Objective To explore the possible associations of serum 25-hydroxyvitamin D concentration [25(OH)D] with COVID-19 in-hospital mortality and need for invasive mechanical ventilation. Patients and Methods A retrospective, observational, cohort study was conducted at two tertiary academic medical centers in Boston and New York. Eligible participants were hospitalized adult patients with laboratory-confirmed COVID-19 between 1 February 2020 and 15 May 2020. Demographic, clinical characteristics, comorbidities, medications, and disease-related outcomes were extracted from electronic medical records. Results The final analysis included 144 patients with confirmed COVID-19 (median age: 66 years, 44.4% male). Overall mortality was 18%, while patients with 25(OH)D levels ≥30 ng/mL had lower rates of mortality compared to those with 25(OH)D levels <30 ng/mL (9.2% vs. 25.3%, P=.02). In the adjusted multivariable analyses, 25(OH)D as a continuous variable was independently significantly associated with lower in-hospital mortality (OR, 0.94; 95% CI, 0.90-0.98; P=.007) and need for invasive mechanical ventilation (OR, 0.96; 95% CI, 0.93-0.99; P=.01). Similar data were obtained when 25(OH)D was studied as a continuous variable after logarithm transformation and as a dichotomous (<30ng/mL vs. ≥30ng/mL) or ordinal variable (quintiles), in the multivariable analyses. Conclusion Among patients admitted with laboratory-confirmed COVID-19, 25(OH)D levels were inversely associated with in-hospital mortality and the need for invasive mechanical ventilation. Further observational studies are needed to confirm these findings and randomized clinical trials to assess the role of vitamin D administration in improving the morbidity and mortality of COVID-19.
Vitamin D Status is Associated With In-hospital Mortality and Mechanical Ventilation: A Cohort of COVID-19 Hospitalized Patients