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维生素 D 对中重度 COVID-19 住院患者抗磷脂抗体的影响。

Effect of vitamin D on antiphospholipid antibodies in hospitalized patients with moderate to severe COVID-19.

机构信息

Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.

RDO Diagnósticos Médicos, São Paulo, SP, Brazil.

出版信息

Clinics (Sao Paulo). 2024 Aug 27;79:100474. doi: 10.1016/j.clinsp.2024.100474. eCollection 2024.

Abstract

OBJECTIVE

To investigate the effect of a single oral dose of 200,000 IU of vitamin D on antiphospholipid antibodies in hospitalized patients with moderate to severe COVID-19.

METHODS

This is a post-hoc, exploratory analysis from a double-blind, placebo-controlled, randomized clinical trial performed in two centers in Sao Paulo, Brazil. Hospitalized patients with COVID-19 were randomly assigned to receive either vitamin D (n = 97) or placebo (n = 97). In this post-hoc analysis, the endpoints were titers and frequency of anti-β2-Glycoprotein-I (aβ2-GP) and Anticardiolipin (aCL) antibodies [Immunoglobulin G, M and A (IgG, IgM and IgA)].

RESULTS

Overall mean (SD) age was 55.3 (13.9) years, Body Mass Index (BMI) was 32.2 (7.1 kg/m), and 106 participants (54.6 %) were male. There was a significant group by time interaction (p = 0.046) for frequency of aCL IgG, with increased values from baseline to discharge in the placebo group [n (%), from 13 (13.4) to 25 (25.8)] compared to the vitamin D [from 25 (25.8) to 29 (29.9)]. However, the frequency of aCL IgG did not change between the groups on discharge. No significant differences between vitamin D3 and placebo groups were found for any other autoantibodies.

CONCLUSION

These findings do not support the use of a single oral dose of 200,000 IU of vitamin D to modulate autoantibodies in hospitalized patients with moderate to severe COVID-19.

摘要

目的

研究单次口服 200000IU 维生素 D 对中重度 COVID-19 住院患者抗磷脂抗体的影响。

方法

这是一项在巴西圣保罗的两个中心进行的双盲、安慰剂对照、随机临床试验的事后探索性分析。将 COVID-19 住院患者随机分为维生素 D 组(n=97)或安慰剂组(n=97)。在这项事后分析中,终点是抗β2-糖蛋白-I(aβ2-GP)和抗心磷脂(aCL)抗体的滴度和频率[免疫球蛋白 G、M 和 A(IgG、IgM 和 IgA)]。

结果

总体平均(SD)年龄为 55.3(13.9)岁,体重指数(BMI)为 32.2(7.1kg/m),106 名参与者(54.6%)为男性。aCL IgG 频率的组间时间交互作用有统计学意义(p=0.046),安慰剂组从基线到出院时升高[n(%),从 13(13.4)到 25(25.8)],而维生素 D 组从 25(25.8)到 29(29.9)。然而,出院时两组间 aCL IgG 的频率没有变化。维生素 D3 组和安慰剂组之间在任何其他自身抗体方面均无显著差异。

结论

这些发现不支持使用单次口服 200000IU 维生素 D 来调节中重度 COVID-19 住院患者的自身抗体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21f0/11399608/c2614ea35321/gr1.jpg

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