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维生素D状态与新型冠状病毒肺炎患者肺部受累及预后的可能关联:一项回顾性研究

Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study.

作者信息

Abrishami Alireza, Dalili Nooshin, Mohammadi Torbati Peyman, Asgari Reyhaneh, Arab-Ahmadi Mehran, Behnam Behdad, Sanei-Taheri Morteza

机构信息

Department of Radiology, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Chronic Kidney Disease Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Eur J Nutr. 2021 Jun;60(4):2249-2257. doi: 10.1007/s00394-020-02411-0. Epub 2020 Oct 30.

Abstract

PURPOSE

Vitamin D deficiency has been reported as a key factor in the development of infectious diseases such as respiratory tract infections and inflammatory processes like acute respiratory distress syndrome. However, the impact of vitamin D on the severity and outcome of COVID-19 is still not fully known. Herein, we aimed to evaluate the prognostic role of serum vitamin D concentration on the extent of lung involvement and final outcome in patients with COVID-19.

METHODS

Seventy-three subjects with confirmed diagnosis of COVID-19 were investigated in this study. The patients had been admitted to our academic hospital from February 28, 2020 to April 19, 2020. Demographic and clinical data, serum 25(OH)D levels, and findings of initial chest computed tomography were recorded. Linear and binary logistic regression, cox regression and ROC curve tests were used for statistical analysis.

RESULTS

The mean age of patients was 55.18 ± 14.98 years old; 46.4% were male. Mean serum 25(OH)D concentration was significantly lower in the deceased (13.83 ± 12.53 ng/ mL compared with discharged patients (38.41 ± 18.51 ng/mL) (P < 0.001). Higher levels of 25(OH)D were associated with significantly less extent of total lung involvement (β = - 0.10, P = 0.004). In addition, vitamin D deficiency [25(OH) D < 25 ng/mL] was associated with a significant increase in the risk of mortality (hazard ratio = 4.15, P = 0.04).

CONCLUSION

This study suggests that serum vitamin D status might provide useful information regarding the clinical course, extent of lung involvement and outcome of patients with COVID-19. However, further studies with larger sample size are needed to confirm these findings.

摘要

目的

维生素D缺乏已被报道为诸如呼吸道感染等传染病以及像急性呼吸窘迫综合征这样的炎症过程发展的关键因素。然而,维生素D对新型冠状病毒肺炎(COVID-19)严重程度和结局的影响仍不完全清楚。在此,我们旨在评估血清维生素D浓度对COVID-19患者肺部受累程度和最终结局的预后作用。

方法

本研究调查了73例确诊为COVID-19的受试者。这些患者于2020年2月28日至2020年4月19日入住我们的教学医院。记录人口统计学和临床数据、血清25(OH)D水平以及初始胸部计算机断层扫描结果。采用线性和二元逻辑回归、Cox回归和ROC曲线检验进行统计分析。

结果

患者的平均年龄为55.18±14.98岁;46.4%为男性。死亡患者的平均血清25(OH)D浓度显著低于出院患者(分别为13.83±12.53 ng/mL和38.41±18.51 ng/mL)(P<0.001)。较高的25(OH)D水平与肺部总受累程度显著降低相关(β=-0.10,P=0.004)。此外,维生素D缺乏[25(OH)D<25 ng/mL]与死亡风险显著增加相关(风险比=4.15,P=0.04)。

结论

本研究表明,血清维生素D状态可能为COVID-19患者的临床病程、肺部受累程度和结局提供有用信息。然而,需要进一步开展更大样本量的研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1d/7595877/cf28dca00f5b/394_2020_2411_Fig1_HTML.jpg

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