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维生素 D 缺乏对 COVID-19 的影响——来自 CovILD 登记处的前瞻性分析。

Impact of Vitamin D Deficiency on COVID-19-A Prospective Analysis from the CovILD Registry.

机构信息

Department of Internal Medicine II, Infectious Diseases, Pneumology, Rheumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria.

Central Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Innsbruck, 6020 Innsbruck, Austria.

出版信息

Nutrients. 2020 Sep 11;12(9):2775. doi: 10.3390/nu12092775.

Abstract

The novel Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is a global health concern. Vitamin D (VITD) deficiency has been suggested to alter SARS-CoV-2 susceptibility and the course of disease. Thus, we aimed to investigate associations of VITD status to disease presentation within the CovILD registry. This prospective, multicenter, observational study on long-term sequelae includes patients with COVID-19 after hospitalization or outpatients with persistent symptoms. Eight weeks after PCR confirmed diagnosis, a detailed questionnaire, a clinical examination, and laboratory testing, including VITD status, were evaluated. Furthermore, available laboratory specimens close to hospital admission were used to retrospectively analyze 25-hydroxyvitamin D levels at disease onset. A total of 109 patients were included in the analysis (60% males, 40% females), aged 58 ± 14 years. Eight weeks after the onset of COVID-19, a high proportion of patients presented with impaired VITD metabolism and elevated parathyroid hormone (PTH) levels. PTH concentrations were increased in patients who needed intensive care unit (ICU) treatment, while VITD levels were not significantly different between disease severity groups. Low VITD levels at disease onset or at eight-week follow-up were not related to persistent symptom burden, lung function impairment, ongoing inflammation, or more severe CT abnormalities. VITD deficiency is frequent among COVID-19 patients but not associated with disease outcomes. However, individuals with severe disease display a disturbed parathyroid-vitamin-D axis within their recovery phase. The proposed significance of VITD supplementation in the clinical management of COVID-19 remains elusive.

摘要

新型冠状病毒病 2019(COVID-19)是由严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)引起的,是全球关注的健康问题。维生素 D(VITD)缺乏被认为会改变 SARS-CoV-2 的易感性和疾病进程。因此,我们旨在研究 VITD 状态与 CovILD 登记处疾病表现之间的关联。这是一项前瞻性、多中心、观察性研究,研究对象为住院后或持续有症状的门诊 COVID-19 患者。在 PCR 确诊后 8 周,评估详细的问卷、临床检查和实验室检测,包括 VITD 状态。此外,还利用接近住院时的可用实验室标本,回顾性分析发病时的 25-羟维生素 D 水平。共纳入 109 例患者进行分析(60%为男性,40%为女性),年龄为 58±14 岁。在 COVID-19 发病后 8 周,很大比例的患者出现 VITD 代谢受损和甲状旁腺激素(PTH)水平升高。需要重症监护病房(ICU)治疗的患者 PTH 浓度升高,而疾病严重程度组之间 VITD 水平无显著差异。发病时或 8 周随访时的低 VITD 水平与持续的症状负担、肺功能损害、持续炎症或更严重的 CT 异常无关。COVID-19 患者中 VITD 缺乏很常见,但与疾病结局无关。然而,在恢复期,严重疾病患者的甲状旁腺-维生素 D 轴受到干扰。维生素 D 补充在 COVID-19 临床管理中的潜在意义仍不明确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5308/7551662/b210d6884ea8/nutrients-12-02775-g001.jpg

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