Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19
Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19
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DOI：
10.1007/s40618-020-01370-x
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发表时间：
2020-08-09
影响因子：
5.4
通讯作者：
Resta, O.
中科院分区：
文献类型：
--
作者：
Carpagnano, G. E.;Di Lecce, V;Resta, O.
目的维生素D缺乏症是一种高度传播的疾病，与呼吸道感染的风险增加有关。如今，世界正处于19型冠状病毒大流行的控制之中。在这些患者中，细胞因子风暴与疾病严重程度有关。考虑到维生素D在免疫系统中的作用，本研究的目的是分析新冠肺炎急性呼吸衰竭患者的维生素D水平，并评估其与疾病严重程度和预后的相关性。方法回顾分析2020年3月11日至4月30日收治的42例新冠肺炎所致急性呼吸衰竭患者的人口学、临床及实验室资料。结果81%的患者存在维生素D缺乏，根据维生素D水平将人群分为4组：无维生素D缺乏组、维生素D缺乏组、中度缺乏组和重度缺乏组。在人口统计学和临床特征方面没有发现差异。一项生存分析强调，在住院10天后，严重维生素D缺乏症患者的死亡率为50%，而维生素D和维生素D含量为10 ng/ml的患者的死亡率为5%(p=0.019)。结论在重症监护病房治疗的新冠肺炎急性呼吸衰竭患者中，维生素D缺乏发生率较高。严重缺乏维生素D的患者死亡风险明显更高。严重的维生素D缺乏可能是这些患者预后不良的标志，这表明辅助治疗可能会改善疾病结局。
Purpose Hypovitaminosis D is a highly spread condition correlated with increased risk of respiratory tract infections. Nowadays, the world is in the grip of the Coronavirus disease 19 (COVID 19) pandemic. In these patients, cytokine storm is associated with disease severity. In consideration of the role of vitamin D in the immune system, aim of this study was to analyse vitamin D levels in patients with acute respiratory failure due to COVID-19 and to assess any correlations with disease severity and prognosis. Methods In this retrospective, observational study, we analysed demographic, clinical and laboratory data of 42 patients with acute respiratory failure due to COVID-19, treated in Respiratory Intermediate Care Unit (RICU) of the Policlinic of Bari from March, 11 to April 30, 2020. Results Eighty one percent of patients had hypovitaminosis D. Based on vitamin D levels, the population was stratified into four groups: no hypovitaminosis D, insufficiency, moderate deficiency, and severe deficiency. No differences regarding demographic and clinical characteristics were found. A survival analysis highlighted that, after 10 days of hospitalization, severe vitamin D deficiency patients had a 50% mortality probability, while those with vitamin D >= 10 ng/mL had a 5% mortality risk (p = 0.019). Conclusions High prevalence of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure, treated in a RICU. Patients with severe vitamin D deficiency had a significantly higher mortality risk. Severe vitamin D deficiency may be a marker of poor prognosis in these patients, suggesting that adjunctive treatment might improve disease outcomes.