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维生素D状态与成人COVID-19住院患者医院发病率和死亡率的关联

Association of Vitamin D Status With Hospital Morbidity and Mortality in Adult Hospitalized Patients With COVID-19.

作者信息

Charoenngam Nipith, Shirvani Arash, Reddy Niyoti, Vodopivec Danica M, Apovian Caroline M, Holick Michael F

机构信息

Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.

Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.

出版信息

Endocr Pract. 2021 Apr;27(4):271-278. doi: 10.1016/j.eprac.2021.02.013. Epub 2021 Mar 9.

Abstract

OBJECTIVE

To determine the association between vitamin D status and morbidity and mortality in adult hospitalized coronavirus disease 2019 (COVID-19) patients METHODS: We performed a retrospective chart review study in COVID-19 patients aged ≥18 year hospitalized at Boston University Medical Center between March 1 and August 4, 2020. All studied patients tested positive for COVID-19 and had serum levels of 25-hydroxyvitamin D (25[OH]D) results measured within 1 year prior to the date of positive tests. Medical information was retrieved from the electronic medical record and was analyzed to determine the association between vitamin D status and hospital morbidity and mortality.

RESULTS

Among the 287 patients, 100 (36%) were vitamin D sufficient (25[OH]D >30 ng/mL) and 41 (14%) died during hospitalization. Multivariate analysis in patients aged ≥65 years revealed that vitamin D sufficiency (25[OH]D ≥30 ng/mL) was statistically significantly associated with decreased odds of death (adjusted OR 0.33, 95% CI, 0.12-0.94), acute respiratory distress syndrome (adjusted OR 0.22, 95% CI, 0.05-0.96), and severe sepsis/septic shock (adjusted OR 0.26, 95% CI, 0.08-0.88), after adjustment for potential confounders. Among patients with body mass index <30 kg/m, vitamin D sufficiency was statistically significantly associated with a decreased odds of death (adjusted OR 0.18, 95% CI, 0.04-0.84). No significant association was found in the subgroups of patients aged <65 years or with body mass index ≥30 kg/m.

CONCLUSION

We revealed an independent association between vitamin D sufficiency defined by serum 25(OH)D ≥30 ng/mL and decreased risk of mortality from COVID-19 in elderly patients and patients without obesity.

摘要

目的

确定2019年冠状病毒病(COVID-19)成年住院患者的维生素D状态与发病率和死亡率之间的关联。方法:我们对2020年3月1日至8月4日在波士顿大学医学中心住院的年龄≥18岁的COVID-19患者进行了一项回顾性病历审查研究。所有研究患者的COVID-19检测呈阳性,且在阳性检测日期前1年内检测了血清25-羟基维生素D(25[OH]D)水平。从电子病历中检索医疗信息并进行分析,以确定维生素D状态与医院发病率和死亡率之间的关联。

结果

在287例患者中,100例(36%)维生素D充足(25[OH]D>30 ng/mL),41例(14%)在住院期间死亡。对年龄≥65岁的患者进行多变量分析显示,在调整潜在混杂因素后,维生素D充足(25[OH]D≥30 ng/mL)与死亡几率降低(调整后的比值比为0.3

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98e7/7939977/99154db8063d/gr1_lrg.jpg

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