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

Author

Listed:
  • Jimmy T. Efird

    (Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA)

  • Ethan J. Anderson

    (College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA)

  • Charulata Jindal

    (Harvard Medical School, Harvard University, Boston, MA 02115, USA)

  • Thomas S. Redding

    (Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA)

  • Andrew D. Thompson

    (Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA)

  • Ashlyn M. Press

    (Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA)

  • Julie Upchurch

    (Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA)

  • Christina D. Williams

    (Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA
    Department of Medicine, Duke University, Durham, NC 27710, USA
    Duke Cancer Institute, Duke University, Durham, NC 27710, USA)

  • Yuk Ming Choi

    (Signify Health, Dallas, TX 75244, USA)

  • Ayako Suzuki

    (Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA
    Division of Gastroenterology, Duke University, Durham, NC 27710, USA
    The Division of Gastroenterology, Durham VA Medical Center, Durham, NC 27705, USA)

Abstract

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.

Suggested Citation

  • Jimmy T. Efird & Ethan J. Anderson & Charulata Jindal & Thomas S. Redding & Andrew D. Thompson & Ashlyn M. Press & Julie Upchurch & Christina D. Williams & Yuk Ming Choi & Ayako Suzuki, 2021. "The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2," IJERPH, MDPI, vol. 19(1), pages 1-19, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2021:i:1:p:447-:d:715710
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    References listed on IDEAS

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    1. Yoav Benjamini & Daniel Yekutieli, 2005. "False Discovery Rate-Adjusted Multiple Confidence Intervals for Selected Parameters," Journal of the American Statistical Association, American Statistical Association, vol. 100, pages 71-81, March.
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    1. Fulvio Lauretani & Marco Salvi & Irene Zucchini & Crescenzo Testa & Chiara Cattabiani & Arianna Arisi & Marcello Maggio, 2023. "Relationship between Vitamin D and Immunity in Older People with COVID-19," IJERPH, MDPI, vol. 20(8), pages 1-19, April.

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