PDF(Pubmed)
Abstract：
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.
摘要：
SARS-CoV-2疫苗接种有望改善COVID-19肺炎患者（最明显的是高龄患者和严重疾病高风险患者）的预后。这里,我们检查血清25-羟基维生素D（25（OH）D）状态和结果在老年（>70岁）和年轻疫苗接种（n=80）和未接种（n=91）的受试者，他们因COVID-19肺炎在一个中心(都柏林康诺利医院)住院。结果包括ICU入院和死亡率。血清25（OH）D水平被归类为D30（<30nmol/L），D40(30-49.99nmol/L)和D50(≥50nmol/L)。在多变量分析中，D30与未接种疫苗的患者入住ICU（OR：6.87（95％CI：1.13-41.85）（p=0.036））和死亡率（OR：24.81（95％CI：1.57-392.1）（p=0.023））独立相关，即使在调整了包括年龄在内的主要混杂因素之后，性别,肥胖和预先存在的糖尿病。虽然在70岁以上的所有类别患者中死亡率始终较高，观察到的最高死亡率为50%，在70岁以上低维生素D状态（D30）的患者中观察到，疫苗接种似乎几乎完全纠正了这两种情况，或者有较高的维生素D状态，即，D30的70岁以上接种疫苗的患者死亡率为14％，而25（OH）D水平大于30nmol/L的70岁以上未接种疫苗的患者死亡率为16％。我们观察到COVID-19肺炎的高死亡率发生在老年患者中，特别是那些未接种疫苗或维生素D水平较低的人。近期接种疫苗或维生素D水平较高都与死亡率降低有关。尽管这些影响并不能完全减轻与高龄相关的死亡风险.
