ◽

2018 ◽

Vol 7 (12) ◽

pp. 5071

Author(s):

Harleen Kour ◽

Shashi Gupta ◽

Swarn K. Gupta ◽

Bawa Ram Bhagat ◽

Gagan Singh

Keyword(s):

Vitamin D ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Tertiary Care ◽

North India ◽

Care Hospital ◽

Vitamin D Status ◽

Pregnant Females ◽

Vitamin D Levels ◽

Maternal And Newborn

Background: In the recent years there has been an increased understanding of the role that vitamin D plays in regulation of cell growth, calcium absorption and immunity and its impact on the developing fetus and maternal health is of significant concern. This study aims at evaluating the Vitamin D status in pregnant women and their newborns.Methods: A cross sectional study was done on 100 pregnant females according to inclusion and exclusion criteria. At the time of delivery, maternal blood was collected, and newborn samples were taken from newborn side of umbilical cord and sent for analysis.Results: The prevalence of Vitamin D deficiency has been found to be 85% of pregnant females and 91% of the newborns. Only 5% of pregnant females and 1% of the newborns showed Vitamin D sufficiency. Maternal and newborn vitamin D levels show a positive correlation. Mean maternal and newborn Vitamin D levels were found to be 16.78±7.04 ng/mL and 11.29±5.75 ng/ml.Conclusions: Vitamin D deficiency is highly prevalent among pregnant women in north India. Low maternal vitamin D levels lead to vitamin D deficiency in the newborns also.

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Levels of vitamin D among overweight and obese adolescents: an observational study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20174136 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1934

Author(s):

T. Prashanth Reddy ◽

Kishore Reddy ◽

Madhu Sudhan Reddy ◽

Manjunath G. A.

Keyword(s):

Vitamin D ◽

Observational Study ◽

Vitamin D Deficiency ◽

Overweight And Obesity ◽

Dietary Factors ◽

Vitamin D Status ◽

Obese Adolescents ◽

Vitamin D Levels ◽

Study Results ◽

Wide Range

Background: Normal growth and development requires vitamin D, and its deficiency compromises long term health and increases the risk of chronic disease. Severe vitamin D deficiency include rickets, osteomalacia, osteoporosis, increased risk of fracture, tooth loss. Studies indicate that vitamin D insufficiency (less severe than deficiency) is associated with a wide range of illnesses and chronic conditions, including type 1 diabetes, hypertension, multiple sclerosis and many types of cancer. Currently world is facing an unrecognized and untreated pandemic of vitamin D deficiency. This study aims at showing the relation between Vitamin D status and obesity in adolescent children and to know the dietary factors, life style factors like physical activity contributing to overweight and obesity in adolescents.Methods: Study design: This is an observational study of 30 overweight and obese adolescents based on BMI were studied and their Vitamin D levels were assessed.Results: A total of 14(46.7%) overweight and 16(53.3%) obese adolescents Vitamin D levels were assessed. 20(66.7%) had vitamin D levels <20ng/ml that is in the deficiency range.4(13.3%) had in the insufficiency range (21-30ng/ml), 6(20%) had in the sufficient range. Results shows vitamin D levels were significantly less in obese and overweight adolescents.Conclusions: Study results confirm that Vitamin D deficiency or insufficiency is common to obese and overweight adolescents, this may help to explain the relationship between obesity and several chronic diseases that are associated with poor Vitamin D status.

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Vitamin D levels in children with COVID-19: a report from Turkey

Epidemiology and Infection ◽

10.1017/s0950268821001825 ◽

2021 ◽

Vol 149 ◽

Author(s):

Aysegul Alpcan ◽

Serkan Tursun ◽

Yaşar Kandur

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Statistical Significance ◽

Serum Vitamin ◽

University Hospital ◽

Control Group ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Normal Vitamin ◽

The Mean

Abstract Several studies have demonstrated that higher levels of vitamin D are associated with better prognosis and outcomes in infectious diseases. We aimed to compare the vitamin D levels of paediatric patients with mild/moderate coronavirus disease 2019 (COVID-19) disease and a healthy control group. We retrospectively reviewed the medical records of patients who were hospitalised at our university hospital with the diagnosis of COVID-19 during the period between 25 May 2020 and 24 December 2020. The mean age of the COVID-19 patients was 10.7 ± 5.5 years (range 1–18 years); 43 (57.3%) COVID-19 patients were male. The mean serum vitamin D level was significantly lower in the COVID-19 group than the control group (21.5 ± 10.0 vs. 28.0 ± 11.0 IU, P < 0.001). The proportion of patients with vitamin D deficiency was significantly higher in the COVID-19 group than the control group (44% vs. 17.5%, P < 0.001). Patients with low vitamin D levels were older than the patients with normal vitamin D levels (11.6 ± 4.9 vs. 6.2 ± 1.8 years, P = 0.016). There was a significant male preponderance in the normal vitamin D group compared with the low vitamin D group (91.7% vs. 50.8%, P = 0.03). C-reactive protein level was higher in the low vitamin D group, although the difference did not reach statistical significance (9.6 ± 2.2 vs. 4.5 ± 1.6 mg/l, P = 0.074). Our study provides an insight into the relationship between vitamin D deficiency and COVID-19 for future studies. Empiric intervention with vitamin D can be justified by low serum vitamin D levels.

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