tetano
Editor, Senior Moderator
Front Nutr
. 2022 Jan 26;9:813485.
doi: 10.3389/fnut.2022.813485. eCollection 2022.
Serum Vitamin D Levels Are Associated With Increased COVID-19 Severity and Mortality Independent of Whole-Body and Visceral Adiposity
Pablo Esteban Vanegas-Cedillo[SUP] 1 2 [/SUP], Omar Yaxmehen Bello-Chavolla[SUP] 1 3 [/SUP], Natalia Ramírez-Pedraza[SUP] 4 [/SUP], Bethsabel Rodríguez Encinas[SUP] 2 2 [/SUP], Carolina Isabel Pérez Carrión[SUP] 2 [/SUP], María Isabel Jasso-Ávila[SUP] 2 [/SUP], Jorge Carlos Valladares-García[SUP] 2 [/SUP], Diana Hernández-Juárez[SUP] 2 [/SUP], Arsenio Vargas-Vázquez[SUP] 1 4 [/SUP], Neftali Eduardo Antonio-Villa[SUP] 1 4 [/SUP], Monica Chapa-Ibarguengoitia[SUP] 5 [/SUP], Alfredo Ponce de Leon[SUP] 6 [/SUP], José Sifuentes-Osornio[SUP] 7 8 [/SUP], Carlos A Aguilar-Salinas[SUP] 8 9 [/SUP], Roopa Mehta[SUP] 1 2 [/SUP]
Affiliations
Abstract
Introduction: Coronavirus disease (COVID-19) is a global pandemic. Vitamin D deficiency has been associated with susceptibility to infectious disease. In this study, the association between COVID-19 outcomes and vitamin D levels in patients attending a COVID-19 reference center in Mexico City are examined.
Methods: Consecutive patients with confirmed COVID-19 were evaluated. All patients underwent clinical evaluation and follow-up, laboratory measurements and a thoracic computerized tomography, including the measurement of epicardial fat thickness. Low vitamin D was defined as levels <20 ng/ml (<50nmol/L) and deficient Vitamin D as a level ≤12 ng/ml (<30 nmol/L).
Results: Of the 551 patients included, low vitamin D levels were present in 45.6% and deficient levels in 10.9%. Deficient Vitamin D levels were associated with mortality (HR 2.11, 95%CI 1.24-3.58, p = 0.006) but not with critical COVID-19, adjusted for age, sex, body-mass index and epicardial fat. Using model-based causal mediation analyses the increased risk of COVID-19 mortality conferred by low vitamin D levels was partly mediated by its effect on D-dimer and cardiac ultrasensitive troponins. Notably, increased risk of COVID-19 mortality conferred by low vitamin D levels was independent of BMI and epicardial fat.
Conclusion: Vitamin D deficiency (≤12 ng/ml or <30 nmol/L), is independently associated with COVID-19 mortality after adjustment for visceral fat (epicardial fat thickness). Low vitamin D may contribute to a pro-inflammatory and pro-thrombotic state, increasing the risk for adverse COVID-19 outcomes.
Keywords: COVID-19; SARS-CoV-2; Vitamin D; adipose tissue; severe COVID-19.
. 2022 Jan 26;9:813485.
doi: 10.3389/fnut.2022.813485. eCollection 2022.
Serum Vitamin D Levels Are Associated With Increased COVID-19 Severity and Mortality Independent of Whole-Body and Visceral Adiposity
Pablo Esteban Vanegas-Cedillo[SUP] 1 2 [/SUP], Omar Yaxmehen Bello-Chavolla[SUP] 1 3 [/SUP], Natalia Ramírez-Pedraza[SUP] 4 [/SUP], Bethsabel Rodríguez Encinas[SUP] 2 2 [/SUP], Carolina Isabel Pérez Carrión[SUP] 2 [/SUP], María Isabel Jasso-Ávila[SUP] 2 [/SUP], Jorge Carlos Valladares-García[SUP] 2 [/SUP], Diana Hernández-Juárez[SUP] 2 [/SUP], Arsenio Vargas-Vázquez[SUP] 1 4 [/SUP], Neftali Eduardo Antonio-Villa[SUP] 1 4 [/SUP], Monica Chapa-Ibarguengoitia[SUP] 5 [/SUP], Alfredo Ponce de Leon[SUP] 6 [/SUP], José Sifuentes-Osornio[SUP] 7 8 [/SUP], Carlos A Aguilar-Salinas[SUP] 8 9 [/SUP], Roopa Mehta[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35155539
- PMCID: PMC8825804
- DOI: 10.3389/fnut.2022.813485
Abstract
Introduction: Coronavirus disease (COVID-19) is a global pandemic. Vitamin D deficiency has been associated with susceptibility to infectious disease. In this study, the association between COVID-19 outcomes and vitamin D levels in patients attending a COVID-19 reference center in Mexico City are examined.
Methods: Consecutive patients with confirmed COVID-19 were evaluated. All patients underwent clinical evaluation and follow-up, laboratory measurements and a thoracic computerized tomography, including the measurement of epicardial fat thickness. Low vitamin D was defined as levels <20 ng/ml (<50nmol/L) and deficient Vitamin D as a level ≤12 ng/ml (<30 nmol/L).
Results: Of the 551 patients included, low vitamin D levels were present in 45.6% and deficient levels in 10.9%. Deficient Vitamin D levels were associated with mortality (HR 2.11, 95%CI 1.24-3.58, p = 0.006) but not with critical COVID-19, adjusted for age, sex, body-mass index and epicardial fat. Using model-based causal mediation analyses the increased risk of COVID-19 mortality conferred by low vitamin D levels was partly mediated by its effect on D-dimer and cardiac ultrasensitive troponins. Notably, increased risk of COVID-19 mortality conferred by low vitamin D levels was independent of BMI and epicardial fat.
Conclusion: Vitamin D deficiency (≤12 ng/ml or <30 nmol/L), is independently associated with COVID-19 mortality after adjustment for visceral fat (epicardial fat thickness). Low vitamin D may contribute to a pro-inflammatory and pro-thrombotic state, increasing the risk for adverse COVID-19 outcomes.
Keywords: COVID-19; SARS-CoV-2; Vitamin D; adipose tissue; severe COVID-19.
