Charkowick Shaun V, Logothetis Constantine N, Tsay Katherine, Jordan Aryanna, Hanna Catherine, Zhang Sherry, Coughlin Emily, Weppelmann Thomas A, Mhaskar Rahul, Oxner Asa
College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA.
Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA.
Cureus. 2023 Jul 13;15(7):e41805. doi: 10.7759/cureus.41805. eCollection 2023 Jul.
Introduction Despite using anti-coagulation therapy in hospitalized coronavirus disease 2019 (COVID-19) patients, they have high rates of pulmonary embolism (PE) and deep vein thrombosis (DVT). The main objective of this study was to evaluate the association between vitamin D deficiency and thrombotic events (defined as the occurrence of a new PE or DVT) in hospitalized COVID-19 patients. Materials and Methods This was a retrospective, cross-sectional study of 208 hospitalized COVID-19 patients who received a computed tomographic pulmonary angiography (CTPA) based on clinical suspicion of PE between January 1, 2020, and February 5, 2021. A <20 ng/mL serum vitamin D level was used to categorize vitamin D deficiency. Nonparametric tests and multivariate binary logistic regression were used to evaluate the association between serum vitamin D levels and clinical outcomes. Results The mean vitamin D level was 26.7±13.0 ng/mL (n=208), and approximately one-third of patients were vitamin D deficient (n=68, 32.7%). No association was found between vitamin D deficiency and the occurrence of thrombotic events. The incidence of PE was 19.1% in vitamin D deficient patients compared to 11.4% in vitamin D sufficient patients (p=0.13). Vitamin D deficiency was positively associated with ICU admission (OR 3.047, 95%CI 1.57-5.91, p=0.001) and mortality (OR 3.76, 95%CI 1.29-11.01, p=0.016). Conclusions This study found no association between vitamin D deficiency and the occurrence of a new PE or DVT in hospitalized COVID-19 patients. Patients with vitamin D deficiency were more likely to be admitted to the ICU and had increased overall mortality.
引言 尽管对住院的2019冠状病毒病（COVID-19）患者使用了抗凝治疗，但他们发生肺栓塞（PE）和深静脉血栓形成（DVT）的几率仍然很高。本研究的主要目的是评估住院COVID-19患者维生素D缺乏与血栓形成事件（定义为新发PE或DVT的发生）之间的关联。材料与方法 这是一项回顾性横断面研究，研究对象为208例住院的COVID-19患者，这些患者在2020年1月1日至2021年2月5日期间因临床怀疑PE接受了计算机断层扫描肺动脉造影（CTPA）。血清维生素D水平<20 ng/mL用于定义维生素D缺乏。采用非参数检验和多因素二元逻辑回归评估血清维生素D水平与临床结局之间的关联。结果 维生素D平均水平为26.7±13.0 ng/mL（n=208）, 约三分之一的患者存在维生素D缺乏（n=68，32.7%）。未发现维生素D缺乏与血栓形成事件的发生之间存在关联。维生素D缺乏患者的PE发生率为19.1%，而维生素D充足患者为11.4%（p=0.13）。维生素D缺乏与入住重症监护病房（ICU）呈正相关（比值比[OR] 3.047，95%置信区间[CI] 1.57–5.91，p=0.001），与死亡率也呈正相关（OR 3.76，95%CI 1.29–11.01，p=0.016）。结论 本研究未发现住院COVID-19患者维生素D缺乏与新发PE或DVT的发生之间存在关联。维生素D缺乏的患者更有可能入住ICU，且总体死亡率增加。
