Influence of vitamin D status on hospital length of stay and prognosis in hospitalized patients with moderate to severe COVID-19: a multicenter prospective cohort study

Carregando...
Imagem de Miniatura
Citações na Scopus
25
Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS
Autores
REIS, Bruna Z.
SANTOS, Mayara D.
SANTOS, Caroline C. Dos
PINTO, Ana J.
GOESSLER, Karla F.
Citação
AMERICAN JOURNAL OF CLINICAL NUTRITION, v.114, n.2, p.598-604, 2021
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Vitamin D acts as a mediator in the immune system regulating antiviral mechanisms and inflammatory processes. Vitamin D insufficiency has been suggested as a potential risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, although its impact on the prognosis of hospitalized patients with coronavirus disease 2019 (COVID-19) remains unclear. Objective: This multicenter prospective cohort study was designed to investigate whether serum 25-hydroxyvitamin D [25(OH)D] concentration is associated with hospital length of stay and prognosis in hospitalized patients with COVID-19. Methods: Patients with moderate to severe COVID-19 (n = 220) were recruited from 2 hospitals in Sao Paulo, Brazil. Serum 25(OH)D concentrations were categorized as follows: <10 ng/mL, 10 to <20 ng/mL, 20 to <30 ng/mL, and >= 30 ng/mL, and <10 ng/mL and >= 10 ng/mL. The primary outcome was hospital length of stay and the secondary outcomes were the rate of patients who required invasive mechanical ventilation and mortality. Results: There were no significant differences in hospital length of stay when the 4 25(OH)D categories were compared (P = 0.120). Patients exhibiting 25(OH)D<10 ng/mL showed a trend (P = 0.057) for longer hospital length of stay compared with those with 25(OH)D >= 10 ng/mL [9.0 d (95% CI: 6.4, 11.6 d) vs. 7.0 d (95% CI: 6.6, 7.4 d)]. The multivariable Cox proportional hazard models showed no significant associations between 25(OH)D and primary or secondary outcomes. Conclusions: Among hospitalized patients with moderate to severe COVID-19, those with severe 25(OH)D deficiency (<10 ng/mL) exhibited a trend for longer hospital length of stay compared with patients with higher 25(OH)D concentrations. This association was not significant in the multivariable Cox regression model. Prospective studies should test whether correcting severe 25(OH)D deficiency could improve the prognosis of patients with COVID-19.
Palavras-chave
SARS-CoV-2 infection, COVID-19, mortality, nutritional status, 25-hydroxyvitamin D
Referências
  1. Abrishami A, 2021, EUR J NUTR, V60, P2249, DOI 10.1007/s00394-020-02411-0
  2. Aibana O, 2019, PLOS MED, V16, DOI 10.1371/journal.pmed.1002907
  3. Alexander J, 2020, NUTRIENTS, V12, DOI 10.3390/nu12082358
  4. Autier P, 2014, LANCET DIABETES ENDO, V2, P76, DOI 10.1016/S2213-8587(13)70165-7
  5. Baktash V, 2021, POSTGRAD MED J, V97, P442, DOI 10.1136/postgradmedj-2020-138712
  6. Bilezikian JP, 2020, EUR J ENDOCRINOL, V183, pR133, DOI 10.1530/EJE-20-0665
  7. Brenner H, 2020, NUTRIENTS, V12, DOI 10.3390/nu12082488
  8. Cereda E, 2021, CLIN NUTR, V40, P2469, DOI 10.1016/j.clnu.2020.10.055
  9. Daneshkhah A, 2020, AGING CLIN EXP RES, V32, P2141, DOI 10.1007/s40520-020-01677-y
  10. Di Rosa M, 2011, IMMUNOLOGY, V134, P123, DOI 10.1111/j.1365-2567.2011.03482.x
  11. Hars M, 2020, OSTEOPOROSIS INT, V31, P2495, DOI 10.1007/s00198-020-05677-6
  12. Hernandez JL, 2021, J CLIN ENDOCR METAB, V106, pE1343, DOI 10.1210/clinem/dgaa733
  13. Kaufman HW, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0239252
  14. Laird E, 2020, Ir Med J, V113, P81
  15. Lips P., 2019, EUR J ENDOCRINOL, V180, pP23, DOI 10.1530/EJE-18-0736
  16. Luo X, 2021, J NUTR, V151, P98, DOI 10.1093/jn/nxaa332
  17. Macaya F, 2020, NUTR HOSP, V37, P1039, DOI 10.20960/nh.03193
  18. Maghbooli Z, 2020, PLOS ONE, V15, DOI 10.1371/journal.pone.0239799
  19. Martineau AR, 2020, LANCET DIABETES ENDO, V8, P735, DOI 10.1016/S2213-8587(20)30268-0
  20. Meltzer DO, 2020, JAMA NETW OPEN, V3, DOI 10.1001/jamanetworkopen.2020.19722
  21. Mitchell F, 2020, LANCET DIABETES ENDO, V8, P570, DOI 10.1016/S2213-8587(20)30183-2
  22. Murai IH, 2021, JAMA-J AM MED ASSOC, V325, P1053, DOI 10.1001/jama.2020.26848
  23. National Institute of Health (NIH), 2020, COR DIS 2019 COVID 1
  24. Pecora F, 2020, NUTRIENTS, V12, DOI 10.3390/nu12103198
  25. Pizzini A, 2020, NUTRIENTS, V12, DOI 10.3390/nu12092775
  26. Quesada-Gomez JM, 2020, J STEROID BIOCHEM, V202, DOI 10.1016/j.jsbmb.2020.105719
  27. Sabetta JR, 2010, PLOS ONE, V5, DOI 10.1371/journal.pone.0011088
  28. Silva MC, 2015, NUTR RES, V35, P91, DOI 10.1016/j.nutres.2014.12.008
  29. Szeto B, 2021, ENDOCR RES, V46, P66, DOI 10.1080/07435800.2020.1867162
  30. WHO, 2021, NOVEL CORONAVIRUS 20
  31. WHO Consultation, 2000, WHO TECH REP SER, V894, P1
  32. Ye K., 2020, J AM COLL NUTR, P1, DOI [10.1080/07315724.2020.1826005, DOI 10.1080/07315724.2020.1826005]
  33. Zhang Y, 2012, J IMMUNOL, V188, P2127, DOI 10.4049/jimmunol.1102412