Endocrine Abstracts

Background: Vitamin D deficiency (VDD) has been implicated in the pathophysiology of respiratory infections, including Coronavirus Disease 2019 (COVID-19). We assessed vitamin D levels of patients who died from COVID-19 during or following admission to Newcastle-upon-Tyne Hospitals.

Methods: We performed a retrospective survey of electronic patient records for 2,355 patients admitted to our institution between 04/02/2020 and 19/01/2021, who had a positive SARS-CoV-2 PCR on nasopharyngeal swab. 308 patients died and had COVID-19 included on their death certificate (mortality rate=13%). 136 patients (44%) also had a serum 25-hydroxyvitamin D (25OHD) measurement within 3 months prior to admission and were included in the analysis.

Results: The median 25OHD was 34nmol/l (interquartile range 19-69.5nmol/l). 60% (n = 81) of patients who died from COVID-19 had 25OHD levels <50nmol/l (local laboratory definition of VDD, Table). 68% (n = 93) of patients who died would have been deemed as having “sufficient” vitamin D levels (≥25nmol/l) according to UK Scientific Advisory Committee on Nutrition (SACN) recommendations. Conversely, only 29 (21%) patients who died had 25OHD levels ≥75nmol/l, which is the definition of vitamin D adequacy used in Endocrine Society guidance. The prevalence of VDD was higher in male deaths compared to female deaths: 67% of males and 46% of females who died had 25OHD levels <50nmol/l (P = 0.0185 using Fisher’s exact test).

Discussion: VDD was highly prevalent in patients who died from COVID-19 in Newcastle-upon-Tyne. Although our study is limited by the lack of a control group, we recommend that vitamin D supplementation aiming for levels of ≥75nmol/l is a safe and cost-effective intervention to mitigate COVID-19’s morbidity and mortality.