Low vitamin D increases death risk in patients with severe infection

Sepsis is caused by bacteria entering and multiplying in the bloodstream. It manifests as severe infection that can rapidly become life-threatening, with fever and chills. In severe cases, blood pressure may fall and heart muscle weaken, leading to septic shock and organ failure. Once septic shock develops, death risk rises substantially (1).

Unfortunately, few treatments effectively reduce death risk in sepsis (2). A new study (3) suggests that adequate blood vitamin D may be an option. Researchers analyzed medical records of 121 patients hospitalized with severe sepsis or septic shock and measured survival during the first 30 hospital days. Deficiency was defined as vitamin D at or below 15 ng/mL.

The 54% with vitamin D deficiency (65/121 patients) had a 170% higher risk of death in the 30 days after admission (p=0.02). Thirty-seven percent of deficient patients died within 30 days, compared with 20% with normal levels. At 90 days, 51% of deficient patients had died versus 25% with normal vitamin D.

Discussing how vitamin D might reduce mortality, researchers considered its immune role. Immune cells specifically increase sensitivity to vitamin D (4,5); vitamin D increases production of T immune cells while reducing inflammatory proteins called cytokines (6).

The researchers acknowledged limitations: this was retrospective data analysis rather than a prospective experiment (7), in a small sample of 121 patients, using a questionable vitamin D measurement method. Nevertheless, they concluded that severe sepsis or septic shock patients may face increased all-cause mortality within 30 hospital days, with a possibility of reducing risk through adequate vitamin D levels.