Endocrine Abstracts

JOINT3965

Introduction: Vitamin D plays a crucial role in the regulation of the immune system in addition to bone metabolism. In the context of the COVID-19 pandemic, its impact on inflammation, antiviral immunity and modulation of the renin-angiotensin system has been shown to be relevant in reducing the severity of the disease. Low vitamin D levels in hospitalized patients have been associated with greater severity of the disease due to immune dysregulation, with a higher rate of severe complications, demand for intensive treatment and higher mortality. In addition, vitamin D deficiency has been closely related to metabolic disorders such as type 2 diabetes mellitus (DM) and obesity.

Objective: The aim of our study was to determine whether there are differences in the prevalence of DM, obesity (defined according to BMI and percentage of fat mass -FM%-) and sarcopenic obesity, rate of in-hospital complications and need for aggressive therapies during hospital admission in a cohort of post-critical patients who were admitted to the ICU for severe COVID-19 pneumonia, according to vitamin D levels at hospital discharge.

Method: Prospective observational study including 94 patients who were admitted to the ICU for severe COVID-19 pneumonia. At 2-3 weeks after hospital discharge, demographic, clinical and analytical data, medical history and morphofunctional assessment including bioimpedanciometry were collected. Patients were divided into three categories according to their serum vitamin D levels (deficit if ≤20 ng/ml, insufficiency if 20.01-29.99ng/ml, sufficiency if ≥ 30ng/ml). Differences in prevalence of DM, prevalence of obesity and in the rate of complications during admission were analyzed according to these vitamin D categories. For the definition of obesity according to FM% and sarcopenic obesity, the ESPEN and EASO consensus (2022) was followed.

Results: Depending on the categories of vitamin D deficiency, insufficiency and sufficiency, statistically significant differences in age (67±12,67±10,57±12; P = 0.32), sarcopenic obesity prevalence (36%,47%,43%; P = 0.04), days of ICU stay (25±9.5,33±9.8,19±9.4; 0.09), days of hospital stay (49±32,85±36,50±24; P = 0.04) and days of IMV (28±14,36±14,23±14; P = 0.84) were shown.

Conclusions: Statistically significant differences were observed in the prevalence of sarcopenic obesity (greater in the vitamin-D-deficiency and insufficiency vs. vitamin-D-sufficiency subgroups) and in days of hospital stay (greater in the vitamin-D-deficiency vs. sufficiency subgroup). When the multiple comparisons test was performed, differences were also observed in age, ICU stay and in days of IMV, being greater in the vitamin-D-deficiency vs. sufficiency group. No differences were observed in the prevalence of DM or obesity.