An investigation into the correlation of vitamin D status and management outcomes in patients with severe COVID-19 at a South African tertiary hospital

Thumeka P. Jalavu, Lovemore N. Sigwadhi, Maritha J. Kotze, Anteneh Yalew, Vera Ngah, Jacques L. Tamuzi, Zivanai C. Chapanduka, Brian W. Allwood, Coenraad F. Koegelenberg, Elvis M. Irusen, Usha Lalla, Tandi E. Matsha, Rajiv T. Erasmus, Alimmudin Zumla, Annalise E. Zemlin, Peter S. Nyasulu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Severe coronavirus disease 2019 (COVID-19) has a poor prognosis, and biomarkers may predict disease severity. The aim of this study was to assess the effect of baseline vitamin D (VitD) inadequacy on the outcomes of patients with severe COVID-19 admitted to the intensive care unit (ICU) of a tertiary hospital in South Africa. Methods: Patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recruited during wave II of the pandemic in Cape Town. Eighty-six patients were included in the study. They were categorized into three groups: VitD deficient, VitD insufficient, and VitD sufficient. The VitD deficient and VitD insufficient groups were combined to form a ‘VitD inadequate’ group. Cox regression analysis was done to assess the association between VitD status and mortality. Factors with P < 0.05 in the adjusted multivariable Cox regression analysis were considered statistically significant. Results: The proportion of VitD inadequacy was 64% (55/86); this group had a significantly higher proportion with hypertension (66%; P = 0.012). The Kaplan–Meier curve showed no significant difference in the probability of survival among the COVID-19 patients admitted to the ICU with or without VitD inadequacy. However, patients with elevated serum creatinine were significantly more at risk of dying (adjusted hazard ratio 1.008, 95% confidence interval 1.002–1.030; P = 0.017). Conclusions: This study found a high prevalence of VitD inadequacy (combined deficiency and insufficiency) in COVID-19 patients admitted to the ICU. This may indicate a possible risk of severe disease. Whilst there was no statistically significant relationship between VitD status and mortality in this cohort, baseline VitD may be an important prognostic biomarker in COVID-19 patients admitted to the ICU, particularly in those with comorbidities that predispose to VitD deficiency.

Original languageEnglish
Pages (from-to)121-128
Number of pages8
JournalIJID Regions
Publication statusPublished - Sept 2023
Externally publishedYes


  • COVID-19
  • ICU
  • Outcomes
  • Prognosis
  • Vitamin D


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