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The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital

Bayramoğlu et al., European Journal of Pediatrics, doi:10.1007/s00431-021-04030-1
Mar 2021  
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Moderate/severe case 70% Improvement Relative Risk Vitamin D for COVID-19  Bayramoğlu et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 103 patients in Turkey Lower severe cases with higher vitamin D levels (p=0.027) c19early.org Bayramoğlu et al., European J. Pediatr.., Mar 2021 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
Retrospective 103 pediatric hospitalized COVID-19 patients, showing an association between vitamin D deficiency and clinical severity.
This is the 59th of 211 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 248,027,826 vigintillion).
risk of moderate/severe case, 69.5% lower, RR 0.30, p = 0.03, high D levels 10 of 60 (16.7%), low D levels 24 of 43 (55.8%), NNT 2.6, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >12 ng/mL, multivariate logistic regression.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bayramoğlu et al., 31 Mar 2021, retrospective, Turkey, peer-reviewed, 7 authors.
This PaperVitamin DAll
The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital
Elvan Bayramoğlu, Gülşen Akkoç, Ayşe Ağbaş, Özlem Akgün, Kamer Yurdakul, Hatice Nilgün Selçuk Duru, Murat Elevli
European Journal of Pediatrics, doi:10.1007/s00431-021-04030-1
Vitamin D has an immunomodulating property that regulates the inflammatory response. In this study, the aim was to evaluate the relationship between vitamin D levels and clinical severity and inflammation markers in children and adolescents with COVID-19. The clinical and laboratory records of 103 pediatric cases with COVID-19, whose vitamin D levels had been measured, were retrospectively reviewed. The cases were divided into groups according to their clinical severity (asymptomatic, mild, and moderate-to-severe) and vitamin D levels. The moderate-to-severe clinical group had significantly higher inflammation markers (CRP, procalcitonin, fibrinogen, D- dimer) and a lower lymphocyte count compared to both the mild and asymptomatic groups. The 25 OH vitamin D levels were also significantly lower (p < 0.001), and the ratio of vitamin D deficiency was 70.6% in the moderate-to-severe group. The vitamin D-deficient group had a significantly higher age and fibrinogen levels while also having a lower lymphocyte count compared to the insufficient and normal groups. The 25 OH vitamin D level was correlated positively with the lymphocyte count (r = 0.375, p = <0.001), and negatively with age (r = −0.496, p = <0.001), CRP (r = −0.309, p = 0.002) and fibrinogen levels (r = −0.381, p = <0.001). In a logistic regression analysis, vitamin D deficiency, D-dimer, and fibrinogen levels on admission were independent predictors of severe clinical course. Conclusion: This study revealed an association between vitamin D deficiency and clinical severity, in addition to inflammation markers in pediatric COVID-19 cases. Prophylactic vitamin D supplementation may be considered, especially in the adolescent age group.
Authors' contributions EB, GA, and AA design the study. EB, GA, KD, and OA data acquisition. EB and AA performed the statistical analysis. EB, AA, and GA wrote the manuscript. EB, GA, AA, HNSD, and ME reviewed the manuscript. Conflict of interest The authors declare no competing interests. Ethics approval This study was approved by the local ethical committee (Haseki Training and Research Hospital, 2020-56, 14.05.2020). Consent to participate None (retrospective study) Consent for publication All authors consent to the publication of the manuscript in European Journal of Pediatrics, should the article be accepted by the Editor-in-chief upon completion of the refereeing process.
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' 'https://doi.org/10.1128/jvi.00127-20', 'journal-title': 'J Virol'}, { 'issue': '11', 'key': '4030_CR26', 'doi-asserted-by': 'publisher', 'first-page': '1259', 'DOI': '10.1042/cs20200492', 'volume': '134', 'author': 'K Lanza', 'year': '2020', 'unstructured': 'Lanza K, Perez LG, Costa LB, Cordeiro TM, Palmeira VA, Ribeiro VT, ' 'Simões ESAC (2020) Covid-19: the renin-angiotensin system imbalance ' 'hypothesis. Clin Sci (Lond) 134(11):1259–1264. ' 'https://doi.org/10.1042/cs20200492', 'journal-title': 'Clin Sci (Lond)'}, { 'key': '4030_CR27', 'doi-asserted-by': 'crossref', 'unstructured': 'Panarese A, Shahini E (2020) Letter: Covid-19, and vitamin D. 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' 'https://doi.org/10.1016/j.ebiom.2020.102763', 'journal-title': 'EBioMedicine'}, { 'issue': '16', 'key': '4030_CR30', 'doi-asserted-by': 'publisher', 'first-page': '2174', 'DOI': '10.1093/cid/ciaa641', 'volume': '71', 'author': 'X Luo', 'year': '2020', 'unstructured': 'Luo X, Zhou W, Yan X, Guo T, Wang B, Xia H, Ye L, Xiong J, Jiang Z, Liu ' 'Y, Zhang B, Yang W (2020) Prognostic value of C-reactive protein in ' 'patients with COVID-19. Clin Infect Dis 71(16):2174–2179. ' 'https://doi.org/10.1093/cid/ciaa641', 'journal-title': 'Clin Infect Dis'}, { 'issue': '4', 'key': '4030_CR31', 'doi-asserted-by': 'publisher', 'first-page': '23', 'DOI': '10.1530/EJE-18-0736', 'volume': '180', 'author': 'P Lips', 'year': '2019', 'unstructured': 'Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, ' 'Obermayer-Pietsch B, Bianchi ML, Stepan J, El-Hajj Fuleihan G, Bouillon ' 'R (2019) Current vitamin D status in European and Middle East countries ' 'and strategies to prevent vitamin D deficiency: a position statement of ' 'the European Calcified Tissue Society. Eur J Endocrinol 180(4):23–54. ' 'https://doi.org/10.1530/EJE-18-0736', 'journal-title': 'Eur J Endocrinol'}], 'container-title': 'European Journal of Pediatrics', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1007/s00431-021-04030-1.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1007/s00431-021-04030-1/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1007/s00431-021-04030-1.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 7, 16]], 'date-time': '2021-07-16T13:04:57Z', 'timestamp': 1626440697000}, 'score': 1, 'resource': {'primary': {'URL': 'https://link.springer.com/10.1007/s00431-021-04030-1'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 3, 31]]}, 'references-count': 31, 'journal-issue': {'issue': '8', 'published-print': {'date-parts': [[2021, 8]]}}, 'alternative-id': ['4030'], 'URL': 'http://dx.doi.org/10.1007/s00431-021-04030-1', 'relation': {}, 'ISSN': ['0340-6199', '1432-1076'], 'subject': ['Pediatrics, Perinatology and Child Health'], 'container-title-short': 'Eur J Pediatr', 'published': {'date-parts': [[2021, 3, 31]]}, 'assertion': [ { 'value': '22 November 2020', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '8 March 2021', 'order': 2, 'name': 'revised', 'label': 'Revised', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '12 March 2021', 'order': 3, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '31 March 2021', 'order': 4, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'The authors declare no competing interests.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Conflict of interest'}}, { 'value': 'This study was approved by the local ethical committee (Haseki Training and ' 'Research Hospital, 2020-56, 14.05.2020).', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval'}}, { 'value': 'None (retrospective study)', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent to participate'}}, { 'value': 'All authors consent to the publication of the manuscript in European Journal of ' 'Pediatrics, should the article be accepted by the Editor-in-chief upon ' 'completion of the refereeing process.', 'order': 5, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'This content has been made available to all.', 'name': 'free', 'label': 'Free to read'}]}
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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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