Vitamin D insufficiency in COVID-19 and influenza A, and critical illness survivors: a cross-sectional study
Creators: name: Hurst, Emma A
name: Mellanby, Richard J
name: Handel, Ian
name: Griffith, David M
name: Rossi, Adriano G
name: Walsh, Timothy S
name: Shankar-Hari, Manu
name: Dunning, Jake
name: Homer, Natalie Z
name: Denham, Scott G
name: Devine, Kerri
name: Holloway, Paul A
name: Moore, Shona C
name: Thwaites, Ryan S
name: Samanta, Romit J
name: Hardwick, Hayley E
name: Oosthuyzen, Wilna
name: Turtle, Lance
name: Semple, Malcolm G
name: Openshaw, Peter J M
name: Baillie, J Kenneth
name: ISARIC4C Investigators
name: Kenneth Baillie, J
name: Carson, Gail
name: Alex, Beatrice
name: Bach, Benjamin
name: Barclay, Wendy S
name: Bogaert, Debby
name: Chand, Meera
name: Cooke, Graham S
name: Docherty, Annemarie B
name: Filipe, Ana Da Silva
name: Fletcher, Tom
name: Green, Christopher A
name: Harrison, Ewen M
name: Hiscox, Julian A
name: Horby, Peter W
name: Ijaz, Samreen
name: Khoo, Saye
name: Klenerman, Paul
name: Law, Andrew
name: Lim, Wei Shen
name: Mentzer, Alexander J
name: Merson, Laura
name: Meynert, Alison M
name: Noursadeghi, Mahdad
name: Palmarini, Massimo
name: Paxton, William A
name: Pollakis, Georgios
name: Price, Nicholas
name: Rambaut, Andrew
name: Robertson, David L
name: Russell, Clark D
name: Sancho-Shimizu, Vanessa
name: Scott, Janet T
name: Silva, Thushan De
name: Sigfrid, Louise
name: Solomon, Tom
name: Sriskandan, Shiranee
name: Stuart, David
name: Summers, Charlotte
name: Tedder, Richard S
name: Thomson, Emma C
name: Roger Thompson, A A
name: Turtle, Lance C W
name: Gupta, Rishi K
name: Zambon, Maria
name: Hardwick, Hayley
name: Donohue, Chloe
name: Lyons, Ruth
name: Griffiths, Fiona
name: Norman, Lisa
name: Pius, Riinu
name: Drake, Thomas M
name: Fairfield, Cameron J
name: Knight, Stephen R
name: Mclean, Kenneth A
name: Murphy, Derek
name: Shaw, Catherine A
name: Dalton, Jo
name: Girvan, Michelle
name: Saviciute, Egle
name: Roberts, Stephanie
name: Harrison, Janet
name: Marsh, Laura
name: Connor, Marie
name: Halpin, Sophie
name: Jackson, Clare
name: Gamble, Carrol
name: Leeming, Gary
name: Wham, Murray
name: Clohisey, Sara
name: Hendry, Ross
name: Scott-Brown, James
name: Greenhalf, William
name: Shaw, Victoria
name: McDonald, Sara
name: Keating, Seán
name: Ahmed, Katie A
name: Armstrong, Jane A
name: Ashworth, Milton
name: Asiimwe, Innocent G
name: Bakshi, Siddharth
name: Barlow, Samantha L
name: Booth, Laura
name: Brennan, Benjamin
name: Bullock, Katie
name: Catterall, Benjamin W A
name: Clark, Jordan J
name: Clarke, Emily A
name: Cole, Sarah
name: Cooper, Louise
name: Cox, Helen
name: Davis, Christopher
name: Dincarslan, Oslem
name: Dunn, Chris
name: Dyer, Philip
name: Elliott, Angela
name: Evans, Anthony
name: Finch, Lorna
name: Fisher, Lewis W S
name: Foster, Terry
name: Garcia-Dorival, Isabel
name: Gunning, Philip
name: Hartley, Catherine
name: Jensen, Rebecca L
name: Jones, Christopher B
name: Jones, Trevor R
name: Khandaker, Shadia
name: King, Katharine
name: Kiy, Robyn T
name: Koukorava, Chrysa
name: Lake, Annette
name: Lant, Suzannah
name: Latawiec, Diane
name: Lavelle-Langham, Lara
name: Lefteri, Daniella
name: Lett, Lauren
name: Livoti, Lucia A
name: Mancini, Maria
name: McDonald, Sarah
name: McEvoy, Laurence
name: McLauchlan, John
name: Metelmann, Soeren
name: Miah, Nahida S
name: Middleton, Joanna
name: Mitchell, Joyce
name: Murphy, Ellen G
name: Penrice-Randal, Rebekah
name: Pilgrim, Jack
name: Prince, Tessa
name: Reynolds, Will
name: Matthew Ridley, P
name: Sales, Debby
name: Shaw, Victoria E
name: Shears, Rebecca K
name: Small, Benjamin
name: Subramaniam, Krishanthi S
name: Szemiel, Agnieska
name: Taggart, Aislynn
name: Tanianis-Hughes, Jolanta
name: Thomas, Jordan
name: Trochu, Erwan
name: Tonder, Libby Van
name: Wilcock, Eve
name: Eunice Zhang, J
name: Flaherty, Lisa
name: Maziere, Nicole
name: Cass, Emily
name: Carracedo, Alejandra Doce
name: Carlucci, Nicola
name: Holmes, Anthony
name: Massey, Hannah
name: Murphy, Lee
name: Wrobel, Nicola
name: McCafferty, Sarah
name: Morrice, Kirstie
name: MacLean, Alan
name: Adeniji, Kayode
name: Agranoff, Daniel
name: Agwuh, Ken
name: Ail, Dhiraj
name: Aldera, Erin L
name: Alegria, Ana
name: Angus, Brian
name: Ashish, Abdul
name: Atkinson, Dougal
name: Bari, Shahedal
name: Barlow, Gavin
name: Barnass, Stella
name: Barrett, Nicholas
name: Bassford, Christopher
name: Basude, Sneha
name: Baxter, David
name: Beadsworth, Michael
name: Bernatoniene, Jolanta
name: Berridge, John
name: Best, Nicola
name: Bothma, Pieter
name: Chadwick, David
name: Brittain-Long, Robin
name: Bulteel, Naomi
name: Burden, Tom
name: Burtenshaw, Andrew
name: Caruth, Vikki
name: Chambler, Duncan
name: Chee, Nigel
name: Child, Jenny
name: Chukkambotla, Srikanth
name: Clark, Tom
name: Collini, Paul
name: Cosgrove, Catherine
name: Cupitt, Jason
name: Cutino-Moguel, Maria-Teresa
name: Dark, Paul
name: Dawson, Chris
name: Dervisevic, Samir
name: Donnison, Phil
name: Douthwaite, Sam
name: DuRand, Ingrid
name: Dushianthan, Ahilanadan
name: Dyer, Tristan
name: Evans, Cariad
name: Eziefula, Chi
name: Fegan, Chrisopher
name: Finn, Adam
name: Fullerton, Duncan
name: Garg, Sanjeev
name: Garg, Atul
name: Gkrania-Klotsas, Effrossyni
name: Godden, Jo
name: Goldsmith, Arthur
name: Graham, Clive
name: Hardy, Elaine
name: Hartshorn, Stuart
name: Harvey, Daniel
name: Havalda, Peter
name: Hawcutt, Daniel B
name: Hobrok, Maria
name: Hodgson, Luke
name: Hormis, Anil
name: Jacobs, Michael
name: Jain, Susan
name: Jennings, Paul
name: Kaliappan, Agilan
name: Kasipandian, Vidya
name: Kegg, Stephen
name: Kelsey, Michael
name: Kendall, Jason
name: Kerrison, Caroline
name: Kerslake, Ian
name: Koch, Oliver
name: Koduri, Gouri
name: Koshy, George
name: Laha, Shondipon
name: Laird, Steven
name: Larkin, Susan
name: Leiner, Tamas
name: Lillie, Patrick
name: Limb, James
name: Linnett, Vanessa
name: Little, Jeff
name: Lyttle, Mark
name: MacMahon, Michael
name: MacNaughton, Emily
name: Mankregod, Ravish
name: Masson, Huw
name: Matovu, Elijah
name: McCullough, Katherine
name: McEwen, Ruth
name: Meda, Manjula
name: Mills, Gary
name: Minton, Jane
name: Mirfenderesky, Mariyam
name: Mohandas, Kavya
name: Mok, Quen
name: Moon, James
name: Moore, Elinoor
name: Morgan, Patrick
name: Morris, Craig
name: Mortimore, Katherine
name: Moses, Samuel
name: Mpenge, Mbiye
name: Mulla, Rohinton
name: Murphy, Michael
name: Nagel, Megan
name: Nagarajan, Thapas
name: Nelson, Mark
name: O'Shea, Matthew K
name: Otahal, Igor
name: Ostermann, Marlies
name: Pais, Mark
name: Palmieri, Carlo
name: Panchatsharam, Selva
name: Papakonstantinou, Danai
name: Paraiso, Hassan
name: Patel, Brij
name: Pattison, Natalie
name: Pepperell, Justin
name: Peters, Mark
name: Phull, Mandeep
name: Pintus, Stefania
name: Pooni, Jagtur Singh
name: Post, Frank
name: Price, David
name: Prout, Rachel
name: Rae, Nikolas
name: Reschreiter, Henrik
name: Reynolds, Tim
name: Richardson, Neil
name: Roberts, Mark
name: Roberts, Devender
name: Rose, Alistair
name: Rousseau, Guy
name: Ryan, Brendan
name: Saluja, Taranprit
name: Shah, Aarti
name: Shanmuga, Prad
name: Sharma, Anil
name: Shawcross, Anna
name: Sizer, Jeremy
name: Smith, Richard
name: Snelson, Catherine
name: Spittle, Nick
name: Staines, Nikki
name: Stambach, Tom
name: Stewart, Richard
name: Subudhi, Pradeep
name: Szakmany, Tamas
name: Tatham, Kate
name: Thomas, Jo
name: Thompson, Chris
name: Thompson, Robert
name: Tridente, Ascanio
name: Tupper-Carey, Darell
name: Twagira, Mary
name: Ustianowski, Andrew
name: Vallotton, Nick
name: Vincent-Smith, Lisa
name: Visuvanathan, Shico
name: Vuylsteke, Alan
name: Waddy, Sam
name: Wake, Rachel
name: Walden, Andrew
name: Welters, Ingeborg
name: Whitehouse, Tony
name: Whittaker, Paul
name: Whittington, Ashley
name: Papineni, Padmasayee
name: Wijesinghe, Meme
name: Williams, Martin
name: Wilson, Lawrence
name: Winchester, Stephen
name: Wiselka, Martin
name: Wolverson, Adam
name: Wootton, Daniel G
name: Workman, Andrew
name: Yates, Bryan
name: Young, Peter
name: Wai Ho, Antonia Ying
Publisher: name: Apollo - University of Cambridge Repository
Year: 2021
Subjects: Infectious diseases
1506
2474
1706
COVID-19
intensive &amp; critical care
respiratory infections
immunology

description: Objectives: The steroid hormone vitamin D has roles in immunomodulation and bone health. Insufficiency is associated with susceptibility to respiratory infections. We report 25-hydroxy vitamin D (25(OH)D) measurements in hospitalised people with COVID-19 and influenza A and in survivors of critical illness to test the hypotheses that vitamin D insufficiency scales with illness severity and persists in survivors. Design: Cross-sectional study. Setting and participants: Plasma was obtained from 295 hospitalised people with COVID-19 (International Severe Acute Respiratory and emerging Infections Consortium (ISARIC)/WHO Clinical Characterization Protocol for Severe Emerging Infections UK study), 93 with influenza A (Mechanisms of Severe Acute Influenza Consortium (MOSAIC) study, during the 2009–2010 H1N1 pandemic) and 139 survivors of non-selected critical illness (prior to the COVID-19 pandemic). Total 25(OH)D was measured by liquid chromatography-tandem mass spectrometry. Free 25(OH)D was measured by ELISA in COVID-19 samples. Outcome measures: Receipt of invasive mechanical ventilation (IMV) and in-hospital mortality. Results: Vitamin D insufficiency (total 25(OH)D 25–50 nmol/L) and deficiency (&lt;25 nmol/L) were prevalent in COVID-19 (29.3% and 44.4%, respectively), influenza A (47.3% and 37.6%) and critical illness survivors (30.2% and 56.8%). In COVID-19 and influenza A, total 25(OH)D measured early in illness was lower in patients who received IMV (19.6 vs 31.9 nmol/L (p&lt;0.0001) and 22.9 vs 31.1 nmol/L (p=0.0009), respectively). In COVID-19, biologically active free 25(OH)D correlated with total 25(OH)D and was lower in patients who received IMV, but was not associated with selected circulating inflammatory mediators. Conclusions: Vitamin D deficiency/insufficiency was present in majority of hospitalised patients with COVID-19 or influenza A and correlated with severity and persisted in critical illness survivors at concentrations expected to disrupt bone metabolism. These findings support early supplementation trials to determine if insufficiency is causal in progression to severe disease, and investigation of longer-term bone health outcomes.