Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19.
Nutrients
; 14(15)2022 Jul 26.
Article
in English
| MEDLINE | ID: covidwho-1957406
ABSTRACT
It is unclear whether vitamin D benefits inpatients with COVID-19. Objective:
To examine the relationship between vitamin D and COVID-19 outcomes.Design:
Cohort study.Setting:
National COVID Cohort Collaborative (N3C) database. Patients 158,835 patients with confirmed COVID-19 and a sub-cohort with severe disease (n = 81,381) hospitalized between 1 January 2020 and 31 July 2021.Methods:
We identified vitamin D prescribing using codes for vitamin D and its derivatives. We created a sub-cohort defined as having severe disease as those who required mechanical ventilation or extracorporeal membrane oxygenation (ECMO), had hospitalization >5 days, or hospitalization ending in death or hospice. Using logistic regression, we adjusted for age, sex, race, BMI, Charlson Comorbidity Index, and urban/rural residence, time period, and study site. Outcomes of interest were death or transfer to hospice, longer length of stay, and mechanical ventilation/ECMO.Results:
Patients treated with vitamin D were older, had more comorbidities, and higher BMI compared with patients who did not receive vitamin D. Vitamin D treatment was associated with an increased odds of death or referral for hospice (adjusted odds ratio (AOR) 1.10 95% CI 1.05-1.14), hospital stay >5 days (AOR 1.78 95% CI 1.74-1.83), and increased odds of mechanical ventilation/ECMO (AOR 1.49 95% CI 1.44-1.55). In the sub-cohort of severe COVID-19, vitamin D decreased the odds of death or hospice (AOR 0.90, 95% CI 0.86-0.94), but increased the odds of hospital stay longer >5 days (AOR 2.03, 95% CI 1.87-2.21) and mechanical ventilation/ECMO (AOR 1.16, 95% CI 1.12-1.21).Limitations:
Our findings could reflect more aggressive treatment due to higher severity.Conclusion:
Vitamin D treatment was associated with greater odds of extended hospitalization, mechanical ventilation/ECMO, and death or hospice referral.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Humans
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
Nu14153073
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