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Real world evidence of calcifediol or vitamin D prescription and mortality rate of COVID-19 in a retrospective cohort of hospitalized Andalusian patients.

Clinical Bioinformatics Area, Fundación Progreso y Salud (FPS), CDCA, Hospital Virgen del Rocio, 41013, Seville, Spain. Institute of Biomedicine of Seville (IBIS), Hospital Virgen del Rocio, 41013, Seville, Spain. Bioinformatics in Rare Diseases (BiER), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), FPS, Hospital Virgen del Rocio, 41013, Seville, Spain. Subdirección Técnica Asesora de Gestión de la Información, Servicio Andaluz de Salud, Seville, Spain. Internal Medicine Department, IMIBIC/Reina Sofia University Hospital/University of Cordoba, 14004, Córdoba, Spain. CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, 28029, Madrid, Spain. Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Seville, Spain. Departamento de Medicina, Universidad de Sevilla, Seville, Spain. Departamento de Bioquimica y Biología Molecular, Facultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, Spain. Instituto Maimónides de Investigacion Biomédica de Córdoba (IMIBIC), 14004, Córdoba, Spain. G. Técnico de Expertos de Andalucía para Estudios de Suplementos e Intervención Nutricional Frente a Covid-19, SGIDIS, Consejería de Salud y Familias, Junta de Andalucia, Seville, Spain. Secretaria General de Investigación, Desarrollo e Innovación en Salud, Consejería de Salud y Familias de la Junta de Andalucía, Seville, Spain. Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KULeuven, Herestraat, 3000, Leuven, Belgium. Clinical Bioinformatics Area, Fundación Progreso y Salud (FPS), CDCA, Hospital Virgen del Rocio, 41013, Seville, Spain. joaquin.dopazo@juntadeandalucia.es. Institute of Biomedicine of Seville (IBIS), Hospital Virgen del Rocio, 41013, Seville, Spain. joaquin.dopazo@juntadeandalucia.es. Bioinformatics in Rare Diseases (BiER), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), FPS, Hospital Virgen del Rocio, 41013, Seville, Spain. joaquin.dopazo@juntadeandalucia.es. FPS/ELIXIR-ES, Fundación Progreso y Salud (FPS), CDCA, Hospital Virgen del Rocio, 41013, Seville, Spain. joaquin.dopazo@juntadeandalucia.es. Instituto Maimónides de Investigacion Biomédica de Córdoba (IMIBIC), 14004, Córdoba, Spain. jmquesada@uco.es. CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Hospital Universitario Reina Sofía, Universidad de Córdoba, Menéndez Pidal s/n, 14004, Córdoba, Spain. jmquesada@uco.es.

Scientific reports. 2021;(1):23380
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Abstract

COVID-19 is a major worldwide health problem because of acute respiratory distress syndrome, and mortality. Several lines of evidence have suggested a relationship between the vitamin D endocrine system and severity of COVID-19. We present a survival study on a retrospective cohort of 15,968 patients, comprising all COVID-19 patients hospitalized in Andalusia between January and November 2020. Based on a central registry of electronic health records (the Andalusian Population Health Database, BPS), prescription of vitamin D or its metabolites within 15-30 days before hospitalization were recorded. The effect of prescription of vitamin D (metabolites) for other indication previous to the hospitalization was studied with respect to patient survival. Kaplan-Meier survival curves and hazard ratios support an association between prescription of these metabolites and patient survival. Such association was stronger for calcifediol (Hazard Ratio, HR = 0.67, with 95% confidence interval, CI, of [0.50-0.91]) than for cholecalciferol (HR = 0.75, with 95% CI of [0.61-0.91]), when prescribed 15 days prior hospitalization. Although the relation is maintained, there is a general decrease of this effect when a longer period of 30 days prior hospitalization is considered (calcifediol HR = 0.73, with 95% CI [0.57-0.95] and cholecalciferol HR = 0.88, with 95% CI [0.75, 1.03]), suggesting that association was stronger when the prescription was closer to the hospitalization.