Vitamin D Status in Autoimmune and Infectious Encephalitis
Ivany Patel1, Sienna Wu1, Rodrigo Hasbun1, Ralph Habis2, Jordan Benderoth2, John Probasco3, Arun Venkatesan3, Rajesh Gupta1
1McGovern Medical School, UTHealth, 2Johns Hopkins School of Medicine, 3The Johns Hopkins Hospital
Objective:

To assess this relationship between Vitamin D and clinical measures and outcomes in Encephalitis patients. 

Background:

Encephalitis is inflammation of the brain, primarily divided into Autoimmune Encephalitis (AE) and Infectious Encephalitis (IE), and poses a substantial burden on the U.S. healthcare system with an inpatient mortality of ~10%. Previous studies suggest both infectious (SARS-CoV-2) and autoimmune (multiple sclerosis) conditions are associated with Vitamin D, where Vitamin D may aid in SARS-CoV-2 prevention/immunomodulation, and hypovitaminosis D is associated with multiple sclerosis development. Despite these findings, the relationship between Vitamin D and Autoimmune and Infectious Encephalitis remains unknown.

Design/Methods:

We conducted a retrospective cohort study using electronic health records from adult Encephalitis patients from 2013-2023 in Greater Houston and Baltimore areas. Vitamin D 1,25(OH)₂ (ng/mL) and Vitamin D 25-OH (ng/mL) values at admission were dichotomized into “Deficient” (< 30 ng/mL) and “Sufficient” (≥ 30 ng/mL). IBM SPSS v.29 was utilized to conduct data analysis.

Results:

Of the 647 patients, 192 had documented Vitamin D values. Analysis revealed Vitamin D Deficiency was more commonly seen in African Americans (p < 0.001), in those with a subacute rather than acute presentation (p = 0.016), in sicker patients [e.g, SOFA score >3 and APACHE 2 score >10 (p = 0.013), higher opening pressures (p = 0.016), and higher proportion of obtundation where Glasgow Coma Score <13 (p = 0.035)], and in patients more likely to be readmitted (p = 0.015). Vitamin D Deficiency was not associated with worse clinical outcomes. 

Conclusions:
Even though our results show evidence that Vitamin D status is associated with being African American, sicker patient status, and hospital readmission, it is not correlated with worse clinical outcomes. Further studies should validate these findings and explore the role of Vitamin D supplementation in encephalitis.
10.1212/WNL.0000000000212265
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