PT  - JOURNAL ARTICLE
AU  - Baktash, Vadir
AU  - Hosack, Tom
AU  - Patel, Nishil
AU  - Shah, Shital
AU  - Kandiah, Pirabakaran
AU  - Van den Abbeele, Koenraad
AU  - Mandal, Amit K J
AU  - Missouris, Constantinos G
TI  - Vitamin D status and outcomes for hospitalised older patients with COVID-19
AID  - 10.1136/postgradmedj-2020-138712
DP  - 2020 Aug 25
TA  - Postgraduate Medical Journal
PG  - postgradmedj-2020-138712
4099  - http://pmj.bmj.com/content/early/2021/01/08/postgradmedj-2020-138712.short
4100  - http://pmj.bmj.com/content/early/2021/01/08/postgradmedj-2020-138712.full
AB  - Purpose Older adults are more likely to be vitamin D deficient. The aim of the study was to determine whether these patients have worse outcomes with COVID-19.Methods We conducted a prospective cohort study between 1 March and 30 April 2020 to assess the importance of vitamin D deficiency in older patients with COVID-19. The cohort consisted of patients aged ≥65 years presenting with symptoms consistent with COVID-19 (n=105). All patients were tested for serum 25-hydroxyvitamin D (25(OH)D) levels during acute illness. Diagnosis of COVID-19 was confirmed via viral reverse transcriptase PCR swab or supporting radiological evidence. COVID-19-positive arm (n=70) was sub-divided into vitamin D-deficient (≤30 nmol/L) (n=39) and -replete groups (n=35). Subgroups were assessed for disease severity using biochemical, radiological and clinical markers. Primary outcome was in-hospital mortality. Secondary outcomes were laboratory features of cytokine storm, thoracic imaging changes and requirement of non-invasive ventilation (NIV).Results COVID-19-positive arm demonstrated lower median serum 25(OH)D level of 27 nmol/L (IQR=20–47 nmol/L) compared with COVID-19-negative arm, with median level of 52 nmol/L (IQR=31.5–71.5 nmol/L) (p value=0.0008). Among patients with vitamin D deficiency, there was higher peak D-dimer level (1914.00 μgFEU/L vs 1268.00 μgFEU/L) (p=0.034) and higher incidence of NIV support and high dependency unit admission (30.77% vs 9.68%) (p=0.042). No increased mortality was observed between groups.Conclusion Older adults with vitamin D deficiency and COVID-19 may demonstrate worse morbidity outcomes. Vitamin D status may be a useful prognosticator.