Dataset Information

The effect of high-dose parenteral vitamin D₃ on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study.

ABSTRACT:

Background

In many studies, vitamin D has been found to be low in COVID-19 patients. In this study, we aimed to investigate the relationship between clinical course and inhospital mortality with parenteral administration of high-dose vitamin D₃ within the first 24 h of admission to patients who were hospitalized in the intensive care unit (ICU) because of COVID-19 with vitamin D deficiency.

Methods

This study included 175 COVID-19 patients with vitamin D deficiency [25(OH) D <12 ng/mL] who were hospitalized in the ICU. Vitamin D₃ group (n = 113) included patients who received a single dose of 300,000 IU vitamin D3 intramuscularly. Vitamin D₃ was not administered to the control group (n = 62).

Results

Median C-reactive protein level was 10.8 mg/dL in the vitamin D₃ group and 10.6 mg/dL in the control group (p = 0.465). Thirty-nine percent (n = 44) of the patients in the vitamin D₃ group were intubated endotracheally, and 50% (n = 31) of the patients in the control group were intubated endotracheally (p = 0.157). Parenteral vitamin D₃ administration was not associated with inhospital mortality by multivariate logistic regression analysis. According to Kaplan-Meier survival analysis, the median survival time was 16 d in the vitamin D3 group and 17 d in the control group (log-rank test, p = 0.459).

Conclusion

In this study, which was performed for the first time in the literature, it was observed that high-dose parenteral vitamin D₃ administration in critical COVID-19 patients with vitamin D deficiency during admission to the ICU did not reduce the need for intubation, length of hospital stay, and inhospital mortality.

SUBMITTER: Guven M

PROVIDER: S-EPMC8299443 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Publications

The effect of high-dose parenteral vitamin D<sub>3</sub> on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study.

Güven Mehmet M Gültekin Hamza H

European journal of clinical nutrition 20210723 9

<h4>Background</h4>In many studies, vitamin D has been found to be low in COVID-19 patients. In this study, we aimed to investigate the relationship between clinical course and inhospital mortality with parenteral administration of high-dose vitamin D<sub>3</sub> within the first 24 h of admission to patients who were hospitalized in the intensive care unit (ICU) because of COVID-19 with vitamin D deficiency.<h4>Methods</h4>This study included 175 COVID-19 patients with vitamin D deficiency [25( ...[more]

PMID: 34302132

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Project description:BackgroundPregnant women are at an increased risk of mortality and morbidity owing to COVID-19. Many studies have reported on the association of COVID-19 with pregnancy-specific adverse outcomes, but prediction models utilizing large cohorts of pregnant women are still lacking for estimating the risk of maternal morbidity and other adverse events.ObjectiveThe main aim of this study was to develop a prediction model to quantify the risk of progression to critical COVID-19 and intensive care unit admission in pregnant women with symptomatic infection.Study designThis was a multicenter retrospective cohort study including 8 hospitals from 4 countries (the United Kingdom, Austria, Greece, and Turkey). The data extraction was from February 2020 until May 2021. Included were consecutive pregnant and early postpartum women (within 10 days of birth); reverse transcriptase polymerase chain reaction confirmed SARS-CoV-2 infection. The primary outcome was progression to critical illness requiring intensive care. The secondary outcomes included maternal death, preeclampsia, and stillbirth. The association between the primary outcome and 12 candidate predictors having a known association with severe COVID-19 in pregnancy was analyzed with log-binomial mixed-effects regression and reported as adjusted risk ratios. All the potential predictors were evaluated in 1 model and only the baseline factors in another. The predictive accuracy was assessed by the area under the receiver operating characteristic curves.ResultsOf the 793 pregnant women who were positive for SARS-CoV-2 and were symptomatic, 44 (5.5%) were admitted to intensive care, of whom 10 died (1.3%). The 'mini-COvid Maternal Intensive Therapy' model included the following demographic and clinical variables available at disease onset: maternal age (adjusted risk ratio, 1.45; 95% confidence interval, 1.07-1.95; P=.015); body mass index (adjusted risk ratio, 1.34; 95% confidence interval, 1.06-1.66; P=.010); and diagnosis in the third trimester of pregnancy (adjusted risk ratio, 3.64; 95% confidence interval, 1.78-8.46; P=.001). The optimism-adjusted area under the receiver operating characteristic curve was 0.73. The 'full-COvid Maternal Intensive Therapy' model included body mass index (adjusted risk ratio, 1.39; 95% confidence interval, 1.07-1.95; P=.015), lower respiratory symptoms (adjusted risk ratio, 5.11; 95% confidence interval, 1.81-21.4; P=.007), neutrophil to lymphocyte ratio (adjusted risk ratio, 1.62; 95% confidence interval, 1.36-1.89; P<.001); and serum C-reactive protein (adjusted risk ratio, 1.30; 95% confidence interval, 1.15-1.44; P<.001), with an optimism-adjusted area under the receiver operating characteristic curve of 0.85. Neither model showed signs of a poor fit. Categorization as high-risk by either model was associated with a shorter diagnosis to intensive care unit admission interval (log-rank test P<.001, both), higher maternal death (5.2% vs 0.2%; P<.001), and preeclampsia (5.7% vs 1.0%; P<.001). A spreadsheet calculator is available for risk estimation.ConclusionAt presentation with symptomatic COVID-19, pregnant and recently postpartum women can be stratified into high- and low-risk for progression to critical disease, even where resources are limited. This can support the nature and place of care. These models also highlight the independent risk for severe disease associated with obesity and should further emphasize that even in the absence of other comorbidities, vaccination is particularly important for these women. Finally, the model also provides useful information for policy makers when prioritizing national vaccination programs to quickly protect those at the highest risk of critical and fatal COVID-19.

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Dataset Information

The effect of high-dose parenteral vitamin D₃ on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study.

Background

Methods

Results

Conclusion

Publications

The effect of high-dose parenteral vitamin D<sub>3</sub> on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

The effect of high-dose parenteral vitamin D3 on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study.

Background

Methods

Results

Conclusion

Publications

The effect of high-dose parenteral vitamin D<sub>3</sub> on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

The effect of high-dose parenteral vitamin D₃ on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study.