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0 0.5 1 1.5 2+ Mortality 53% Improvement Relative Risk Ventilation 19% ICU admission 33% Vitamin D for COVID-19  Asghar et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 91 patients in Pakistan Lower mortality with higher vitamin D levels (p=0.046) Asghar et al., Am. J. Trop. Med. Hyg., Nov 2021 Favors vitamin D Favors control

Evaluation of Vitamin-D Status and Its Association with Clinical Outcomes Among COVID-19 Patients in Pakistan

Asghar et al., Am. J. Trop. Med. Hyg., doi:10.4269/ajtmh.21-0577
Nov 2021  
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Retrospective 91 hospitalized patients in Pakistan, showing vitamin D deficiency associated with mortality in multivariate Cox regression.
This is the 102nd of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion).
risk of death, 53.1% lower, HR 0.47, p = 0.046, high D levels (≥10ng/mL) 73, low D levels (<10ng/mL) 18, inverted to make HR<1 favor high D levels (≥10ng/mL), multivariate Cox regression.
risk of mechanical ventilation, 19.4% lower, HR 0.81, p = 0.32, high D levels (≥10ng/mL) 5 of 73 (6.8%), low D levels (<10ng/mL) 6 of 18 (33.3%), NNT 3.8, adjusted per study, inverted to make HR<1 favor high D levels (≥10ng/mL), multivariate Cox regression.
risk of ICU admission, 32.9% lower, HR 0.67, p = 0.54, high D levels (≥10ng/mL) 73, low D levels (<10ng/mL) 18, inverted to make HR<1 favor high D levels (≥10ng/mL), multivariate Cox regression.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Asghar et al., 10 Nov 2021, retrospective, Pakistan, peer-reviewed, 8 authors.
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This PaperVitamin DAll
Evaluation of Vitamin-D Status and Its Association with Clinical Outcomes Among COVID-19 Patients in Pakistan
Muhammad Sohaib Asghar, Farah Yasmin, Kartik Dapke, Syed Muhammad Ismail Shah, Muhammad Daim Bin Zafar, Anosh Aslam Khan, Osama Mohiuddin, Salim Surani
The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.21-0577
The risk of acute respiratory tract infections is particularly pronounced in patients deficient in 25-hydroxyvitamin D (25(OH)D). With respect to COVID-19, there are conflicting evidence on the association of 25(OH)D levels with disease severity. We undertook this study to evaluate the 25(OH)D status in COVID-19 patients admitted in Karachi, Pakistan, and associated vitamin D deficiency with primary outcomes of mortality, length of stay, intubation, and frequency of COVID-19 symptoms. A total of 91 patients were evaluated for 25(OH)D status during their COVID-19 disease course. 25-hydroxyvitamin D levels were classified as deficient (, 10 ng/mL), insufficient (10-30 ng/mL), or sufficient (. 30 ng/mL). The study population comprised 68.1% males (N 5 62). The mean age was 52.6 6 15.7 years. Vitamin D deficiency was significantly associated with intensive care unit (ICU) admission (RR: 3.20; P 5 0.048), invasive ventilation (RR: 2.78; P 5 0.043), persistent pulmonary infiltrates (RR: 7.58; P , 0.001), and death (RR: 2.98; P , 0.001) on univariate Cox regression. On multivariate Cox regression, only death (RR: 2.13; P 5 0.046) and persistent pulmonary infiltrates (RR: 6.78; P 5 0.009) remained significant after adjustment for confounding factors. On Kaplan Meier curves, vitamin D deficient patients had persistent pulmonary infiltrates and a greater probability of requiring mechanical ventilation than patients with 25(OH)D $ 10 ng/mL. Mechanical ventilation had to be initiated early in the deficient group during the 30-day hospital stay (Chi-square: 4.565, P 5 0.033). Patients with 25(OH)D $ 10 ng/mL also demonstrated a higher probability of survival than those with 25(OH)D concentrations , 10 ng/mL. 25-hydroxyvitamin D deficient population had longer hospital stays and worse outcomes.
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