Individuals with vitamin D deficiency or vitamin D insufficiency may be at increased risk for SARS-CoV-2 infection, as well as COVID-19-related severity and mortality, according to findings from a systematic review and meta-analysis presented at the American Society for Bone and Mineral Research (ASBMR) 2021 Annual Meeting, held from October 1 to 4, 2021, in San Diego, California and real-time virtually.
Study authors sought to explore whether vitamin D status was linked to COVID-19 severity and mortality —the primary study outcomes — as well as risk for SARS-CoV-2 infection and hospitalization — the secondary study outcomes.
Original studies were eligible in the analysis if they included patients hospitalized with COVID-19 (with information available on admission to intensive care unit [ICU] and/or mortality); patients with/without SARS-CoV-2 infection; and patients with COVID-19 who did or did not require hospitalization. Studies that reported on the prevalence of vitamin D insufficiency (25-hydroxyvitamin D [25 OHD] <30 ng/dL), and/or vitamin D deficiency (25 OHD <20 ng/dL), and/or severe vitamin D deficiency (25 OHD <10 ng/dL) were also included. A total of 53 studies were included in the current analysis.
Overall, the link between vitamin D status and COVID-19-related ICU admission,
mortality, and hospitalization, and SARS-CoV-2 infection was reported by 28, 36, 10, and 16 studies, respectively.
Severe vitamin D deficiency (odds ratio [OR], 2.63; 95% CI, 1.45-4.77), vitamin D deficiency (OR, 2.16; 95% CI, 1.43-3.26), and vitamin D insufficiency (OR, 2.83; 95% CI, 1.74-4.61) were all associated with COVID-19-related ICU admission. Further, severe vitamin D deficiency (OR, 2.29; 95% CI, 1.39-3.49), vitamin D deficiency (OR, 1.84; 95% CI, 1.26-2.69), and vitamin D insufficiency (OR, 4.15; 95% CI, 1.76-9.77) were all associated with COVID-19-related mortality.
Study authors also noted that COVID-19-related hospitalization was associated with severe vitamin D deficiency (OR, 2.50; 95% CI, 1.63-3.85), vitamin D deficiency (OR, 2.38; 95% CI, 1.56-3.63), and vitamin D insufficiency (OR, 1.82; 95% CI, 1.43-2.33).
With regard to the secondary endpoints, SARS-CoV-2 infection was linked to severe vitamin D deficiency (OR, 1.68; 95% CI, 1.32-2.13), vitamin D deficiency (OR, 1.83; 95% CI, 1.43-2.22), and vitamin D insufficiency (OR, 1.49; 95% CI, 1.16-1.91).
Study results were not modified even considering specific populations, such as White patients, older vs middle-aged patients, and high-quality studies.
The researchers concluded, “[The] results [from the analysis] suggest that [individuals] with either vitamin D insufficiency or deficiency present an increased risk of SARS-CoV-2 infection, [COVID-19-related] severity and death.”
Chiodini I, Gatti D, Soranna D, et al. Vitamin D status and Covid-19 related severity and mortality: a systematic review and meta-analysis. Presented at: ASBMR 2021; October 1-4, 2021; San Diego, CA. Abstract VPL-311.