The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2.

Journal Article (Journal Article)

This data-based cohort consisted of 26,508 (7%) United States veterans out of the 399,290 who tested positive for SARS-CoV-2 from 1 March to 10 September 2020. We aimed to assess the interaction of post-index vitamin D (Vit D) and corticosteroid (CRT) use on 30-day mortality among hospitalized and non-hospitalized patients with coronavirus disease 2019 (COVID-19). Combination Vit D and CRT drug use was assessed according to four multinomial pairs (-|+, -|-, +|+, +|-). Respective categorical effects were computed on a log-binomial scale as adjusted relative risk (aRR). Approximately 6% of veterans who tested positive for SARS-CoV-2 died within 30 days of their index date. Among hospitalized patients, a significantly decreased aRR was observed for the use of Vit D in the absence of CRTs relative to patients who received CRTs but not Vit D (aRR = 0.30; multiplicity corrected, p = 0.0004). Among patients receiving systemically administered CRTs (e.g., dexamethasone), the use of Vit D was associated with fewer deaths in hospitalized patients (aRR = 0.51) compared with non-hospitalized patients (aRR = 2.5) (P-for-Interaction = 0.0071). Evaluating the effect of modification of these compounds in the context of hospitalization may aid in the management of COVID-19 and provide a better understanding of the pathophysiological mechanisms underlying this and future infectious disease outbreaks.

Full Text

Duke Authors

Cited Authors

  • Efird, JT; Anderson, EJ; Jindal, C; Redding, TS; Thompson, AD; Press, AM; Upchurch, J; Williams, CD; Choi, YM; Suzuki, A

Published Date

  • December 31, 2021

Published In

Volume / Issue

  • 19 / 1

PubMed ID

  • 35010701

Pubmed Central ID

  • PMC8744830

Electronic International Standard Serial Number (EISSN)

  • 1660-4601

Digital Object Identifier (DOI)

  • 10.3390/ijerph19010447

Language

  • eng

Conference Location

  • Switzerland