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0 0.5 1 1.5 2+ Mortality 54% Improvement Relative Risk Ventilation 8% ICU admission 28% Vitamin D  Guðnadóttir et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 273 patients in Iceland (February 2020 - March 2021) Lower mortality (p=0.15) and ICU admission (p=0.43), not sig. c19early.org Guðnadóttir et al., Clinical Nutrition.., Mar 2024 Favors vitamin D Favors control

High risk of malnutrition among hospitalised coronavirus disease 2019 (COVID-19) patients is associated with mortality and other clinical outcomes

Guðnadóttir et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2024.02.023
Mar 2024  
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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 8 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments. c19early.org
Retrospective 273 hospitalized COVID-19 patients in Iceland showing high risk of malnutrition associated with ICU admission, mechanical ventilation, and mortality. Mortality was higher with vitamin D insufficiency, but this result was not statistically significant.
This is the 194th of 196 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 11,637 vigintillion).
risk of death, 54.3% lower, OR 0.46, p = 0.15, high D levels (≥50nmol/L) 221, low D levels (<50nmol/L) 52, adjusted per study, inverted to make OR<1 favor high D levels (≥50nmol/L), multivariable, RR approximated with OR.
risk of mechanical ventilation, 8.3% lower, OR 0.92, p = 0.86, high D levels (≥50nmol/L) 221, low D levels (<50nmol/L) 52, adjusted per study, inverted to make OR<1 favor high D levels (≥50nmol/L), multivariable, RR approximated with OR.
risk of ICU admission, 28.1% lower, OR 0.72, p = 0.43, high D levels (≥50nmol/L) 221, low D levels (<50nmol/L) 52, adjusted per study, inverted to make OR<1 favor high D levels (≥50nmol/L), multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Guðnadóttir et al., 4 Mar 2024, retrospective, Iceland, peer-reviewed, 4 authors, study period February 2020 - March 2021. Contact: sandradg@landspitali.is.
This PaperVitamin DAll
High risk of malnutrition among hospitalised coronavirus disease 2019 (COVID-19) patients is associated with mortality and other clinical outcomes
Sandra Dögg Guðnadóttir, Ingibjörg Gunnarsdóttir, Ubaldo Benitez Hernandez, Áróra Rós Ingadóttir
Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2024.02.023
Introduction: Increasing evidence indicates an association between nutritional status and Coronavirus disease 2019 (COVID-19) disease severity. The aim of the study was to describe the risk of malnutrition, body mass index (BMI) and vitamin D status of hospitalised COVID-19 patients and assess whether they are associated with duration of hospital stay, intensive care unit (ICU) admission, mechanical ventilation, and mortality. Methods: The study is a descriptive retrospective study of 273 patients with COVID-19 admitted to Hospital from February 2020 to March 2021. Patients were screened for risk of malnutrition using a validated screening tool. BMI was calculated from height and weight. Insufficient Vitamin D status was defined as 25(OH)vitD <50 nmol/L. Logistic regression analysis was used to assess the association between indicators of nutritional status of patients with COVID-19, and outcomes such as duration of stay >7 days, ICU admission, mechanical ventilation, and mortality. Interaction between risk of malnutrition and BMI of 30 kg/m 2 was assessed using the likelihood ratio test with hospital stay, ICU admission, mechanical ventilation, and mortality as outcomes. Results: Screening for risk of malnutrition identified 201 (74%) patients at a medium to high risk of malnutrition. Patients defined as being at a medium or high risk of malnutrition were more likely to be hospitalised for >7 days compared to those defined as low risk (OR: 10.72; 95% CI: 3.9e29.46; p < 0.001 and OR: 61.57; 95% CI: 19.48e194.62; p < 0.001, respectively). All patients who were admitted to ICU (n ¼ 41) and required mechanical ventilation (n ¼ 27) were defined as having medium or high risk of malnutrition. High risk of malnutrition was also associated with increased odds of mortality (OR: 8.87; 955 CI 1.08e72,96; p ¼ 0.042). BMI of 30 kg/m 2 (43%) and 25(OH)vitD <50 nmol/L (20%) were not associated with duration of stay >7 days or mortality, although BMI 30 kg/m 2 was associated with increased risk of ICU admission (OR: 7.12; 95% CI: 1.59e31.94; p ¼ 0.010) and mechanical ventilation (OR: 8.86; 95% CI: 1.12e69.87; p ¼ 0.038). Interactions between risk of malnutrition and BMI 30 kg/m 2 were not significant to explain the outcomes of hospital stay >7 days, ICU admission, mechanical ventilation, or mortality. Conclusion: High risk of malnutrition among hospitalised COVID-19 patients was associated with longer duration of hospital stay, ICU admission, mechanical ventilation and mortality, and BMI 30 kg/m 2 was associated with ICU admission and mechanical ventilation. Insufficient Vitamin D status was not associated with duration of hospital stay, ICU admission, mechanical ventilation, or mortality.
Author contribution Sandra D€ ogg Guðnad ottir: Formal analysis, Investigation, Writing-Original Draft, Visualization, Funding acquisition. Ar ora R os Ingad ottir: Conceptualization, Methodology, Writing e Review and Editing, Visualization, Supervision, Funding acquisition. Ingibj€ org Gunnarsd ottir: Writing e Review and Editing, Visualization, Supervision, Funding acquisition. Ubaldo Benitez Hernandez: Statistical consulting. Declaration of competing interest The authors have no conflict of interest to declare. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi.org/10.1016/j.clnesp.2024.02.023.
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