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  • POS1250 VITAMIN D DEFICIENCY IS MAINLY ASSOCIATED WITH SEVERE LUNG INVOLVEMENT, LONGER DISEASE DURATION AND RISK OF DEATH IN ELDERLY COVID-19 PATIENTS

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Scientific Abstracts
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COVID-19
POS1250 VITAMIN D DEFICIENCY IS MAINLY ASSOCIATED WITH SEVERE LUNG INVOLVEMENT, LONGER DISEASE DURATION AND RISK OF DEATH IN ELDERLY COVID-19 PATIENTS
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  1. A. Sulli1,
  2. E. Gotelli1,
  3. A. Casabella1,
  4. M. Grosso2,
  5. C. Schenone1,
  6. C. Pizzorni1,
  7. S. Paolino1,
  8. E. Alessandri1,
  9. V. Smith3,
  10. M. Cutolo1
  1. 1Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genova, Italy
  2. 2Pneumology Unit, IRCCS San Martino Polyclinic Hospital, Genova, Italy
  3. 3Department of Rheumatology, Ghent University Hospital, Department of Internal Medicine, VIB Inflammation Research Centre Ghent University, Ghent, Belgium

Abstract

Background: Vitamin D regulates the innate and adaptive immune system responses and low vitamin D levels have been associated with the increased risk of respiratory tract infections (1). Vitamin D deficiency has been recently reported to interfere with the prognosis of COVID-19 (2,3).

Objectives: The aim of this study was to correlate the 25OH-vitamin D serum levels with lung involvement and disease severity, in a cohort of elderly patients hospitalized for SARS-CoV-2 infection.

Methods: Sixty-five COVID-19 patients (mean age 76±13 years) and sixty-five sex- and age-matched control subjects (CNT) were included in the study. Respiratory parameters (PaO2, SO2, PaCO2, PaO2/FiO2), clinical and laboratory parameters (including 25OH-vitamin D, D-dimer, C-reactive protein) and type of radiological pulmonary involvement were collected at hospital admission. Statistical analysis was performed by non-parametric tests.

Results: Vitamin D sufficiency (>30 ng/ml), insufficiency (between 20 and 30 ng/ml), deficiency (between 10 and 20 ng/ml) and severe deficiency (<10 ng/ml) were observed respectively in 11, 11, 21 and 57 % of COVID-19 patients. Vitamin D serum levels were found significantly lower in COVID-19 patients than in CNT (median 8 vs 16 ng/ml, p=0.001). A statistically significant positive correlation was observed between vitamin D serum levels and SO2 (p=0.05), PaO2 (p=0.03), PaO2/FiO2 (p=0.02). A statistically significant negative correlation was found between vitamin D serum levels and severity of radiologic pulmonary involvement: vitamin D was significantly lower in COVID-19 patients with either diffuse/severe interstitial lung involvement (p=0.05) or multiple lung consolidations (p=0.0001) than in those with mild radiological lung involvement. Significantly lower vitamin D serum levels were found in COVID-19 patients who died during hospitalization, compared to those who survived (median 3 vs 8 ng/ml, p=0.05). Finally, a statistically significant negative correlation was found between vitamin D serum levels and D-dimer (p=0.04), C-reactive protein (p=0.04) and disease duration (p=0.05).

Conclusion: This study confirms that severe vitamin D deficiency is associated with more severe lung involvement, longer disease duration and risk of death in elderly COVID-19 patients.

References: [1]Cutolo M, et al. RMD Open. 2020; 6(3):e001454.

[2]Bilezikian JP, et al. Eur J Endocrinol. 2020; 183(5):R133-R147.

[3]Weir EK, et al. Clin Med (Lond). 2020; 20:e107-e108.

Disclosure of Interests: None declared

https://doi.org/10.1136/annrheumdis-2021-eular.3576

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