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All Studies   Meta Analysis    Recent:   

Assessment of vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate cancer using electronic medical records

Galaznik et al., Journal of Clinical Oncology, doi:10.1200/JCO.2021.39.15_suppl.6589
May 2021  
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0 0.5 1 1.5 2+ Case 35% Improvement Relative Risk Case (b) 32% Vitamin D for COVID-19  Galaznik et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 16,287 patients in the USA Fewer cases with higher vitamin D levels (p=0.012) c19early.org Galaznik et al., J. Clinical Oncology, May 2021 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 16,287 breast cancer and 14,919 prostate cancer showing increased risk of COVID-19 cases with vitamin D deficiency.
This is the 68th 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).
risk of case, 35.1% lower, OR 0.65, p = 0.01, high D levels 13,903, low D levels 2,384, adjusted per study, inverted to make OR<1 favor high D levels, breast cancer patients, logistic regression, RR approximated with OR.
risk of case, 32.4% lower, OR 0.68, p = 0.045, high D levels 13,601, low D levels 1,318, adjusted per study, inverted to make OR<1 favor high D levels, prostate cancer patients, logistic regression, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Galaznik et al., 28 May 2021, retrospective, USA, preprint, 6 authors.
This PaperVitamin DAll
Abstract: Assessment of Vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate cancer using Electronic Medical Records Aaron Galaznik, MD MBA1 | Emelly Rusli, MPH1 | Vicki Wing, MS1 | Rahul Jain, PhD1 | Sheila Diamond, MS CGC1 | David Fajgenbaum, MD MBA MSc FCPP2 1 Medidata Acorn AI, a Dassault Systèmes company, New York, NY, 10014 | 2 Castleman Disease Collaborative Network and the University of Pennsylvania, Philadelphia, PA, 19104 RESULTS BACKGROUND BACKGROUND • • While patients with cancer are known to be at increased risk of infection in part due to the immunocompromising nature of cancer treatments, recent data indicate a particularly high risk for COVID-19 infection and poor outcomes. 1 • Our study suggests potentially vulnerable populations, such as breast and prostate cancer patients, may have an elevated risk of COVID-19 infection if vitamin D deficient. Vitamin D deficiency has been previously reported in two leading causes of cancer deaths: breast and prostate. 4 • In this study, we performed a retrospective cohort analysis on nationally representative electronic medical records (EMR) to assess whether vitamin D deficiency affects risk of COVID19 among these patients. Vitamin D may play an important role in COVID-19. A recent study demonstrated vitamin D deficiency may increase risk of COVID-19 infection, and a small randomized controlled trial in Spain reported significant improvement in mortality among hospitalized patients treated with calcifediol. 2,3 METHODS Figure 1. Study Timeline • A total of 16,287 breast cancer and 14,919 prostate cancer patients were included in the study. (Figure 2) Table 1. Patient Demographic and Clinical Characteristics Breast Cancer TOTAL (N = 16,287) Patient Characteristics N/Mean %/SD N/Mean %/SD 68.9 11.3 73.6 8.5 <70 years (n, %) 7,962 48.9% 4,625 31.0% 70-79 years (n, %) 5,368 33.0% 6,499 43.6% 80+ years (n, %) 2,957 18.2% 3,795 25.4% 16,287 100.0% 0 0.0% 0 13,805 2,102 305 16 49 10 0.0% 84.8% 12.9% 1.9% 0.1% 0.3% 0.1% 14,919 12,390 2,405 89 12 22 1 100.0% 83.1% 16.1% 0.6% 0.1% 0.1% 0.0% 2,384 14.6% 1,318 8.8% 1.1 1.5 1.4 1.7 Congestive heart failure (n, %) 1,075 6.60% 1,483 9.94% Obesity (n, %) 5,036 30.9% 4,627 31.0% Diabetes mellitus (n, %) 3,327 20.4% 3,897 26.1% 356 2.2% 303 2.0% 1,730 10.6% 2,371 15.9% Age (Mean, SD) Sex (n, %) Female Male White Race (n, %) Black Asian Native Hawaiian/Pacific Islander American Indian or Alaska Native Missing Vitamin D deficient (n, %) Comorbid Conditions Quan Charlson Comorbidity Index (Mean, SD) Liver disease (n, %) Figure 2. Patient Attrition Patient with ≥ 1 encounter between 3/1/2018 and 3/1/2019, and after 3/1/2020 (index date) Age ≥ 18 and non-missing sex and race n = 1,630,384 (52.8%) • • • Patients with breast (female) or prostate (male) cancer were identified between 3/1/2018 and 3/1/2020 from Healthjump EMR data provided pro-bono by the COVID-19 Research Database.5 Logistic regressions, adjusted for baseline demographic and clinical characteristics assessed in the 12 months prior to 3/1/2020, were conducted to estimate the effect of • • The average age was 68.9 years in the breast cancer cohort and 73.6 years in the prostate cancer cohort. (Table 1) • Approximately 15% of the breast cancer cohort and 9% of the prostate cancer cohort had vitamin D deficiency. • The most common comorbid conditions were obesity (approximately a third..
{ 'indexed': { 'date-parts': [[2021, 12, 16]], 'date-time': '2021-12-16T01:13:47Z', 'timestamp': 1639617227727}, 'reference-count': 0, 'publisher': 'American Society of Clinical Oncology (ASCO)', 'issue': '15_suppl', 'funder': [{'name': 'None'}], 'content-domain': {'domain': ['ascopubs.org'], 'crossmark-restriction': True}, 'short-container-title': ['JCO'], 'published-print': {'date-parts': [[2021, 5, 20]]}, 'abstract': '<jats:p> 6589 </jats:p><jats:p> Background: While patients with cancer are known to be at ' 'increased risk of infection in part due to the immunocompromising nature of cancer ' 'treatments, recent data indicate a particularly high risk for COVID-19 infection and poor ' 'outcomes (Wang et\xa0al., 2020). A recent study (Meltzer et\xa0al., 2020) demonstrated ' 'Vitamin D deficiency may increase risk of COVID-19 infection, and a small randomized ' 'controlled trial in Spain reported significant improvement in mortality among hospitalized ' 'patients treated with calcifediol. Vitamin D deficiency has been reported in two leading ' 'causes of cancer deaths: breast and prostate. In this study, we performed a retrospective ' 'cohort analysis on nationally representative electronic medical records (EMR) to assess ' 'whether Vitamin D deficiency affects risk of COVID-19 among these patients. Methods: Patients ' 'with breast (female) or prostate (male) cancer were identified between 3/1/2018 and 3/1/2020 ' 'from EMR data provided pro-bono by the COVID-19 Research Database ( ' 'covid19researchdatabase.org ). Patients with an ICD-10 code for Vitamin D deficiency or &lt; ' '20ng/mL 20(OH)D laboratory result within 12 months prior to 3/1/2020 were classified as ' 'Vitamin D deficient. COVID-19 diagnosis was defined using ICD-10 codes and laboratory results ' 'for COVID-19 at any time after 3/1/2020. Logistic regressions, adjusting for baseline ' 'demographic and clinical characteristics, were conducted to estimate the effect of Vitamin D ' 'deficiency on COVID-19 incidence in each cancer cohort. Results: A total of 16,287 breast ' 'cancer and 14,919 prostate cancer patients were included in the study. The average age was ' '68.9 years in the breast cancer cohort and 73.6 years in the prostate cancer cohort. The ' 'breast cancer cohort consisted of 85% Whites, 13% Black or African Americans, and less than ' '5% of other races. A similar race distribution was observed in the prostate cancer cohort. ' 'Unadjusted analysis showed the risk of COVID-19 was higher among Vitamin D deficient patients ' 'compared to non-deficient patients in both cohorts (breast: OR = 1.60 [95% C.I.: 1.15, 2.20]; ' 'prostate: OR = 1.59 [95% C.I.: 1.08, 2.33]). Similar findings were observed when assessed in ' 'subgroups of patients with newly diagnosed cancer in the dataset, as well as after adjusting ' 'for baseline characteristics. Conclusions: Our study suggests breast and prostate cancer ' 'patients may have an elevated risk of COVID-19 infection if Vitamin D deficient. These ' 'results support findings by Meltzer et\xa0al., 2020 demonstrating a relationship between ' 'Vitamin D deficiency and COVID-19 infection. While a randomized clinical trial is warranted ' 'to confirm the role for Vitamin D supplementation in preventing COVID-19, our study ' 'underscores the importance of monitoring Vitamin D levels across and within cancer ' 'populations, particularly in the midst of the global COVID-19 pandemic. </jats:p>', 'DOI': '10.1200/jco.2021.39.15_suppl.6589', 'type': 'journal-article', 'created': {'date-parts': [[2021, 6, 2]], 'date-time': '2021-06-02T14:28:38Z', 'timestamp': 1622644118000}, 'page': '6589-6589', 'update-policy': 'http://dx.doi.org/10.1200/crossmark', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': [ 'Assessment of vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate ' 'cancer using electronic medical records.'], 'prefix': '10.1200', 'volume': '39', 'author': [ { 'given': 'Aaron', 'family': 'Galaznik', 'sequence': 'first', 'affiliation': [ { 'name': 'Acorn AI By Medidata, a Dassault Systèmes Company, New York, ' 'NY;'}]}, { 'given': 'Emelly', 'family': 'Rusli', 'sequence': 'additional', 'affiliation': [ { 'name': 'Acorn AI By Medidata, a Dassault Systèmes Company, New York, ' 'NY;'}]}, { 'given': 'Vicki', 'family': 'Wing', 'sequence': 'additional', 'affiliation': [ { 'name': 'Acorn AI By Medidata, a Dassault Systèmes Company, New York, ' 'NY;'}]}, { 'given': 'Rahul', 'family': 'Jain', 'sequence': 'additional', 'affiliation': [ { 'name': 'Acorn AI By Medidata, a Dassault Systèmes Company, New York, ' 'NY;'}]}, { 'given': 'Sheila', 'family': 'Diamond', 'sequence': 'additional', 'affiliation': [ { 'name': 'Acorn AI By Medidata, a Dassault Systèmes Company, New York, ' 'NY;'}]}, { 'given': 'David', 'family': 'Fajgenbaum', 'sequence': 'additional', 'affiliation': [ { 'name': 'Castleman Disease Collaborative Network and the University of ' 'Pennsylvania, Philadelphia, PA;'}]}], 'member': '233', 'container-title': ['Journal of Clinical Oncology'], 'original-title': [], 'language': 'en', 'deposited': { 'date-parts': [[2021, 6, 3]], 'date-time': '2021-06-03T17:38:14Z', 'timestamp': 1622741894000}, 'score': 1, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 5, 20]]}, 'references-count': 0, 'journal-issue': {'issue': '15_suppl', 'published-print': {'date-parts': [[2021, 5, 20]]}}, 'alternative-id': ['10.1200/JCO.2021.39.15_suppl.6589'], 'URL': 'http://dx.doi.org/10.1200/jco.2021.39.15_suppl.6589', 'relation': {}, 'ISSN': ['0732-183X', '1527-7755'], 'issn-type': [{'value': '0732-183X', 'type': 'print'}, {'value': '1527-7755', 'type': 'electronic'}], 'subject': ['Cancer Research', 'Oncology'], 'published': {'date-parts': [[2021, 5, 20]]}, 'assertion': [ { 'value': '2021-05-28', 'order': 3, 'name': 'published', 'label': 'Published', 'group': {'name': 'publication_history', 'label': 'Publication History'}}]}
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