Exploring the association between vitamin D status and Corona Virus-19 infection in a cohort of adults aged 50 years and older

S U M M A R Y: Objective: Evaluate the association between vitamin D (vitD) status and Corona Virus-19 (COVID-19) infection in adults aged 50 years and older. Design: Adults ≥50 undergoing COVID-19 testing from July 2020 to December 2021, without prior vaccination, consented to blood analysis. SARS...

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Main Authors: Carol L. Wagner, John E. Baatz, Myla Ebeling, Danforth A. Newton, Judith R. Shary, Mathew Gregoski, Mark T. Wagner, David Zava, Carole Baggerly, Sonya Ketchens, Jeffrey Korte, Bruce W. Hollis
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Clinical Nutrition Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667268525000567
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Summary:S U M M A R Y: Objective: Evaluate the association between vitamin D (vitD) status and Corona Virus-19 (COVID-19) infection in adults aged 50 years and older. Design: Adults ≥50 undergoing COVID-19 testing from July 2020 to December 2021, without prior vaccination, consented to blood analysis. SARS-CoV-2 PCR confirmed current COVID-19 infection. VitD status was assessed via 25(OH)D concentration (LCMS/MS, ZRT Labs, Portland, OR). Sociodemographic data were collected at enrollment. Statistical analyses (SAS 9.4) examined associations between sociodemographics, COVID-19, and vitD status. Multivariate logistic regression analyzed factors linked to COVID-19 or vitD status. Results: Of 131 participants, 46.6% were ≥65 years old, 71.0% married, 19.9% Black American, 36.6% male, 38.9% Medicaid/Medicare/self-pay, and 42.8% BMI≥30. VitD status and Black American (P=0.0001) significantly associated with COVID-19 infection (P=0.0001). Black American (P=0.0003), males (P=0.003), and BMI (P=0.007) were inversely associated with 25(OH)D concentration. In a multiple logistic regression model predicting COVID-19 infection, only vitamin D status remained significant after controlling for certain sociodemographic and clinical factors (P<0.0001, OR 0.92, 95% CI 0.89–0.95).Of the 44 COVID-positive participants, 35 (79.6%) were hospitalized and 19 (43.2%) were admitted to the Intensive Care Unit (ICU). Hospitalization due to COVID-19 was associated with age ≥65 years old (P=0.02; OR 12.0, 95% CI 1.34–106.79), male (P=0.02, OR 10.7, 95% CI 1.20–94.73), and 25(OH)D <40 ng/mL (P=0.0006, OR 42.5, 95% CI 3.90–461.01). In multivariate analysis, the association between vitamin D status and the risk of COVID-related hospitalization remained significant and inversely associated (P=0.03, OR 0.88, 95% CI 0.78–0.99).In unadjusted analysis, COVID pneumonia was associated with male sex (P=0.049; OR 4.6, 95% CI 1.06–20.16) and 25(OH)D <40 ng/mL (P=0.006, OR 18.8, 95% CI 1.9–184.10). Participants with COVID infection and 25(OH)D <20 ng/mL were 2.1 times more likely to be admitted to ICU/death (P=0.03). In unadjusted analysis, ICU admission and/or death were linked to age ≥65 years (P=0.0002, OR 16.9, 95% CI 3.63–78.56), Medicaid/Medicare/self-pay insurance status (P=0.004, OR 0.1, 0.04–0.56), and 25(OH)D <20 (P=0.03, OR 3.9, 1.09–13.66) and <40 ng/mL (P=0.03); however, only age ≥65 remained significant in multivariate analysis (P=0.04, OR 6.7, CI 1.05–43.0). Conclusions: Lower 25(OH)D concentration was a significant predictor and/or contributor to COVID-19 infection, suggesting the importance of maintaining adequate vitamin D status in reducing infection risk and mitigating severe outcomes.
ISSN:2667-2685