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Article

Vitamin D Serum Levels and the Development of Intensive Care Unit-Acquired Weakness: Insights from a COVID-19 Intensive Care Cohort

by
Jelena Gulišija
1,*,
Vesna Čapkun
2,
Stefan Golic
3 and
Sanda Stojanović Stipić
4
1
Department of Neurology, University Hospital of Split, 21000 Split, Croatia
2
Department of Nuclear Medicine, University Hospital of Split, 21000 Split, Croatia
3
School of Medicine, University of Split, 21000 Split, Croatia
4
Department of Anesthesiology and Intensive Care Unit, University Hospital of Split, 21000 Split, Croatia
*
Author to whom correspondence should be addressed.
Pathophysiology 2025, 32(2), 21; https://doi.org/10.3390/pathophysiology32020021
Submission received: 29 January 2025 / Revised: 22 April 2025 / Accepted: 6 May 2025 / Published: 9 May 2025
(This article belongs to the Section Systemic Pathophysiology)

Abstract

Background/Objectives: The pathogenesis of intensive care unit-acquired weakness (ICU-AW) is multi-factorial, with some of the main risk factors being sepsis, multiorgan failure, and the inflammatory response related to critical illness. Vitamin D is crucial for muscle function, the immune response, and inflammation, and has been identified as a predictor of negative outcomes in intensive care unit (ICU) patients with COVID-19. The objective of this preliminary study was to examine the relationship between vitamin D serum levels and the incidence of ICU-AW in a cohort from the University Hospital of Split. Methods: A prospective observational cohort study was conducted in the University Hospital of Split in ICU from December 2021 to March 2022. The inclusion criteria were as follows: patients over 18 years old who had a confirmed severe acute respiratory coronavirus disease 2 (SARS-CoV-2) infection, patients who were mechanically ventilated for more than 48 h, and patients who were weaned from a ventilator over at least 24 h. The exclusion criteria were a history of neurological or musculoskeletal disorders and a pre-existing poor functional status. Vitamin D was detected in the first routine blood sample. Results: A total of 77 patients were observed, with 36 patients who were successfully weaned from a ventilator over at least 24 h and 1 patient who could not be examined because of impaired consciousness (this patient was excluded from further analysis), and thus a total of 35 patients were analyzed. Of these 35 patients, 12 (34%) developed ICU-AW. The median vitamin D serum level in the ICU-AW group was 17 (7.5–73.3), while that in the non-ICU-AW group was 25.2 (12.3–121). The difference in vitamin D serum levels between the groups was not significantly different from zero (p = 0.567). All patients, except for one, were vitamin D insufficient. Conclusions: Vitamin D serum levels in the ICU-AW group were not statistically different from the non-ICU-AW group, possibly due to the small sample size. Given the known roles of vitamin D in muscle function, immune modulation, and inflammation, a potential etiopathogenetic role in ICU-AW cannot be excluded without additional studies. Therefore, further studies with larger sample sizes than ours are necessary to determine whether vitamin D deficiency contributes to the development of ICU-AW and whether supplementation could have preventive or therapeutic value.
Keywords: ICU-AW; critical illness; COVID-19 pneumonia; vitamin D; respiratory failure; mechanical ventilation ICU-AW; critical illness; COVID-19 pneumonia; vitamin D; respiratory failure; mechanical ventilation

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MDPI and ACS Style

Gulišija, J.; Čapkun, V.; Golic, S.; Stojanović Stipić, S. Vitamin D Serum Levels and the Development of Intensive Care Unit-Acquired Weakness: Insights from a COVID-19 Intensive Care Cohort. Pathophysiology 2025, 32, 21. https://doi.org/10.3390/pathophysiology32020021

AMA Style

Gulišija J, Čapkun V, Golic S, Stojanović Stipić S. Vitamin D Serum Levels and the Development of Intensive Care Unit-Acquired Weakness: Insights from a COVID-19 Intensive Care Cohort. Pathophysiology. 2025; 32(2):21. https://doi.org/10.3390/pathophysiology32020021

Chicago/Turabian Style

Gulišija, Jelena, Vesna Čapkun, Stefan Golic, and Sanda Stojanović Stipić. 2025. "Vitamin D Serum Levels and the Development of Intensive Care Unit-Acquired Weakness: Insights from a COVID-19 Intensive Care Cohort" Pathophysiology 32, no. 2: 21. https://doi.org/10.3390/pathophysiology32020021

APA Style

Gulišija, J., Čapkun, V., Golic, S., & Stojanović Stipić, S. (2025). Vitamin D Serum Levels and the Development of Intensive Care Unit-Acquired Weakness: Insights from a COVID-19 Intensive Care Cohort. Pathophysiology, 32(2), 21. https://doi.org/10.3390/pathophysiology32020021

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