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No Association Seen Between Vitamin D Deficiency and COVID-19 Infection, Hospitalization, or Mortality

  • Bradley Fox, MD
  • J. Owen Sizemore, PhD
Posted on

A recent publication suggested patients’ vitamin D levels may impact the severity of their COVID-19 symptoms.1 EHR data for 28,185 patients for whom both COVID-19 disease status and vitamin D deficiency status were known show no statistically significant difference in the risk of COVID-19 infection, hospitalization, or mortality between vitamin D deficient and non-vitamin D deficient patients.2

Figure 1. Percentages of COVID-19 positive patients, hospitalizations, and deaths by vitamin D deficiency status.

The prevalence of COVID-19 infections was not significantly different between patients who were vitamin D deficient (27.9%) and those who were not (26.7%). For patients who were COVID-19 positive, hospitalization rates were similar for those with vitamin D deficiency and those without vitamin D deficiency (19.5% and 21.2%, respectively), and though the difference in mortality rates (5.8% and 8.2%, respectively) was larger, our population was too small to verify the statistical significance of this difference. Figure 1 illustrates these findings.

Because screening for vitamin D deficiency is not done routinely, testing for vitamin D levels is more likely to occur when deficiency is suspected. In this analysis, 86% of all patients with known vitamin D status were found to be vitamin D deficient.

Existing literature suggests vitamin D deficiency and severe COVID-19 disease share some of the same risk factors, such as patient age over 65, chronic kidney disease, obesity, and institutional living.3,4

A future study that includes a representative sample of patients with normal vitamin D levels could provide a deeper understanding of the impact vitamin D deficiency has on COVID-19 severity. Additionally, future studies are also needed to assess what, if any, role vitamin D supplementation has in the prevention or treatment of COVID-19.

Data are pooled from 52 health systems representing 259 hospitals that span 26 states and cover 15 million patients.

1Daneshkhah, A et al. The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. medRxiv. May 18, 2020. https://doi.org/10.1101/2020.04.08.20058578

2The X2 test was used as test of statistical significance.

3Parva NR, Tadepalli S, Singh P, et al. Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus. 2018;10(6):e2741. Published 2018 Jun 5. doi:10.7759/cureus.2741

4People Who Are at Higher Risk for Severe Illness. CDC. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html

1 Comment

  1. Hi,
    Much of the talk about vitamin D seems to revolve around severity and complications of a Vitamin D deficient patient with other pre-existing risk factors once infected with COVID-19. Given that there is a large population of individuals in the U.S. with undiagnosed Vitamin D deficiencies, comparison of “non-deficient” patients vs known deficient patients is somewhat unreliable. Or in other words, there may be large swatches of Vitamin D deficient patients in the “non-deficient” group. It would be very interesting to know, of those patients strictly identified with pre-existing conditions who were hospitalized with COVID infection and confirmed Vitaman D deficiencies – either by prescriptions and/or previous lab results – what was this very defined group’s experience with level of severity, complications and length of stay, and including a correlation of disease state regarding their pre-existing primary diagnosis.

    Anyway, this is great and very insightful.


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