Xavier Nogues1,2, Diana Ovejero1,2, Marta Pineda-Moncusí1, Roger Bouillon3, Dolors Arenas4, Julio Pascual4, Anna Ribes1, Robert Guerri-Fernandez1,5, Judit Villar-Garcia5, Abora Rial2, Carme Gimenez-Argente2, Maria Lourdes Cos2, Jaime Rodriguez-Morera2, Isabel Campodarve2, José Manuel Quesada-Gomez6, Natalia Garcia-Giralt1. 1. IMIM (Hospital del Mar Medical Research Institute), Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain. 2. Internal Medicine Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain. 3. Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Herestraat, Leuven, Belgium. 4. Department of Nephrology, Hospital del Mar-IMIM, Barcelona, Spain. 5. Department of Infectious Diseases, Hospital del Mar-IMIM, Barcelona, Spain. 6. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC). Fundación Progreso y Salud. CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES). Hospital Universitario Reina Sofía. Universidad de Córdoba. Menéndez Pidal s/n, Córdoba, Spain.
Abstract
CONTEXT: COVID-19 is a major health problem because of saturation of intensive care units (ICU) and mortality. Vitamin D has emerged as a potential treatment able to reduce the disease severity. OBJECTIVE: To elucidate the effect of calcifediol [25OHD3] treatment on COVID-19-related outcomes. DESIGN: Observational cohort study from March to May, 2020. SETTING: Patients admitted to COVID-19 wards of Hospital del Mar, Barcelona, Spain. PATIENTS: A total of 930 patients with COVID-19 were included. Ninety-two were excluded due to previous calcifediol intake. INTERVENTION: Of the remaining 838, a total of 447 received calcifediol (532ug on day one plus 266ug on day 3, 7, 15, and 30) whereas 391 were not treated at the time of hospital admission (Intention-to-Treat). Of the latter, 53 patients were treated later during ICU admission and were allocated in the treated group in a second analysis. In healthy subjects, calcifediol is about 3.2-fold more potent on a weight basis than cholecalciferol. MAIN OUTCOME MEASURES: ICU admission and mortality. RESULTS: ICU assistance was required by 102 (12.2%) participants. Out of 447 patients treated with calcifediol at admission, 20 (4.5%) required ICU, compared to 82 (21%) out of 391 non-treated (p-value<0.0001). Logistic regression of calcifediol treatment on ICU admission, adjusted by age, gender, linearized 25OHD levels at baseline, and comorbidities showed that treated patients had a reduced risk to require ICU (OR 0.13 [95% CI 0.07;0.23]). Overall mortality was 10%. In the Intention-to-Treat analysis, 21 (4.7%) out of 447 patients treated with calcifediol at admission died compared to 62 patients (15.9%) out of 391 non-treated (p=0.0001). Adjusted results showed a reduced mortality risk with an OR 0.21 [95% CI 0.10; 0.43]). In the second analysis, the obtained OR was 0.52 [95% CI 0.27;0.99]. CONCLUSIONS: In patients hospitalized with COVID-19, calcifediol treatment significantly reduced ICU admission and mortality.
CONTEXT: COVID-19 is a major health problem because of saturation of intensive care units (ICU) and mortality. Vitamin D has emerged as a potential treatment able to reduce the disease severity. OBJECTIVE: To elucidate the effect of calcifediol [25OHD3] treatment on COVID-19-related outcomes. DESIGN: Observational cohort study from March to May, 2020. SETTING:Patients admitted to COVID-19 wards of Hospital del Mar, Barcelona, Spain. PATIENTS: A total of 930 patients with COVID-19 were included. Ninety-two were excluded due to previous calcifediol intake. INTERVENTION: Of the remaining 838, a total of 447 received calcifediol (532ug on day one plus 266ug on day 3, 7, 15, and 30) whereas 391 were not treated at the time of hospital admission (Intention-to-Treat). Of the latter, 53 patients were treated later during ICU admission and were allocated in the treated group in a second analysis. In healthy subjects, calcifediol is about 3.2-fold more potent on a weight basis than cholecalciferol. MAIN OUTCOME MEASURES: ICU admission and mortality. RESULTS: ICU assistance was required by 102 (12.2%) participants. Out of 447 patients treated with calcifediol at admission, 20 (4.5%) required ICU, compared to 82 (21%) out of 391 non-treated (p-value<0.0001). Logistic regression of calcifediol treatment on ICU admission, adjusted by age, gender, linearized 25OHD levels at baseline, and comorbidities showed that treated patients had a reduced risk to require ICU (OR 0.13 [95% CI 0.07;0.23]). Overall mortality was 10%. In the Intention-to-Treat analysis, 21 (4.7%) out of 447 patients treated with calcifediol at admission died compared to 62 patients (15.9%) out of 391 non-treated (p=0.0001). Adjusted results showed a reduced mortality risk with an OR 0.21 [95% CI 0.10; 0.43]). In the second analysis, the obtained OR was 0.52 [95% CI 0.27;0.99]. CONCLUSIONS: In patients hospitalized with COVID-19, calcifediol treatment significantly reduced ICU admission and mortality.
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Authors: Iacopo Chiodini; Davide Gatti; Davide Soranna; Daniela Merlotti; Christian Mingiano; Angelo Fassio; Giovanni Adami; Alberto Falchetti; Cristina Eller-Vainicher; Maurizio Rossini; Luca Persani; Antonella Zambon; Luigi Gennari Journal: Front Public Health Date: 2021-12-22
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Authors: John P Bilezikian; Anna Maria Formenti; Robert A Adler; Neil Binkley; Roger Bouillon; Marise Lazaretti-Castro; Claudio Marcocci; Nicola Napoli; Rene Rizzoli; Andrea Giustina Journal: Rev Endocr Metab Disord Date: 2021-12-23 Impact factor: 6.514