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The effect of 1-hydroxy-vitamin D treatment in hospitalized patients with COVID-19: A retrospective study
Takashi Ogasawara1, Yasuhisa Tajima2, Naoto Nakamura1
1Department of Respiratory Medicine, Hamamatsu Medical Center, Japan.
Insights
Vitamin D supplementation may improve outcomes for hospitalized COVID-19 patients. Treatment with 1-hydroxy-vitamin D reduced the need for respiratory support and in-hospital mortality in a recent study.
Area of Science:
- Infectious Diseases
- Endocrinology
- Critical Care Medicine
Background:
- The role of vitamin D in COVID-19 outcomes is not fully understood.
- Vitamin D deficiency is common in hospitalized patients.
- This study investigates 1-hydroxy-vitamin D's effect on severe COVID-19.
Purpose of the Study:
- To evaluate the impact of 1-hydroxy-vitamin D on severe COVID-19 progression.
- To assess the effect on respiratory support needs and in-hospital mortality.
- To analyze outcomes in patients hospitalized with COVID-19.
Main Methods:
- Retrospective study of 312 COVID-19 patients (Delta and Omicron variants).
- Comparison of patients receiving 1-hydroxy-vitamin D versus a control group.
- Primary endpoint: need for respiratory support and in-hospital mortality.
Main Results:
- 1-hydroxy-vitamin D group showed significantly lower rates of respiratory support and mortality (6% vs. 14%).
- Patients in the control group had a more severe baseline disease profile.
- Propensity score matching confirmed a statistically significant improvement in outcomes for the treated group.
Conclusions:
- 1-hydroxy-vitamin D treatment may be beneficial for hospitalized COVID-19 patients.
- Supplementation appears to reduce the composite endpoint of respiratory support and mortality.
- Further research may confirm vitamin D's role in managing severe COVID-19.
Background & Aims:
The efficacy of vitamin D supplementation in coronavirus disease 2019 (COVID-19) remains unclear. This study aimed to evaluate the effect of 1-hydroxy-vitamin D on the prevention of severe disease and mortality in patients hospitalized for COVID-19.
Methods:
This retrospective study included 312 patients with COVID-19 who were admitted to our hospital between April 2021 and October 2021 (primarily the Delta variant) and between July 2022 and September 2022 (primarily Omicron variant). Serum 25-hydroxyvitamin D (25(OH)D) levels were measured at the time of admission and 1-hydroxy-vitamin D was prescribed by the treating physicians. The patients were divided into two groups: those administered 1-hydroxy-vitamin D (Vit D group) and those who were not (control group). The composite primary endpoint was the need for additional respiratory support, including high-flow oxygen therapy or invasive mechanical ventilation, and in-hospital mortality rate.
Results:
Of 312 patients, 122 (39%) received 1-hydroxy-vitamin D treatment. Although the median age was not significantly higher in the Vit D group than in the control group (66 vs. 58 years old, P = 0.06) and there was no significant difference in the proportion of vitamin D deficiency (defined as serum 25(OH)D level less than 20 ng/mL, 77% vs. 65%, P = 0.07), patients in the control group had a more severe baseline profile compared to the Vit D group according to the Japanese disease severity definition for COVID-19 (P = 0.01). The proportion of those requiring more respiratory support and in-hospital mortality was significantly lower in the Vit D group than in the control group (6% vs. 14%, P = 0.01 log-rank test). After propensity score matching, a statistically significant difference in the primary endpoint was observed (P = 0.03 log-rank test).
Conclusions:
1-hydroxy-vitamin treatment may improve outcomes in hospitalized patients with COVID-19, reducing composite outcomes including the need for additional respiratory support and in-hospital mortality.
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