Acute and Critical Care

Original Articles

Infection
Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study: Alireza Fatemi, Seyed Hossein Ardehali, Ghazaleh Eslamian, Morvarid Noormohammadi, Shirin Malek; Acute Crit Care. 2021;36(4):300-307. Published online November 29, 2021; DOI: https://doi.org/10.4266/acc.2021.00605

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Background
As the coronavirus disease 2019 (COVID-19) pandemic continues to escalate, it is important to identify the prognostic factors related to increased mortality and disease severity. To assess the possible associations of vitamin D level with disease severity and survival, we studied 248 hospitalized COVID-19 patients in a single center in a prospective observational study from October 2020 to May 2021 in Tehran, Iran.
Methods
Patients who had a record of their 25-hydroxyvitamin D level measured in the previous year before testing positive with COVID-19 were included. Serum 25-hydroxyvitamin D level was measured upon admission in COVID-19 patients. The associations between clinical outcomes of patients and 25-hydroxyvitamin D level were assessed by adjusting for potential confounders and estimating a multivariate logistic regression model.
Results
The median (interquartile range) age of patients was 60 years (44–74 years), and 53% were male. The median serum 25-hydroxyvitamin D level prior to admission decreased with increasing COVID-19 severity (P=0.009). Similar findings were obtained when comparing median serum 25-hydroxyvitamin D on admission between moderate and severe patients (P=0.014). A univariate logistic regression model showed that vitamin D deficiency prior to COVID-19 was associated with a significant increase in the odds of mortality (odds ratio, 2.01; P=0.041). The Multivariate Cox model showed that vitamin D deficiency on admission was associated with a significant increase in risk for mortality (hazard ratio, 2.35; P=0.019).
Conclusions
Based on our results, it is likely that deficient vitamin D status is associated with increased mortality in COVID-19 patients. Thus, evaluating vitamin D level in COVID-19 patients is warranted.

Citations

Citations to this article as recorded by

The close association of micronutrients with COVID-19
Aimin Zhang, Yue Yin, Jiashu Tian, Xialin Wang, Zhihong Yue, Lin Pei, Li Liu, Li Qin, Mei Jia, Hui Wang, Qingwei Ma, Wei-bo Gao, Lin-Lin Cao
Heliyon.2024; 10(7): e28629. CrossRef
The bounds of meta-analytics and an alternative method
Ramalingam Shanmugam, Mohammad Tabatabai, Derek Wilus, Karan P Singh
Epidemiology and Health.2024; : e2024016. CrossRef
Systematic Mendelian randomization study of the effect of gut microbiome and plasma metabolome on severe COVID-19
Han Yan, Si Zhao, Han-Xue Huang, Pan Xie, Xin-He Cai, Yun-Dan Qu, Wei Zhang, Jian-Quan Luo, Longbo Zhang, Xi Li
Frontiers in Immunology.2023;[Epub] CrossRef
Risk Factors Associated with Severity and Death from COVID-19 in Iran: A Systematic Review and Meta-Analysis Study
Ahmad Mehri, Sahar Sotoodeh Ghorbani, Kosar Farhadi-Babadi, Elham Rahimi, Zahra Barati, Niloufar Taherpour, Neda Izadi, Fatemeh Shahbazi, Yaser Mokhayeri, Arash Seifi, Saeid Fallah, Rezvan Feyzi, Koorosh Etemed, Seyed Saeed Hashemi Nazari
Journal of Intensive Care Medicine.2023; 38(9): 825. CrossRef
Vitamin D: A Role Also in Long COVID-19?
Luigi Barrea, Ludovica Verde, William B. Grant, Evelyn Frias-Toral, Gerardo Sarno, Claudia Vetrani, Florencia Ceriani, Eloisa Garcia-Velasquez, José Contreras-Briceño, Silvia Savastano, Annamaria Colao, Giovanna Muscogiuri
Nutrients.2022; 14(8): 1625. CrossRef

Trauma
Prevalence and clinical impact of vitamin D deficiency in critically ill Korean patients with traumatic injuries: a single-center, prospective, observational study: Kyoung Hoon Lim, Jihoon Jang, Jinyoung Park; Acute Crit Care. 2021;36(2):92-98. Published online April 29, 2021; DOI: https://doi.org/10.4266/acc.2020.00801

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Abstract PDF: Background
This study investigated the prevalence and impact of 25-hydroxyvitamin D (25(OH) vitamin D) deficiency in critically ill Korean patients with traumatic injuries.
Methods
This prospective observational cohort study assessed the 25(OH) vitamin D status of consecutive trauma patients admitted to the trauma intensive care unit (TICU) of Kyungpook National University Hospital between January and December 2018. We analyzed the prevalence of 25(OH) vitamin D deficiency and its impact on clinical outcomes.
Results
There were no significant differences in the duration of mechanical ventilation (MV), lengths of TICU and hospital stays, and rates of nosocomial infection and mortality between patients with 25(OH) vitamin D <20 ng/ml and those with 25(OH) vitamin D ≥20 ng/ml within 24 hours of TICU admission. The duration of MV and lengths of TICU and hospital stays were shorter and the rate of nosocomial infection was lower in patients with 25(OH) vitamin D level ≥20 ng/ml on day 7 of hospitalization. The duration of MV, lengths of TICU and hospital stays, and nosocomial infection rate were significantly lower in patients with increased concentrations compared with those with decreased concentrations on day 7 of hospitalization, but the mortality rate did not differ significantly.
Conclusions
The 25(OH) vitamin D level measured within 24 hours after TICU admission was unrelated to clinical outcomes in critically ill patients with traumatic injuries. However, patients with increased 25(OH) vitamin D level after 7 days of hospitalization had better clinical outcomes than those with decreased levels.

Endocrinology
Prevalence and Related Factors of Vitamin D Deficiency in Critically Ill Patients: Hyun Jung Kim, Min Su Sohn, Eun Young Choi; Korean J Crit Care Med. 2016;31(4):300-307. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00276

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182 Download
3 Crossref

Abstract PDF

Background
To identify the prevalence and related factors for vitamin D deficiency in the patients who admitted to the medical intensive care unit (ICU) of a Korean tertiary care hospital.
Methods
We retrospectively analyzed the data from ICU patients requiring mechanical ventilation (MV) for a period of > 48 h to identify the prevalence and associated factors for vitamin D deficiency. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] level < 20 ng/mL.
Results
Among 570 patients admitted to the ICU, 221 were enrolled in the study, 194 in the vitamin D deficient group and 27 in the non-deficient group. Prevalence of vitamin D deficiency in critically ill patients was 87.8%. The patient age was lower in the vitamin D deficient group compared with the non-deficient group (64.4 ± 15.4 vs. 71.0 ± 9.6 years, p = 0.049). A higher acute physiology and chronic health evaluation II (APACHE II) score (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.37) and chronic illness (OR 3.12, 95% CI 1.08-9.01) were associated with vitamin D deficiency after adjusting for age and body mass index. Clinical outcomes of duration of MV, ICU stay, and 28- and 90-day mortality rates were not significantly different between the vitamin D deficient and nondeficient groups.
Conclusions
Vitamin D deficiency was common in critically ill patients, particularly among younger patients. Higher APACHE II score and chronic illness were associated with vitamin D deficiency.

Citations

Citations to this article as recorded by

Vitamin D deficiency and mortality among critically ill surgical patients in an urban Korean hospital
Ji-hyun Lee, Seo-rin Doo, Dongha Kim, Yoo-kyoung Park, Eun-jeong Park, Jae-myeong Lee
International Journal for Vitamin and Nutrition Research.2022; 92(2): 101. CrossRef
Vitamin D Deficiency in Critically Ill Patients
Ji Hyun Lee, Jae-Myeong Lee
Surgical Metabolism and Nutrition.2017; 8(2): 17. CrossRef
Should We Measure Vitamin D Level?
Jae Hwa Cho
The Korean Journal of Critical Care Medicine.2016; 31(4): 369. CrossRef

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