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Association between Vitamin D Status and Secondary Infections in Patients with Severe COVID-19 Admitted in the Intensive Care Unit of a Tertiary-Level Hospital in Turkey

Batur et al., Diagnostics, doi:10.3390/diagnostics13010059
Dec 2022  
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0 0.5 1 1.5 2+ Mortality 72% Improvement Relative Risk Secondary infection 23% Vitamin D for COVID-19  Batur et al.  ICU PATIENTS Are vitamin D levels associated with COVID-19 outcomes? Retrospective 194 patients in Turkey (March 2020 - June 2021) Lower mortality with higher vitamin D levels (p<0.000001) c19early.org Batur et al., Diagnostics, December 2022 Favors vitamin D Favors control
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
 
*, now known with p < 0.00000000001 from 120 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Retrospective 194 ICU patients and 30 non-COVID-19 patients in Turkey, showing significantly lower vitamin D levels in COVID-19 patients. There was significantly higher COVID-19 mortality with vitamin D deficiency, and significantly higher risk of secondary hospital infections.
Severe COVID-19 patients with vitamin D deficiency may have increased risks due to secondary infections.
This is the 154th of 198 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 361,397 vigintillion).
This study is excluded in the after exclusion results of meta analysis: unadjusted differences between groups.
risk of death, 71.9% lower, RR 0.28, p < 0.001, high D levels (≥20ng/mL) 17 of 76 (22.4%), low D levels (<20ng/mL) 94 of 118 (79.7%), NNT 1.7.
secondary infection, 23.3% lower, RR 0.77, p = 0.03, high D levels (≥20ng/mL) 40 of 76 (52.6%), low D levels (<20ng/mL) 81 of 118 (68.6%), NNT 6.2, growth in culture.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Batur et al., 26 Dec 2022, retrospective, Turkey, peer-reviewed, 2 authors, study period March 2020 - June 2021. Contact: lbatur@biruni.edu.tr (corresponding author).
This PaperVitamin DAll
Association between Vitamin D Status and Secondary Infections in Patients with Severe COVID-19 Admitted in the Intensive Care Unit of a Tertiary-Level Hospital in Turkey
Lutfiye Karcioglu Batur, Suna Koç
Diagnostics, doi:10.3390/diagnostics13010059
There are several studies showing that the vitamin D status can determine risk of COVID-19 infections, severity and mortality from coronavirus disease 2019 . However, the association between vitamin D (25(OH)D) and secondary infections in the prognosis of COVID-19 patients has not been reported yet. The aim was to investigate whether the vitamin D status affects the rates of secondary infections in patients with severe COVID-19 hospitalized in the intensive care unit (ICU) of a tertiary-level hospital in Turkey. The data of 194 patients with diagnosis of severe COVID-19 who were admitted to the ICU from March 2020 to June 2021 and older than 18 years were evaluated in this retrospective study. The patients were divided into two groups according to total serum 25(OH)D level as normal group (≥20 ng/mL) and low group (<20 ng/mL). The 25(OH)D level was low in 118 (60.8%) and normal in 76 (39.2%) patients. The mean age of the low group was significantly higher than that of the normal group (67.02 ± 14.47 vs. 61.70 ± 14.38; p = 0.013). The systolic and diastolic blood pressure as well as the Glasgow coma scale score of the low group were significantly lower than that of the normal group (p = 0.004, 0.002 and 0.001, respectively). The intubation rate and APACHE (Acute Physiology and Chronic Health Evaluation) score of the low group was significantly higher than that of the normal group (p = 0.001). The platelets number and blood pH decreased, and the neutrophil/lymphocyte ratio, procalcitonin, lactate, urea, creatinine and lactate dehydrogenase concentrations increased significantly in the low group (p < 0.05). The mortality rate was 79.7% in the low group and 22.4% in the normal group (p < 0.001). Microbiological growth was observed in 68.6% of the normal group and 52.6% of the normal group (p = 0.025). The number of cultures with resistant bacteria was significantly higher in the low group (25.9%) than that in the normal group (17.5%) (p = 0.035). The severe COVID-19 patients hospitalized with vitamin D deficiency may have increased risks of poor prognosis and mortality due to secondary infections in the ICU.
Author Contributions: L.K.B. designed the study and S.K. collected the patient data. All authors have read and agreed to the published version of the manuscript. Conflicts of Interest: The authors declare no conflict of interest.
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The aim was to investigate whether ' 'the vitamin D status affects the rates of secondary infections in patients with severe ' 'COVID-19 hospitalized in the intensive care unit (ICU) of a tertiary-level hospital in ' 'Turkey. The data of 194 patients with diagnosis of severe COVID-19 who were admitted to the ' 'ICU from March 2020 to June 2021 and older than 18 years were evaluated in this retrospective ' 'study. The patients were divided into two groups according to total serum 25(OH)D level as ' 'normal group (≥20 ng/mL) and low group (&lt;20 ng/mL). The 25(OH)D level was low in 118 ' '(60.8%) and normal in 76 (39.2%) patients. The mean age of the low group was significantly ' 'higher than that of the normal group (67.02 ± 14.47 vs. 61.70 ± 14.38; p = 0.013). The ' 'systolic and diastolic blood pressure as well as the Glasgow coma scale score of the low ' 'group were significantly lower than that of the normal group (p = 0.004, 0.002 and 0.001, ' 'respectively). The intubation rate and APACHE (Acute Physiology and Chronic Health ' 'Evaluation) score of the low group was significantly higher than that of the normal group (p ' '= 0.001). The platelets number and blood pH decreased, and the neutrophil/lymphocyte ratio, ' 'procalcitonin, lactate, urea, creatinine and lactate dehydrogenase concentrations increased ' 'significantly in the low group (p &lt; 0.05). The mortality rate was 79.7% in the low group ' 'and 22.4% in the normal group (p &lt; 0.001). Microbiological growth was observed in 68.6% of ' 'the normal group and 52.6% of the normal group (p = 0.025). The number of cultures with ' 'resistant bacteria was significantly higher in the low group (25.9%) than that in the normal ' 'group (17.5%) (p = 0.035). 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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