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25-hydroxyvitamin D is a predictor of COVID-19 severity of hospitalized patients.
Nguyen, Nguyen N; Raju, Muppala N P; da Graca, Briget; Wang, Dapeng; Mohamed, Nada A; Mutnal, Manohar B; Rao, Arundhati; Bennett, Monica; Gokingco, Matthew; Pham, Huy; Mohammad, Amin A.
  • Nguyen NN; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
  • Raju MNP; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
  • da Graca B; Baylor Scott & White Research Institute, Dallas, Texas, United States of America.
  • Wang D; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
  • Mohamed NA; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
  • Mutnal MB; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
  • Rao A; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
  • Bennett M; Baylor Scott & White Research Institute, Dallas, Texas, United States of America.
  • Gokingco M; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
  • Pham H; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
  • Mohammad AA; Department of Pathology, Baylor Scott & White Central Texas, Temple, Texas, United States of America.
PLoS One ; 17(5): e0268038, 2022.
Article in English | MEDLINE | ID: covidwho-1910625
ABSTRACT

OBJECTIVES:

Studies investigating the association between vitamin D and severity of COVID-19 have mixed results perhaps due to immunoassay assessment of total 25-hydroxyvitamin D (tD) (the sum of 25-hydroxyvitamin-D2 [25-OH-D2] and 25-hydroxyvitamin-D3 [25-OH-D3]). Liquid chromatography tandem mass spectrometry (LC-MS/MS) has high analytical specificity and sensitivity for 25-OH-D2 and 25-OH-D3, and thus enables a more accurate assessment of impact on COVID-19 outcomes.

METHODS:

We established reference intervals for 25-OH-D3 and tD using LC-MS/MS. 25-OH-D2, 25-OH-D3 and tD were quantitated for 88 COVID-19 positive and 122 COVID-19 negative specimens. Chi-square or Fisher's exact tests were used to test associations in binary variables. T-Tests or Wilcoxon rank sum tests were used for continuous variables. Cox proportional hazards were used to test associations between 25-OH-D3 or tD levels and length of stay (LOS). For mortality and ventilation, logistic regression models were used.

RESULTS:

COVID-19 patients with deficient (<20 ng/mL) levels of 25-OH-D3 had significantly longer LOS by 15.3 days. COVID-19 P patients with deficient (<20 ng/mL) and insufficient (<30 ng/mL) of tD had significantly longer LOS by 12.1 and 8.2 days, respectively. Patients with insufficient levels of tD had significantly longer LOS by 13.7 days. COVID-19 patients with deficient serum 25-OH-D3 levels had significantly increased risk-adjusted odds of in-hospital mortality (OR [95% CI] 5.29 [1.53-18.24]); those with insufficient 25-OH-D3 had significantly increased risk for requiring ventilation during hospitalization was found at LCMS insufficient cutoff (OR [95% CI] 2.75 [1.10-6.90]).

CONCLUSIONS:

There is an inverse relationship of 25-hydroxyvitamin D levels and hospital LOS for COVID-19 patients. Vitamin D status is a predictor for severity of outcomes. LCMS results are useful for assessing the odds of mortality and the need for ventilation during hospitalization.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Tandem Mass Spectrometry / COVID-19 Type of study: Prognostic study Limits: Humans Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0268038

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Tandem Mass Spectrometry / COVID-19 Type of study: Prognostic study Limits: Humans Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0268038