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接受无创通气支持的新型冠状病毒肺炎患者的维生素D情况

Vitamin D in SARS-CoV-2 patients with non-invasive ventilation support.

作者信息

Barassi Alessandra, Pezzilli Raffaele, Mondoni Michele, Rinaldo Rocco F, Davì Matteo, Cozzolino Mario, Melzi D'Eril Gianvico, Centanni Stefano

机构信息

Laboratory of Clinical Chemistry, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.

Department of Health Sciences, University of Milan, Milan, Italy.

出版信息

Panminerva Med. 2023 Mar;65(1):23-29. doi: 10.23736/S0031-0808.21.04277-4. Epub 2021 Jan 25.

Abstract

BACKGROUND

Vitamin D (VitD) deficiency has been reported to be associated with respiratory tract infection. In this work we evaluated the concentration of VitD in COVID-19 patients experiencing acute respiratory infections of different levels of severity excluding those who underwent invasive respiratory support.

METHODS

The levels of serum VitD and C-reactive protein (CRP) were analyzed in 118 consecutive hospitalized COVID-19 patients (74 male, 44 female), confirmed with rRT-PCR. Of these patients with ventilation support 52 (44.1%) received oxygen via nasal cannula, oxygen mask or an oxygen mask with a reservoir, 48 (40.7%) were on a continuous positive airway pressure device (CPAP) and 18 (15,3%) on non-invasive mechanical ventilation (NIMV).

RESULTS

The median values (range) of VitD and of CRP were 15.1 ng/mL (1.3-73.3) and 14.2 mg/L (5.0-151.2), respectively. A negative correlation from VitD levels and those of CRP (correlation coefficient: 0.259: P=0.005) was observed. VitD levels in O2 support patients were significantly higher than in both CPAP and NIMV patients. No statistical differences were found for CRP levels (P=0.834) among the three type of oxygen support. Fewer patients with O2 support had VitD <30 ng/mL and <20 ng/mL than CPAP and NIMV patients. There were no relationships between VitD and the three classes of IgM (P=0.419) and of IgG (P=0.862) SARS-CoV-2 antibodies values. The behavior was the same for CRP.

CONCLUSIONS

Our study shows that a significant proportion of COVID-19 patients have a VitD deficiency and that this condition is more frequent in CPAP and in NIMV patients.

摘要

背景

据报道,维生素D(VitD)缺乏与呼吸道感染有关。在本研究中,我们评估了排除接受有创呼吸支持的患者后,不同严重程度急性呼吸道感染的新型冠状病毒肺炎(COVID-19)患者的VitD浓度。

方法

对118例经逆转录聚合酶链反应(rRT-PCR)确诊的连续住院COVID-19患者(74例男性,44例女性)的血清VitD和C反应蛋白(CRP)水平进行分析。在这些接受通气支持的患者中,52例(44.1%)通过鼻导管、氧气面罩或带储氧袋的氧气面罩吸氧,48例(40.7%)使用持续气道正压通气装置(CPAP),18例(15.3%)接受无创机械通气(NIMV)。

结果

VitD和CRP的中位数(范围)分别为15.1 ng/mL(1.3 - 73.3)和14.2 mg/L(5.0 - 151.2)。观察到VitD水平与CRP水平呈负相关(相关系数:0.259;P = 0.005)。接受氧气支持的患者的VitD水平显著高于接受CPAP和NIMV的患者。三种氧气支持类型之间的CRP水平无统计学差异(P = 0.834)。与接受CPAP和NIMV的患者相比,接受氧气支持的患者中VitD<30 ng/mL和<20 ng/mL的患者较少。VitD与三类新型冠状病毒2(SARS-CoV-2)IgM抗体值(P = 0.419)和IgG抗体值(P = 0.862)之间无相关性。CRP的情况相同。

结论

我们的研究表明,相当一部分COVID-19患者存在VitD缺乏,且这种情况在接受CPAP和NIMV的患者中更常见。

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