Vitamin D deficiency and SARS‑CoV‑2 infection: A retrospective case–Control study with big-data analysis covering March 2020 to March 2021

• Published in: PloS one 2023-09, Vol.18 (9), p.e0277388-e0277388
• Main Authors: Neira Álvarez, Marta, Navarro Jiménez, Gema, Anguita Sánchez, Noemi, del Mar Bermejo Olano, Mª, Queipo, Rocio, Benavent Núñez, María, Parralejo Jimenez, Alejandro, López Yepes, Guillermo, Sáez Nieto, Carmen
• Format: Article
• Language: English
• Subjects: Aged; Alfacalcidol; Analysis; Antigens; Artificial intelligence; Big Data; Biology and life sciences; Calcifediol; Calciferol; Computer and Information Sciences; Coronaviruses; COVID-19; Data analysis; Electronic health records; Electronic medical records; Health aspects; Health risks; Hospitals; Immunomodulation; Infection; Infections; Information management; Intensive care; Kidney diseases; Malnutrition; Medical records; Medical research; Medicine and health sciences; Medicine, Experimental; Mortality; Nursing homes; Observational studies; Pathogenesis; Patients; Physical sciences; Prevalence studies (Epidemiology); Prognosis; Respiratory diseases; Severe acute respiratory syndrome coronavirus 2; Software; Variables; Viral diseases; Vitamin D; Vitamin D deficiency; Vitamin deficiency
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0277388

Vitamin D may have immunomodulatory functions, and might therefore play a role in the pathogenesis of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, no conclusive evidence exists regarding its impact on the prevalence of this infection, the associated course of disease, or prognosis. To study the association between SARS-CoV-2 infection and vitamin D deficiency in patients attending a tertiary university hospital, and to examine the clinical course of infection and prognosis for these patients. This non-interventional, retrospective study, which involved big-data analysis and employed artificial intelligence to capture data from free text in the electronic health records of patients diagnosed with SARS-CoV-2, was undertaken at a tertiary university hospital in Madrid, Spain, between March 2020 and March 2021. The variables recorded were vitamin D deficiency, sociodemographic and clinical characteristics, course of disease, and prognosis. Of the 143,157 patients analysed, 36,261 had SARS-CoV-2 infection (25.33%) during the study period, among whom 2,588 (7.14%) had a vitamin D deficiency. Among these latter patients, women (OR 1.45 [95%CI 1.33-1.57]), adults over 80 years of age (OR 2.63 [95%CI 2.38-2.91]), people living in nursing homes (OR 2.88 [95%CI 2.95-3.45]), and patients with walking dependence (OR 3.45 [95%CI 2.85-4.26]) appeared in higher proportion. After adjusting for confounding factors, a higher proportion of subjects with SARS-CoV-2 plus vitamin D deficiency required hospitalisation (OR 1.38 [95%CI 1.26-1.51]), and had a longer mean hospital stay (3.94 compared to 2.19 days in those with normal levels; P = 0.02). A low serum 25(OH) vitamin D concentration in patients with SARS-CoV-2 infection is significantly associated with a greater risk of hospitalisation and a longer hospital stay. Among such patients, higher proportions of institutionalised and dependent people over 80 years of age were detected.