The Uloga serumske koncentracije vitamina D u predikciji toka i ishoda COVID-19
Sažetak
Cilj: S obzirom na to da, prema dostupnoj literaturi, premorbidna stanja utiču na tok COVID-19, želeli smo da ispitamo ulogu prijemne koncentracije vitamina D u predikciji toka i ishoda bolesti hospitalizovanih pacijenata.
Metode: Opservaciona, prospektivna, kohortna studija sprovedena na 329 konsekutivno hospitalizovanih COVID-19 pacijenata u Univerzitetskom Kliničkom Centru Kragujevac (Srbija), u periodu između oktobra i decembra 2021. godine. Unutar 24 časa od prijema, koncentracija vitamina D određivana je iz periferne venske krvi. Sociodemografski i podaci u vezi sa istorijom bolesti prikupljeni su anamnestički i koristeći Zdravstveni informacioni sistem (COMTRADE, Srbija). Kao događaj od interesa posmatrani su potreba za intenzivnom negom i smrtni ishod u toku hospitalizacije.
Rezultati: Prevalneca hipovitaminoze D na prijemu bila je 27,7%. Pacijenti sa smrtnim ishodom I potrebom za prijem u jedinicu intenzivne nege značajno češće su imali hipovitaminozu D u odnosu na preživele i pacijente sa standardnim nivoom nege. Dodatno, koncentracija vitamina D < 20 ng/mL bila je nezavistan prediktor mortaliteta (aOR 2.142), ali ne i potrebe za lečenjem u jedinici intenzivne nege.
Zaključak: Snižena koncentracija vitamina D na prijemu može biti značajan prediktor ishoda hospitalizovanih COVID-19 pacijenata.
Reference
References:
1. Shi K, Liu Y, Zhang Q, Ran CP, Hou J, Zhang Y, Wang XB. Severe Type of COVID-19: Pathogenesis, Warning Indicators and Treatment. Chin J Integr Med. 2022 Jan;28(1):3-11. doi: 10.1007/s11655-021-3313-x. Epub 2021 Dec 28. https://link.springer.com/article/10.1007/s11655-021-3313-x
2. Chiodini I, Gatti D, Soranna D, Merlotti D, Mingiano C, Fassio A, Adami G, Falchetti A, Eller-Vainicher C, Rossini M, Persani L, Zambon A, Gennari L. Vitamin D Status and SARS-CoV-2 Infection and COVID-19 Clinical Outcomes. Front Public Health. 2021 Dec 22;9:736665. doi: 10.3389/fpubh.2021.736665 https://pubmed.ncbi.nlm.nih.gov/35004568/
3. World Health Organisation. COVID-19 Clinical Management: Living Guidance. 2021. Available online: https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1 (accessed on 25 January 2023). https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-2
4. Bilezikian JP, Bikle D, Hewison M, Lazaretti-Castro M, Formenti AM, Gupta A, Madhavan MV, Nair N, Babalyan V, Hutchings N, Napoli N, Accili D, Binkley N, Landry DW, Giustina A. MECHANISMS IN ENDOCRINOLOGY: Vitamin D and COVID-19. Eur J Endocrinol. 2020 Nov;183(5):R133-R147. doi: 10.1530/EJE-20-0665. https://pubmed.ncbi.nlm.nih.gov/32755992/
5. Mercola J, Grant WB, Wagner CL. Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity. Nutrients. 2020 Oct 31;12(11):3361. doi: 10.3390/nu12113361.. https://pubmed.ncbi.nlm.nih.gov/33142828/
6. Charoenngam N, Holick MF. Immunologic Effects of Vitamin D on Human Health and Disease. Nutrients. 2020 Jul 15;12(7):2097. doi: 10.3390/nu12072097. https://pubmed.ncbi.nlm.nih.gov/32679784/
7. Kaya MO, Pamukçu E, Yakar B. The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies. Epidemiol Health. 2021;43:e2021074. doi: 10.4178/epih.e2021074. Epub 2021 Sep 23. https://pubmed.ncbi.nlm.nih.gov/34607398/
8. Teshome A, Adane A, Girma B, Mekonnen ZA. The Impact of Vitamin D Level on COVID-19 Infection: Systematic Review and Meta-Analysis. Front Public Health. 2021 Mar 5;9:624559. doi: 10.3389/fpubh.2021.624559. https://pubmed.ncbi.nlm.nih.gov/33748066/
9. Chen J, Mei K, Xie L, Yuan P, Ma J, Yu P, Zhu W, Zheng C, Liu X. Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs. Nutr J. 2021 Oct 31;20(1):89. doi: 10.1186/s12937-021-00744-y. https://pubmed.ncbi.nlm.nih.gov/34719404/
10. Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, Salazar-Mather TP, Dumenco L, Savaria MC, Aung SN, Flanigan T, Michelow IC. Predictors of COVID-19 severity: A literature review. Rev Med Virol. 2021 Jan;31(1):1-10. doi: 10.1002/rmv.2146. Epub 2020 Jul 30. https://pubmed.ncbi.nlm.nih.gov/32845042/
11. Djaharuddin I, Munawwarah S, Nurulita A, Ilyas M, Tabri NA, Lihawa N. Comorbidities and mortality in COVID-19 patients. Gac Sanit. 2021;35 Suppl 2:S530-S532. doi:10.1016/j.gaceta.2021.10.085 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8677356/
12. Name JJ, Souza ACR, Vasconcelos AR, Prado PS, Pereira CPM. Zinc, Vitamin D and Vitamin C: Perspectives for COVID-19 With a Focus on Physical Tissue Barrier Integrity. Front Nutr. 2020 Dec 7;7:606398. doi: 10.3389/fnut.2020.606398. https://pubmed.ncbi.nlm.nih.gov/33365326/
13. Borsche L, Glauner B, von Mendel J. COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3: Results of a Systematic Review and Meta-Analysis. Nutrients. 2021 Oct 14;13(10):3596. doi: 10.3390/nu13103596. https://pubmed.ncbi.nlm.nih.gov/34684596/
14. Zappulo F, Cappuccilli M, Cingolani A, Scrivo A, Chiocchini ALC, Nunzio MD, Donadei C, Napoli M, Tondolo F, Cianciolo G, La Manna G. Vitamin D and the Kidney: Two Players, One Console. Int J Mol Sci. 2022 Aug 15;23(16):9135. doi: 10.3390/ijms23169135. https://www.mdpi.com/1422-0067/23/16/9135
15. Petrelli F, Luciani A, Perego G, Dognini G, Colombelli PL, Ghidini A. Therapeutic and prognostic role of vitamin D for COVID-19 infection: A systematic review and meta-analysis of 43 observational studies. J Steroid Biochem Mol Biol. 2021;211:105883. doi:10.1016/j.jsbmb.2021.105883 https://pubmed.ncbi.nlm.nih.gov/33775818/