Serum 25(OH)D Level on Hospital Admission Associated With COVID-19 Stage and Mortality

Dieter De Smet, Kristof De Smet, Pauline Herroelen, Stefaan Gryspeerdt, Geert A Martens

Research output: Contribution to journalArticle

13 Citations (Scopus)


OBJECTIVES: Vitamin D deficiency was previously correlated with incidence and severity of coronavirus disease 2019 (COVID-19). We investigated the association between serum 25-hydroxyvitamin D (25(OH)D) level on admission and radiologic stage and outcome of COVID-19 pneumonia.

METHODS: A retrospective observational trial was done on 186 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected individuals hospitalized from March 1, 2020, to April 7, 2020, with combined chest computed tomography (CT) and 25(OH)D measurement on admission. Multivariate regression analysis was performed to study if vitamin D deficiency (25(OH)D <20 ng/mL) correlates with survival independently of confounding comorbidities.

RESULTS: Of the patients with COVID-19, 59% were vitamin D deficient on admission: 47% of females and 67% of males. In particular, male patients with COVID-19 showed progressively lower 25(OH)D with advancing radiologic stage, with deficiency rates increasing from 55% in stage 1 to 74% in stage 3. Vitamin D deficiency on admission was not confounded by age, ethnicity, chronic lung disease, coronary artery disease/hypertension, or diabetes and was associated with mortality (odds ratio [OR], 3.87; 95% confidence interval [CI], 1.30-11.55), independent of age (OR, 1.09; 95% CI, 1.03-1.14), chronic lung disease (OR, 3.61; 95% CI, 1.18-11.09), and extent of lung damage expressed by chest CT severity score (OR, 1.12; 95% CI, 1.01-1.25).

CONCLUSIONS: Low 25(OH)D levels on admission are associated with COVID-19 disease stage and mortality.

Original languageEnglish
Pages (from-to)381-388
Number of pages8
JournalAmerican Journal of Clinical Pathology
Issue number3
Early online date25 Nov 2020
Publication statusPublished - 1 Mar 2021

Bibliographical note

© American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail:


  • 25(OH)D
  • COVID-19 disease
  • Coronavirus
  • Laboratory analysis
  • SARS-CoV-2
  • Viral pneumonia
  • Vitamin D deficiency

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