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维生素 D 和皮质类固醇在住院 COVID-19 患者中的相互作用:对文献中不一致发现的潜在解释。

Interaction of Vitamin D and Corticosteroid Use in Hospitalized COVID-19 Patients: A Potential Explanation for Inconsistent Findings in the Literature.

机构信息

VA Cooperative Studies Program Coordinating Center, Boston, MA 02130, USA.

Department of Radiation Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH 44105, USA.

出版信息

Curr Pharm Des. 2022;28(21):1695-1702. doi: 10.2174/1381612828666220418132847.

Abstract

Vitamin D is an important immune-modulator with anti-inflammatory properties. While this prohormone has been studied extensively in the prevention and treatment of COVID-19, findings have been inconsistent regarding its overall benefit in patients hospitalized with COVID-19. Most studies to date have been observational in nature, not accounting for the use of corticosteroids. Furthermore, the few randomized clinical trials designed to examine the effect of vitamin D supplementation on COVID-19 outcomes have been relatively small and thus insufficiently powered to assure a balance of corticosteroid use between study arms. The current perspective addresses the interaction of vitamin D and corticosteroids as a potential explanation for the divergent results reported in the literature. Future research on vitamin D and COVID-19 will benefit by considering this interaction, especially among hospitalized patients requiring oxygen and mechanical ventilation.

摘要

维生素 D 是一种重要的免疫调节剂,具有抗炎特性。虽然这种前激素已在 COVID-19 的预防和治疗中被广泛研究,但关于其在 COVID-19 住院患者中的整体益处的研究结果一直不一致。迄今为止,大多数研究都是观察性的,没有考虑到皮质类固醇的使用。此外,为数不多的旨在研究维生素 D 补充剂对 COVID-19 结局影响的随机临床试验规模相对较小,因此不足以确保研究组之间皮质类固醇使用的平衡。当前的观点探讨了维生素 D 和皮质类固醇之间的相互作用,这可能是文献中报告的不同结果的一个解释。未来关于维生素 D 和 COVID-19 的研究将受益于考虑这种相互作用,特别是在需要吸氧和机械通气的住院患者中。

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