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Association between vitamin D deficiency and post-acute outcomes of SARS-CoV-2 infection

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Abstract

Objectives

This study aimed to investigate the association between vitamin D deficiency (VDD) and post-acute outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Methods

This retrospective study used the TriNetX research network to identify COVID-19 patients between January 1 and November 30, 2022. Patients were matched using propensity score matching (PSM) and divided into VDD (< 20 ng/mL) and control (≥ 20 ng/mL) groups. The primary outcome was a composite of post-COVID-19 condition (identified by ICD-10 code), all-cause emergency department (ED) visits, hospitalization, and death during the follow-up period (90–180 days) after the diagnosis of COVID-19.

Results

From an initial recruitment of 42,674 non-hospitalized patients with COVID-19 and known 25(OH)D status, a VDD group of 8300 was identified and propensity matched with 8300 controls. During the follow-up period, the VDD group had a higher risk of the primary outcome than did the control group [hazard ratio (HR) = 1.122; 95% confidence interval (CI) = 1.041–1.210]. The VDD group also had a higher risk of all-cause ED visits (HR = 1.114; 95% CI = 1.012–1.226), all-cause hospitalization (HR = 1.230; 95% CI = 1.105–1.369), and all-cause death (HR = 1.748; 95% CI = 1.047–2.290) but not post-COVID-19 condition (HR = 0.980; 95% CI = 0.630–1.523), individually.

Conclusion

Among the COVID-19 patients, VDD might be associated with a higher risk of all-cause ED visits, hospitalization, and death during the post-acute phase.

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Data availability

The findings of this study are available on request from the corresponding author.

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Author information

Author notes

  1. Jheng-Yan Wu and Mei-Yuan Liu contributed equally to this article.

Authors and Affiliations

  1. Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan

    Jheng-Yan Wu & Mei-Yuan Liu

  2. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Jheng-Yan Wu

  3. Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Jheng-Yan Wu

  4. Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan, Taiwan

    Mei-Yuan Liu

  5. Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan

    Mei-Yuan Liu

  6. Department of Health and Nutrition, Chia Nan University of Pharmacy & Science, Tainan, Taiwan

    Mei-Yuan Liu

  7. Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan

    Wan-Hsuan Hsu

  8. Center of Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan

    Ya-Wen Tsai

  9. Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan

    Ting-Hui Liu

  10. Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan

    Po-Yu Huang & Min-Hsiang Chuang

  11. Department of Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan

    Szu-En Chin

  12. Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan

    Chih-Cheng Lai

  13. School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan

    Chih-Cheng Lai

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Contributions

J-YW conceptualized, designed the study performed the data analysis and drafted the manuscript. M-YL, W-HH, Y-WT, T-HL, P-YH, M-HC, and S-EC assisted data collection and created figures. M-YL and C-CL contributed to project design and edited the manuscript. J-YW was responsible for the data interpretation. C-CL finalized the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Chih-Cheng Lai.

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Wu, JY., Liu, MY., Hsu, WH. et al. Association between vitamin D deficiency and post-acute outcomes of SARS-CoV-2 infection. Eur J Nutr 63, 613–622 (2024). https://doi.org/10.1007/s00394-023-03298-3

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