Arvinte Cristian, Singh Maharaj, Marik Paul E
Intensivist & Pulmonologist, North Suburban Medical Center, Thornton, Colorado 80229, USA.
Research Assistant Professor, Biostatistics, Research and Graduate Studies, Marquette University, School of Dentistry, Milwaukee, Wisconsin 53201, USA.
Med Drug Discov. 2020 Dec;8:100064. doi: 10.1016/j.medidd.2020.100064. Epub 2020 Sep 18.
The COVID-19 pandemic has placed an enormous and growing burden on the population and health infrastructure, warranting innovative ways to mitigate risk of contracting and developing severe forms of this disease. A growing body of literature raises the issue of vitamin C and vitamin D as a risk-assessment tool, and therapeutic option, in COVID-19.
The objective of this pilot study was to measure serum vitamin C and vitamin D levels in a cohort of patients with critical COVID-19 illness in our community hospital ICU, correlate with other illness risk factors (age, BMI, HgbA1c, smoking status), generate hypotheses, and suggest further therapeutic intervention studies.
This pilot study included all 21 critically ill COVID-19 patients hospitalized in May 2020 in the ICU of North Suburban Medical Center, Thornton, Colorado, in whose care the principal investigator (C.A.) was involved. We measured patients' serum vitamin C and vitamin D levels, and standard risk factors like age, BMI, HbA1c, and smoking status. Variables in this study were gauged using descriptive statistics.
Of 21 critically ill COVID-19 patients (15 males and 6 females, 17 Hispanic and 4 Caucasian, of median age 61 years, range 20-94), there were 11 survivors.Serum levels of vitamin C and vitamin D were low in most of our critically ill COVID-19 ICU patients.Older age and low vitamin C level appeared co-dependent risk factors for mortality from COVID-19 in our sample.Insulin resistance and obesity were prevalent in our small cohort, but smoking was not.
Our pilot study found low serum levels of vitamin C and vitamin D in most of our critically ill COVID-19 ICU patients. Older age and low vitamin C level appeared co-dependent risk factors for mortality. Many were also insulin-resistant or diabetic, overweight or obese, known as independent risk factors for low vitamin C and vitamin D levels, and for COVID-19.These findings suggest the need to further explore whether caring for COVID-19 patients ought to routinely include measuring and correcting serum vitamin C and vitamin D levels, and whether treating critically ill COVID-19 warrants acute parenteral vitamin C and vitamin D replacement.
新型冠状病毒肺炎疫情给民众和卫生基础设施带来了巨大且不断增加的负担,因此需要创新方法来降低感染和发展为该疾病重症形式的风险。越来越多的文献提出了维生素C和维生素D作为新型冠状病毒肺炎风险评估工具及治疗选择的问题。
本初步研究的目的是测量我们社区医院重症监护病房中一组新型冠状病毒肺炎重症患者的血清维生素C和维生素D水平,将其与其他疾病风险因素(年龄、体重指数、糖化血红蛋白、吸烟状况)相关联,提出假设,并建议进一步开展治疗干预研究。
本初步研究纳入了2020年5月在科罗拉多州桑顿市北郊医疗中心重症监护病房住院的所有21例新型冠状病毒肺炎重症患者,首席研究员(C.A.)参与了对他们的治疗。我们测量了患者的血清维生素C和维生素D水平,以及年龄、体重指数、糖化血红蛋白和吸烟状况等标准风险因素。本研究中的变量采用描述性统计进行评估。
在21例新型冠状病毒肺炎重症患者中(15例男性和6例女性,17例西班牙裔和4例白种人,中位年龄61岁,范围20 - 94岁),有11例存活。我们大多数新型冠状病毒肺炎重症监护病房患者的血清维生素C和维生素D水平较低。在我们的样本中,年龄较大和维生素C水平较低似乎是新型冠状病毒肺炎死亡的共同风险因素。胰岛素抵抗和肥胖在我们这个小队列中很普遍,但吸烟并非如此。
我们的初步研究发现,大多数新型冠状病毒肺炎重症监护病房患者的血清维生素C和维生素D水平较低。年龄较大和维生素C水平较低似乎是死亡的共同风险因素。许多患者还存在胰岛素抵抗或糖尿病、超重或肥胖,这些都是维生素C和维生素D水平较低以及新型冠状病毒肺炎发病的独立风险因素。这些发现表明有必要进一步探索,对新型冠状病毒肺炎患者的护理是否应常规包括测量和纠正血清维生素C和维生素D水平,以及对新型冠状病毒肺炎重症患者的治疗是否需要急性肠外补充维生素C和维生素D。