Vitamin D as a prognostic biomarker in COVID-19: single-center study and meta-analyses

Abstract

Vitamin D was investigated as a prognostic biomarker in COVID-19, in relation to both disease susceptibility and outcomes in infected individuals. Patients admitted to the hospital with a confirmed COVID-19 diagnosis were included if they had a vitamin D measurement prior to hospitalization. Using age- and sex-matched controls, vitamin D levels were investigated for an association with COVID-19 related hospitalizations. Further, vitamin D levels were investigated for an association with 30-day mortality in hospitalized COVID-19 patients. Additionally, three meta-analyses were conducted, investigating the association of vitamin D with the following outcomes: Having a positive SARS-CoV-2 test, hospitalization with COVID-19, and mortality in COVID-19 patients. A total of 685 hospitalized COVID-19 patients were included in the single-center study. Compared to controls, they had higher vitamin D levels. Unadjusted analysis of these 685 cases found higher vitamin D levels associated with increased 30-day mortality. This association disappeared after adjusting for age. In the fully adjusted model, no association between vitamin D and 30-day mortality was found. The meta-analyses found significant associations between lower vitamin D and having a positive SARS-CoV-2 test, and mortality among hospital-admitted COVID-19 patients. The relationship between lower vitamin D and COVID-19 related hospital admissions trended towards being positive but was not statistically significant. Many factors seem to influence the associations between vitamin D and COVID-19 related outcomes. Consequently, we do not believe that vitamin D in and of itself is likely to be a clinically useful and widely applicable predictor for the susceptibility and severity of COVID-19 infections.

Keywords:

• (MeSH): vitamin D
• vitamin D deficiency
• COVID-19
• SARS-CoV-2
• mortality
• hospitalization

Acknowledgments

The authors would like to thank Copenhagen University Hospital – Amager and Hvidovre for the cooperation in this study.

Disclosure statement

The authors declare no conflicts of interest in relation to the given study.

Unrelated to the given manuscript, TB declares:

Novo Nordisk Foundation (Unrestricted grant), Simonsen Foundation (Unrestricted grant), Lundbeck Foundation (Unrestricted grant), Kai Foundation (Unrestricted grant), Erik and Susanna Olesen’s Charitable Fund (Unrestricted grant), GSK (Unrestricted grant, advisory board), Pfizer (Unrestricted grant, principal investigator//clinical trial, advisory board), Boehringer Ingelheim (Principal investigator//clinical trial), Gilead Sciences (Unrestricted grant to, principal investigator//clinical trial, advisory board), MSD (Unrestricted grant, principal investigator, advisory board), Pentabase (Board member), Roche (Principal investigator/clinical trial) Novartis (Principal investigator/clinical trial) Kancera AB (Principal investigator/clinical trial), Janssen (Advisory board), Astra Zeneca (Advisory board).

Consulting fees: GSK, Pfizer.

Lectures: GSK, Pfizer, Gilead Sciences, Boehringer Ingelheim, Abbvie, Astra Zeneca

Donation of trial medication (baricitinib) from Eli Lilly.

Additional information

Funding

No funding to declare for the given study.