1. Vitamin D insufficiency in COVID-19 and influenza A, and critical illness survivors: a cross-sectional study
- Author
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Natalie Pattison, Richard J Mellanby, Ian Handel, Timothy S Walsh, Marlies Ostermann, Mark Lyttle, Adriano G Rossi, David M Griffith, Manu Shankar-Hari, Carlo Palmieri, Lance Turtle, Alexander J Mentzer, Lewis W S Fisher, James Scott-Brown, Danai Papakonstantinou, Effrossyni Gkrania-Klotsas, Kerri Devine, Daniel G Wootton, Padmasayee Papineni, Benjamin W A Catterall, Lara Lavelle-Langham, Emily Cass, Alejandra Doce Carracedo, Lisa Flaherty, Nicole Maziere, Hannah Massey, Anthony Holmes, Nicola Carlucci, Matthew K O'Shea, Emma A Hurst, Natalie Z Homer, Scott G Denham, Paul A Holloway, Romit J Samanta, Thushan de Silva, A A Roger Thompson, Ruth Lyons, Murray Wham, Sara Clohisey, Sara McDonald, Seán Keating, Lorna Finch, Lee Murphy, Nicola Wrobel, Sarah McCafferty, Kirstie Morrice, Alan MacLean, Erin L Aldera, Sneha Basude, Steven Laird, Antonia Ying Wai Ho, UKRI MRC COVID-19 Rapid Response Call, National Institute for Health Research, Commission of the European Communities, and UK Research and Innovation
- Subjects
Cross-sectional study ,medicine.medical_treatment ,Bone remodeling ,immunology ,Influenza A Virus, H1N1 Subtype ,Pandemic ,INFECTION ,Survivors ,Respiratory system ,Vitamin D ,General Medicine ,Infectious Diseases ,Medicine ,AUTOPHAGY ,Vitamin D Deficiency/complications ,Life Sciences & Biomedicine ,HIGH-DOSE VITAMIN-D-3 ,Influenza, Human/complications ,intensive & critical care ,medicine.medical_specialty ,D SUPPLEMENTATION ,Critical Illness ,vitamin D deficiency ,1117 Public Health and Health Services ,respiratory infections ,D DEFICIENCY ,Medicine, General & Internal ,Internal medicine ,General & Internal Medicine ,Influenza, Human ,medicine ,Vitamin D and neurology ,Humans ,Pandemics ,ISARIC4C Investigators ,Mechanical ventilation ,Science & Technology ,business.industry ,SARS-CoV-2 ,COVID-19 ,1103 Clinical Sciences ,medicine.disease ,Vitamin D Deficiency ,Steroid hormone ,Cross-Sectional Studies ,business ,1199 Other Medical and Health Sciences - Abstract
ObjectivesThe steroid hormone vitamin D has roles in immunomodulation and bone health. Insufficiency is associated with susceptibility to respiratory infections. We report 25-hydroxy vitamin D (25(OH)D) measurements in hospitalised people with COVID-19 and influenza A and in survivors of critical illness to test the hypotheses that vitamin D insufficiency scales with illness severity and persists in survivors.DesignCross-sectional study.Setting and participantsPlasma was obtained from 295 hospitalised people with COVID-19 (International Severe Acute Respiratory and emerging Infections Consortium (ISARIC)/WHO Clinical Characterization Protocol for Severe Emerging Infections UK study), 93 with influenza A (Mechanisms of Severe Acute Influenza Consortium (MOSAIC) study, during the 2009–2010 H1N1 pandemic) and 139 survivors of non-selected critical illness (prior to the COVID-19 pandemic). Total 25(OH)D was measured by liquid chromatography-tandem mass spectrometry. Free 25(OH)D was measured by ELISA in COVID-19 samples.Outcome measuresReceipt of invasive mechanical ventilation (IMV) and in-hospital mortality.ResultsVitamin D insufficiency (total 25(OH)D 25–50 nmol/L) and deficiency (ConclusionsVitamin D deficiency/insufficiency was present in majority of hospitalised patients with COVID-19 or influenza A and correlated with severity and persisted in critical illness survivors at concentrations expected to disrupt bone metabolism. These findings support early supplementation trials to determine if insufficiency is causal in progression to severe disease, and investigation of longer-term bone health outcomes.
- Published
- 2021