Bogliolo Laura, Cereda Emanuele, Klersy Catherine, Stefano Ludovico De, Lobascio Federica, Masi Sara, Crotti Silvia, Bugatti Serena, Montecucco Carlomaurizio, Demontis Stefania, Mascheroni Annalisa, Cerutti Nadia, Malesci Alberto, Corrao Salvatore, Caccialanza Riccardo
Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Front Nutr. 2022 Jul 5;9:934258. doi: 10.3389/fnut.2022.934258. eCollection 2022.
Several studies and meta-analyses suggested the role of vitamin D 25OH in preventing severe forms of coronavirus disease 2019 (COVID-19). However, the evidence on the clinical benefits of vitamin D 25OH adequacy in patients hospitalized for COVID-19 remain conflicting and speculative. We aimed to investigate the association between vitamin D 25OH serum levels and mortality in hospitalized patients with moderate to severe COVID-19.
This prospective observational multicentre study included 361 consecutive patients with moderate to severe COVID-19 admitted to the Italian hospitals involved in the NUTRI-COVID19 trial from March to August 2020. For each patient, serum vitamin D 25OH levels were assessed 48 h since admission and classified as deficient (<20 ng/mL) or adequate (≥20 ng/mL). We built a propensity score for low/adequate vitamin D 25OH levels to balance the clinical and demographic properties of the cohort, which resulted in 261 patients with good common support used for the survival analysis.
Two Hundred-seventy-seven (77%) of the 361 enrolled patients (207 [57%] males, median age 73 ± 15.6 years) had vitamin D 25OH deficiency. Fifty-two (20%) of the 261 matched patients died during the hospital stay, corresponding to a hazard ratio of 1.18 for vitamin D 25OH deficiency (95% confidence interval: 0.86-1.62; = 0.29).
The prevalence of vitamin D 25OH deficiency was confirmed to be very high in hospitalized patients with COVID-19. The use of a propensity score demonstrate an absence of significant association between vitamin D deficiency and mortality in hospitalized patients.
多项研究和荟萃分析表明，25-羟维生素D在预防严重的2019冠状病毒病（COVID-19）方面发挥作用。然而，关于COVID-19住院患者25-羟维生素D充足的临床益处的证据仍然相互矛盾且具有推测性。我们旨在研究中重度COVID-19住院患者的血清25-羟维生素D水平与死亡率之间的关联。
这项前瞻性观察性多中心研究纳入了2020年3月至8月参与NUTRI-COVID19试验的意大利医院连续收治的361例中重度COVID-19患者。对于每位患者，入院后48小时评估血清25-羟维生素D水平，并分为缺乏（<20 ng/mL）或充足（≥20 ng/mL）。我们构建了一个25-羟维生素D水平低/充足的倾向评分，以平衡队列的临床和人口统计学特征，最终有261例具有良好共同支持度的患者用于生存分析。
361例入组患者中有277例（77%）（207例[57%]为男性，中位年龄73±15.6岁）存在25-羟维生素D缺乏。261例匹配患者中有52例（20%）在住院期间死亡，25-羟维生素D缺乏的风险比为1.18（95%置信区间：0.86-1.62；P = 0.29）。
COVID-19住院患者中25-羟维生素D缺乏的患病率被证实非常高。倾向评分的使用表明，住院患者维生素D缺乏与死亡率之间没有显著关联。
