| Autor: |
Sanecka M; School of Biological, Health & Sports Sciences, Technological University Dublin, D07 XT95 Dublin, Ireland., Youssef M; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Abdulsalam M; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Raza SF; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Qadeer A; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Ioana J; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Aldoresi A; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Shah SI; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Al Lawati A; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Feely J; Department of Biochemistry, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Tormey WP; Department of Biochemistry, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., O'Neill E; Department of Microbiology, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Cormican LJ; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., Judge EP; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland., McCartney DMA; School of Biological, Health & Sports Sciences, Technological University Dublin, D07 XT95 Dublin, Ireland., Faul JL; Department of Respiratory and Sleep Medicine, Connolly Hospital Dublin, D15 X40D Dublin, Ireland.; Department of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland.; Department of Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland. |
| Abstrakt: |
SARS-CoV-2 vaccination promises to improve outcomes for patients with COVID-19 pneumonia (most notably those with advanced age and at high risk for severe disease). Here, we examine serum 25-Hydroxyvitamin D (25(OH)D) status and outcomes in both old (>70 years) and young vaccinated ( n = 80) and unvaccinated ( n = 91) subjects, who were hospitalized due to COVID-19 pneumonia in a single center (Connolly Hospital Dublin). Outcomes included ICU admission and mortality. Serum 25(OH)D levels were categorized as D30 (<30 nmol/L), D40 (30-49.99 nmol/L) and D50 (≥50 nmol/L). In multivariate analyses, D30 was independently associated with ICU admission (OR: 6.87 (95% CI: 1.13-41.85) ( p = 0.036)) and mortality (OR: 24.81 (95% CI: 1.57-392.1) ( p = 0.023)) in unvaccinated patients, even after adjustment for major confounders including age, sex, obesity and pre-existing diabetes mellitus. While mortality was consistently higher in all categories of patients over 70 years of age, the highest observed mortality rate of 50%, seen in patients over 70 years with a low vitamin D state (D30), appeared to be almost completely corrected by either vaccination, or having a higher vitamin D state, i.e., mortality was 14% for vaccinated patients over 70 years with D30 and 16% for unvaccinated patients over 70 years with a 25(OH)D level greater than 30 nmol/L. We observe that high mortality from COVID-19 pneumonia occurs in older patients, especially those who are unvaccinated or have a low vitamin D state. Recent vaccination or having a high vitamin D status are both associated with reduced mortality, although these effects do not fully mitigate the mortality risk associated with advanced age. |
