Vitamin D Deficiency COVID-19 Hospitalisation Risk

Edward B Jude, Stephanie F Ling, Rebecca Allcock, Beverly X Y Yeap, Joseph M Pappachan
The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 11, November 2021, Pages e4708–e4715
https://doi.org/10.1210/clinem/dgab439

Abstract

Context

One risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is postulated to be vitamin D deficiency. To better understand the role of vitamin D deficiency in the disease course of COVID-19, we undertook a retrospective case-control study in North West England.

Objective

To examine whether hospitalization with COVID-19 is more prevalent in individuals with lower vitamin D levels.

Methods

The study included individuals with test results for serum 25-hydroxyvitamin D (25[OH]D) between April 1, 2020, and January 29, 2021, from 2 districts in North West England. The last 25(OH)D level in the previous 12 months was categorized as “deficient” if less than 25 nmol/L and “insufficient” if 25 to 50 nmol/L.

Results

The study included 80 670 participants. Of these, 1808 were admitted to the hospital with COVID-19, of whom 670 died. In a primary cohort, median serum 25(OH)D in nonhospitalized participants with COVID-19 was 50.0 nmol/L (interquartile range [IQR], 34.0–66.7) vs 35.0 nmol/L (IQR, 21.0–57.0) in those admitted with COVID-19 (P < 0.005). In a validation cohort, median serum 25(OH)D was 47.1 nmol/L (IQR, 31.8–64.7) in nonhospitalized vs 33.0 nmol/L (IQR, 19.4–54.1) in hospitalized patients. Age-, sex-, and season-adjusted odds ratios for hospital admission were 2.3 to 2.4 times higher among participants with serum 25(OH)D <50 nmol/L compared with those with normal serum 25(OH)D levels, without excess mortality risk.

Conclusion

Vitamin D deficiency is associated with higher risk of COVID-19 hospitalization. Widespread measurement of serum 25(OH)D and treatment of insufficiency or deficiency may reduce this risk.

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