Relationship of Vitamin D Deficiency to Mortality and Hospitalization Period and the need for intensive care in Patients with Exacerbation of Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is one of the top ten causes of death globally, as it causes gradual and persistent obstruction of the respiratory tract, accompanied by an increasing chronic inflammatory response. It is a treatable and preventable disease, and patients with COPD often suffer from acute exacerbations, due to exposure to risk factors, many other diseases and the insufficient commitment to treatment. An acute exacerbation (AECOPD) leads to decreased lung functions, decline the quality of patient’s life and poor prognosis of the disease, In addition to the high economic cost. So more studies have recently shed light on the role of vitamin D and its relationship to COPD, and many studies have indicated that a deficiency in vitamin D levels linked to poor lung function and increases the risk of many lung diseases, including COPD. Therefore, our current study aimed to investigate the association between vitamin D deficiency in COPD patients and the duration of hospitalization, the need for intensive care admission, and death.

Materials and methods: This prospective observational and interventional study included 100 COPD patients of both sexes, who were diagnosed with an acute exacerbation of COPD. The patient population was classified into COPD patients with vitamin D insufficiency (n=43), and patients with COPD with vitamin D deficiency (n=57). The vitamin D assay was performed according to the principle of electrochemiluminescence immunoassay. The values were expressed using mean and standard deviation, and the Independent-Sample T test was applied to compare the means of quantitative variables, while the Chi square test was used for qualitative variables, and the Pearson test was used to study the correlations between the quantitative variables. P-value < 0.05 was considered as a statistically significant value.

Results: Our study showed an increased need for admission to intensive care in COPD patients with vitamin D deficiency (P=0.000, < 0.05). Also, the duration required for hospitalization due to an acute exacerbation of COPD increased in the presence of vitamin D deficiency (P=0.000, < 0.05), while we did not find a significant correlation between vitamin D deficiency and death (P=0.257).

Conclusions: Our study found that vitamin D deficiency is associated with both the increased need for admission to intensive care and increased duration of hospitalization. Therefore, it can be suggest that giving vitamin D supplements has an important role in improving the prognosis of acute exacerbations in COPD patients, and reducing its severity. 

Keywords: Chronic Obstructive Pulmonary Disease (COPD), vitamin D, Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD).