scholarly journals Low 25(OH)D Level Is Associated with Severe Course and Poor Prognosis in COVID-19

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3021
Author(s):  
Tatiana L. Karonova ◽  
Alena T. Andreeva ◽  
Ksenia A. Golovatuk ◽  
Ekaterina S. Bykova ◽  
Anna V. Simanenkova ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Severe Disease ◽  
Fatal Outcome ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
Severe Deficiency ◽  
Moderate Disease ◽  
Increased Risk ◽  
Discharged Patients

We evaluated associations between serum 25-hydroxyvitamin D [25(OH)D] level and severity of new coronavirus infection (COVID-19) in hospitalized patients. We assessed serum 25(OH)D level in 133 patients aged 21–93 years. Twenty-five (19%) patients had severe disease, 108 patients (81%) had moderate disease, and 18 (14%) patients died. 25(OH)D level ranged from 3.0 to 97.0 ng/mL (median, 13.5 [25%; 75%, 9.6; 23.3] ng/mL). Vitamin D deficiency was diagnosed in 90 patients, including 37 with severe deficiency. In patients with severe course of disease, 25(OH)D level was lower (median, 9.7 [25%; 75%, 6.0; 14.9] ng/mL), and vitamin D deficiency was more common than in patients with moderate course (median, 14.6 [25%; 75%, 10.6; 24.4] ng/mL, p = 0.003). In patients who died, 25(OH)D was 9.6 [25%; 75%, 6.0; 11.5] ng/mL, compared with 14.8 [25%; 75%, 10.1; 24.3] ng/mL in discharged patients (p = 0.001). Severe vitamin D deficiency was associated with increased risk of COVID-19 severity and fatal outcome. The threshold for 25(OH)D level associated with increased risk of severe course was 11.7 ng/mL. Approximately the same 25(OH)D level, 10.9 ng/mL, was associated with increased risk of mortality. Thus, most COVID-19 patients have vitamin D deficiency; severe vitamin D deficiency is associated with increased risk of COVID-19 severity and fatal outcome.

Effect of Severe Vitamin D Deficiency at Admission on Shock Reversal in Children With Septic Shock: A Prospective Observational Study

2017 ◽  
Vol 34 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Jhuma Sankar ◽  
Javed Ismail ◽  
Rashmi Das ◽  
Nishanth Dev ◽  
Anubhuti Chitkara ◽  
...  
Keyword(s):  
Vitamin D ◽  
Septic Shock ◽  
Multivariate Analysis ◽  
Vitamin D Deficiency ◽  
Univariate Analysis ◽  
Pediatric Intensive Care ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
Severe Deficiency ◽  
Shock Reversal

Objectives: To evaluate the association of severe vitamin D deficiency with clinically important outcomes in children with septic shock. Methods: We enrolled children ≤17 years with septic shock prospectively over a period of 6 months. We estimated 25-hydroxyvitamin D [25 (OH) D] levels at admission and 72 hours. Severe deficiency was defined as serum 25 (OH) <10 ng/mL. We performed univariate and multivariate analysis to evaluate association with clinically important outcomes. Results: Forty-three children were enrolled in the study. The prevalence of severe vitamin D deficiency was 72% and 69% at admission and 72 hours, respectively. On univariate analysis, severe vitamin D deficiency at admission was associated with lower rates of shock reversal, 74% (23) versus 25% (3); relative risk (95% confidence interval [CI]): 2.9 (1.09-8.08), at 24 hours and greater need for fluid boluses (75 vs 59 mL/kg). On multivariate analysis, nonresolution of shock at 24 hours was significantly associated with severe vitamin D deficiency after adjusting for other key baseline and clinical variables, adjusted odds ratio (95% CI): 12 (2.01-87.01); 0.01. Conclusion: The prevalence of severe vitamin D deficiency is high in children with septic shock admitted to pediatric intensive care unit. Severe vitamin D deficiency at admission seems to be associated with lower rates of shock reversal at 24 hours of ICU stay. Our study provides preliminary data for planning interventional studies in children with septic shock and severe vitamin D deficiency.

scholarly journals Vitamin D and Cardiovascular Disease: An Updated Narrative Review

2021 ◽  
Vol 22 (6) ◽  
pp. 2896
Author(s):  
Armin Zittermann ◽  
Christian Trummer ◽  
Verena Theiler-Schwetz ◽  
Elisabeth Lerchbaum ◽  
Winfried März ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
High Risk ◽  
General Population ◽  
Vitamin D Deficiency ◽  
Specific Gene ◽  
Vitamin D Status ◽  
Cvd Risk ◽  
Severe Vitamin ◽  
Increased Risk

During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.

scholarly journals Influence of secondary hyperparathyroidism in management anemia in patients on regular hemodialysis

2020 ◽  
Vol 77 (5) ◽  
pp. 508-515
Author(s):  
Nedim Hamzagic ◽  
Marija Andjelkovic ◽  
Marijana Stanojevic-Pirkovic ◽  
Petar Canovic ◽  
Vesna Ignjatovic ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Iron Status ◽  
Hemodialysis Patients ◽  
Dialysis Adequacy ◽  
Hydroxyvitamin D ◽  
Reactive Protein ◽  
Severe Vitamin ◽  
Kolmogorov Smirnov ◽  
Regular Hemodialysis

Background/Aim. Anemia is a common complication in hemodialysis patients. Treatment of anemia is affected by iron deficiency, insufficient dose of erythropoietin, microinflammation, vitamin D deficiency, increased intact parathyroid hormone concentration and inadequate hemodialysis. The aim of the study was to determine the prevalence of vitamin D deficiency and its impact on hemoglobin con-centration, iron status, microinflammation, malnutrition, dialysis adequacy and erythropoietin dose in patients on regular hemodialysis. Methods. The study involved 120 patients divided into three groups: severely deficient of vitamin D: 25- hydroxyvitamin D[25(OH)D] < 10 ng/mL; deficient ? 25(OH)D within range of 10?20 ng/mL, and insufficient ? 25(OH)D > 20 ng/mL. For statistical analysis Kolmogorov- Smirnov test, the single-factor parametric analysis of variance ? ANOVA and Kruskal-Wallis test were used. Results. The prevalence of vitamin D deficiency in patients on regular hemodialysis was 75.83%, while the prevalence of severe vitamin D deficiency was 24.7%. Patients with severe vitamin D deficiency had lower blood concentration of hemoglobin, hematocrit, serum concentration of total proteins and albumin, and dialysis indices were also lower compared to the other two groups of patients. The level of C-reactive protein was significantly higher in the group of patients with severe vitamin D deficiency than in the two rest groups. Conclusion. Hemodialysis patients with severe vitamin D deficiency have lower hemoglobin, lower dialysis adequacy, significant microinflammation, malnutrition, bone metabolism disorders and need higher dose of erythropoietin than patients whose vitamin D was higher than 10 ng/mL. Vitamin D is important risk factor for development of anemia in hemodialysis patients and important factor that can affect treatment of anemia in these patients.

scholarly journals Are Indian obese children and adolescents at increased risk for Vitamin D deficiency?

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Aashima Dabas ◽  
T. Aravind ◽  
Sangeeta Yadav ◽  
Mukta Mantan ◽  
Smita Kaushik
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
Obese Children ◽  
Indian Children ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
High Risk Factor ◽  
25 Hydroxyvitamin D ◽  
Obese Subjects

Objectives: Obesity has been mentioned as a high risk factor for Vitamin D deficiency (VDD) requiring supplementation in Indian children. Material and Methods: Forty obese and age-matched non-obese subjects (age 5–18 years) were assessed for lifestyle parameters, metabolic profile, and serum 25-hydroxyvitamin D (25OHD). VDD was defined as serum 25OHD < 12 ng/mL. Results: Mean 25OHD was comparable among obese and controls (15.0 ± 9.95 and 15.1 ± 4.79 ng/mL; P = 0.97) with VDD seen in 82% of cases and 85% of controls. Pubertal cases had lower 25OHD values than prepubertal obese cases (10.78 ± 4.69 and 17.2 ± 11 ng/mL; P = 0.06). Mean duration of physical activity (<2 h/week) and screen time (>2 h/day) was similar across prepubertal and pubertal groups and between obese and controls. Obesity was not associated with risk for VDD among cases and controls (odds ratio 0.83, 95% C.I. 0.25–2.7, P = 0.76). Conclusion: Obese pubertal subjects were more at risk for VDD than prepubertal subjects. Routine Vitamin D supplementation to obese Indian children may be considered during adolescence.

scholarly journals Vitamin D deficiency is associated with inflammatory cytokine concentrations in patients with diabetic foot infection

2014 ◽  
Vol 112 (12) ◽  
pp. 1938-1943 ◽  
Author(s):  
Shalbha Tiwari ◽  
Daliparthy Devi Pratyush ◽  
Sanjeev Kumar Gupta ◽  
Surya Kumar Singh
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Diabetic Foot ◽  
Inflammatory Cytokine ◽  
Diabetic Foot Infection ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
Tnf Α ◽  
25 Hydroxyvitamin D ◽  
Ifn Γ

Vitamin D has been recognised as a potent immunomodulator and its deficiency is common in different population groups including patients with diabetic foot infection. Diabetic foot infection reflects the altered immune status of the host. As cytokine regulation plays a significant role in infection and wound-healing processes, the present study aimed to evaluate the association between vitamin D status and inflammatory cytokine profiles in patients with diabetic foot infection. The serum concentrations of vitamin D (25-hydroxyvitamin D), IL-1β, IL-6, TNF-α and interferon-γ (IFN-γ) were measured in 112 diabetic foot infection cases and 109 diabetic controls. Severe vitamin D deficiency (25-hydroxyvitamin D concentration < 25 nmol/l) was more common in cases than in controls (48·2v.20·5 %). Although age, duration of diabetes, HbA1C(glycosylated Hb) concentration and BMI were similar, cases had significantly higher concentrations of IL-6 (P≤ 0·001), IL-1β (P≤ 0·02) and TNF-α (P≤ 0·006) than controls. A significant negative correlation was also observed between 25-hydroxyvitamin D concentration and circulating concentrations of IL-1β (r− 0·323;P≤ 0·001) as well as IL-6 (r− 0·154;P≤ 0·04), but not between 25-hydroxyvitamin D and TNF-α and IFN-γ concentrations. Furthermore, a significant difference in IL-1β (P≤ 0·007) and IL-6 (P≤ 0·02) concentrations was observed in patients with severe 25-hydroxyvitamin D deficiency compared with patients with 25-hydroxyvitamin D concentration ≥ 25 nmol/l, and this difference was remarkable for TNF-α. In conclusion, severe vitamin D deficiency is associated with elevated inflammatory cytokine concentrations in diabetic patients, particularly in those with foot infection. A 25-hydroxyvitamin D concentration value < 25 nmol/l is suggested as the ‘cut-off’ for such immunological alterations in patients with diabetes mellitus.

In COVID-19 patients, low 25-hydroxyvitamin D level in serum is associated with longer viral clearance time and higher risk of intensive care unit admission

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jameela Al-Salman ◽  
Sarah Alghareeb ◽  
Eman Alarab ◽  
Haitham Jahrami ◽  
William B. Grant
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Viral Clearance ◽  
Clearance Time ◽  
Rt Pcr ◽  
Content Type ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
25 Hydroxyvitamin D ◽  
Age And Sex

Purpose This study aims to investigate the association between vitamin D measured in serum 25 hydroxyvitamin D [25(OH)D] and outcomes of COVID-19 patients in Bahrain. This paper hypothesized that lower serum 25(OH)D concentration in COVID 19 patients is associated with longer viral clearance time (VCT) and higher risk of admission to the intensive care unit (ICU). Design/methodology/approach This study used a retrospective cohort design of patients admitted to Salmaniya Medical Complex, Manama, Kingdom of Bahrain, from February to June 2020. This study included patients with positive, confirmed COVID-19 diagnosis made using reverse transcription-polymerase chain reaction (RT-PCR), World Health Organization diagnosis manual and local diagnostic guidelines. Primary outcome measures were: VCT measured as the time in days between the first positive RT-PCR test result and the first of two consecutive negative RT-PCR results on recovery and admission need to ICU. Findings A total of 450 patients were analyzed; mean age was 46.4 ± 12.4 years and 349 (78%) were men. Mean 25(OH)D concentration was 41.7 ± 23.7 nmol/L for the entire sample. Severe vitamin D deficiency (<25 nmol/L) was present in 20%, mild-to-moderate deficiency (25–50 nmol/L) in 55%, insufficiency (50 to <75 nmol/L) in 18% and sufficiency (=75 nmol/L) in 7%. The mean VCT was 12.9 ± 8.2 days. Multivariate linear regression analysis showed that severe vitamin D deficiency was associated with longer VCT, with an average of three extra days after correction for age and sex (β = 3.1; p = 0.001). Multinomial regression analysis showed that vitamin D deficiency was associated with an 83% increased risk of admission to ICU after correction for age and sex (odds ratio = 1.8; p = 0.03). Originality/value The results showed that severe vitamin D deficiency was associated with longer recovery time from COVID-19. Low serum 25(OH)D is associated with increased need for critical care in an ICU. Large-scale randomized controlled trials are necessary to further investigate the complex association between vitamin D and COVID-19 infection.

scholarly journals Prevalence and severity of vitamin D deficiency in patients with diabetic foot infection

2012 ◽  
Vol 109 (1) ◽  
pp. 99-102 ◽  
Author(s):  
Shalbha Tiwari ◽  
Daliparthy D. Pratyush ◽  
Balram Gupta ◽  
Awanindra Dwivedi ◽  
Sandeep Chaudhary ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Diabetic Foot ◽  
Vitamin D Supplementation ◽  
Diabetic Patients ◽  
Similar Data ◽  
Diabetic Foot Infection ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
Diabetic Foot Infections

The aim of the present research was to study the prevalence and severity of vitamin D deficiency in patients with diabetic foot infection. Patients were enrolled in two groups: diabetic patients with foot infection (n 125) as cases and diabetic patients without the infection as controls (n 164). Serum 25-hydroxyvitamin D (25(OH)D) was measured by RIA. Data were presented as means and standard deviations unless otherwise indicated and were analysed by SPSS. Results revealed that 25(OH)D (nmol/l) was significantly lower (40·25 (sd 38·35) v. 50·75 (sd 33·00); P < 0·001) in cases than in controls. Vitamin D inadequacy (25(OH)D < 75 nmol/l) was equally common in cases and controls (OR 1·45, 95 % CI 0·8, 3·0; P = 0·32), but cases had a greater risk of vitamin D deficiency (25(OH)D < 50 nmol/l) than controls (OR 1·8, 95 % CI 1·1, 3·0; P = 0·02). Risk of severe vitamin D deficiency (25(OH)D < 25 nmol/l) was significantly higher in cases than in controls (OR 4·0, 95 % CI 2·4, 6·9; P < 0·0001). Age, duration of diabetes and HbA1c were significantly higher in cases than in controls and therefore adjusted to nullify the effect of these variables, if any, on study outcome. The study concluded that vitamin D deficiency was more prevalent and severe in patients with diabetic foot infection. This study opens up the issue of recognising severe vitamin D deficiency ( < 25 nmol/l) as a possible risk factor for diabetic foot infections and the need for vitamin D supplementation in such patients for a better clinical outcome. This could be substantiated by similar data from future studies.

scholarly journals Severe vitamin D deficiency is a risk factor for renal hyperfiltration

2018 ◽  
Vol 108 (6) ◽  
pp. 1342-1351 ◽  
Author(s):  
Jong Hyun Jhee ◽  
Ki Heon Nam ◽  
Seong Yeong An ◽  
Min-Uk Cha ◽  
Misol Lee ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Risk Factor ◽  
Glomerular Filtration Rate ◽  
Vitamin D Deficiency ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Hydroxyvitamin D ◽  
Severe Vitamin ◽  
25 Hydroxyvitamin D

ABSTRACT Background Vitamin D deficiency is associated with renal progression in chronic kidney disease. Moreover, improvement of clinical outcomes after vitamin D supplementation has been reported in the diabetic and chronic kidney disease population. Objective We investigated the association between renal hyperfiltration (RHF) and vitamin D status in a relatively healthy population. Design Data were retrieved from the Korean NHANES, a nationwide population-based cross-sectional study from 2008 to 2015. Overall, 33,210 subjects with normal renal function were included in the final analysis. Severe vitamin D deficiency was defined as serum 25-hydroxyvitamin D concentration <10 ng/mL. RHF was defined as estimated glomerular filtration rate with residual in the >95th percentile after adjustment for age, sex, height, weight, and history of hypertension or diabetes. Results The mean ± SD age of subjects was 48.1 ± 15.9 y, and the number of women was 18,779 (56.5%). Estimated glomerular filtration rate was negatively associated with serum 25-hydroxyvitamin D concentrations in multivariable linear regression analysis (β: −0.02; 95% CI: −0.02, −0.01; P < 0.001). Furthermore, 1637 (4.9%) subjects were categorized into the RHF group, and the prevalence of RHF was significantly higher in the severe vitamin D deficiency group than in the sufficiency group (5.8% compared with 5.0%, P < 0.001). In a multivariable logistic regression model, severe vitamin D deficiency was a significant risk factor for RHF (OR: 2.41; 95% CI, 1.72, 3.43; P < 0.001). Conclusions Severe vitamin D deficiency is significantly associated with increasing prevalence of RHF in a relatively healthy adult population.

Severe vitamin D deficiency increases the risk for moderate to severe disease activity in Chinese patients with SLE

Lupus ◽  
2016 ◽  
Vol 25 (11) ◽  
pp. 1224-1229 ◽  
Author(s):  
C-C Gao ◽  
S-Y Liu ◽  
Z-Z Wu ◽  
T-F Li ◽  
G-M Gao ◽  
...  
Keyword(s):  
Vitamin D ◽  
Disease Activity ◽  
Vitamin D Deficiency ◽  
Severe Disease ◽  
Chinese Patients ◽  
Severe Vitamin

scholarly journals Association of Serum 25-Hydroxyvitamin D Deficiency with Risk of Incidence of Disability in Basic Activities of Daily Living in Adults >50 Years of Age

2020 ◽  
Vol 150 (11) ◽  
pp. 2977-2984
Author(s):  
Mariane M Luiz ◽  
Roberta Máximo ◽  
Dayane C Oliveira ◽  
Paula C Ramírez ◽  
Aline F de Souza ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Activities Of Daily Living ◽  
Vitamin D Deficiency ◽  
Daily Living ◽  
Clinical Characteristics ◽  
Hydroxyvitamin D ◽  
Increased Risk ◽  
25 Hydroxyvitamin D

ABSTRACT Background Vitamin D deficiency compromises muscle function and is related to the etiology of several clinical conditions that can contribute to the development of disability. However, there are few epidemiological studies investigating the association between vitamin D deficiency and the incidence of disability. Objectives We aimed to assess whether vitamin D deficiency is associated with the incidence of disability in basic activities of daily living (BADL) and to verify whether there are sex differences in this association. Methods A 4-y follow-up study was conducted involving individuals aged 50 y or older who participated in ELSA (English Longitudinal Study of Ageing). The sample consisted of 4814 participants free of disability at baseline according to the modified Katz Index. Vitamin D was assessed by serum 25-hydroxyvitamin D [25(OH)D] concentrations and the participants were classified as sufficient (&gt;50 nmol/L), insufficient (&gt;30 to ≤50 nmol/L), or deficient (≤30 nmol/L). Sociodemographic, behavioral, and clinical characteristics were also investigated. BADL were re-evaluated after 2 and 4 y of follow-up. The report of any difficulty to perform ≥1 BADL was considered as an incident case of disability. Poisson models stratified by sex and controlled for sociodemographic, behavioral, and clinical characteristics were carried out. Results After 4-y follow-up, deficient serum 25(OH)D was a risk factor for the incidence of BADL disability in both women (IRR: 1.53; 95% CI: 1.16, 2.03) and men (IRR: 1.44; 95% CI: 1.02, 2.02). However, insufficient serum 25(OH)D was not a risk factor for the incidence of BADL disability in either men or women. Conclusions Independently of sex, deficient serum 25(OH)D concentrations were associated with increased risk of incidence of BADL disability in adults &gt;50 y old and should be an additional target of clinical strategies to prevent disability in these populations.

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