Bad Prognosis in Critical Ill Patients with COVID-19 during Short-Term ICU Stay regarding Vitamin D Levels
Lourdes Herrera-Quintana, Yenifer Gamarra-Morales, Héctor Vázquez-Lorente, Jorge Molina-López, José Castaño-Pérez, Juan Francisco Machado-Casas, Ramón Coca-Zúñiga, José Miguel Pérez-Villares, Elena Planells
Nutrients, doi:10.3390/nu13061988
Background and aims: Vitamin D inadequacy may be involved in the mechanisms of SARS-CoV-2 infection and in potential risk factors for disease propagation or control of coronavirus disease 2019 (COVID-19). This study assessed a short-term evolution of vitamin D status and its influence upon different clinical parameters in critically ill patients with COVID-19. Methods: A prospective analytical study in which 37 critically ill volunteers between 41 and 71 years of age with COVID-19 were evaluated at baseline and three days of intensive care unit (ICU) stay. 25-OH-D 3 and 25-OH-D 2 were analyzed by liquid chromatography-tandem mass spectrometry and total 25-OH-D levels were calculated as the sum of both. Results: All patients presented low 25-OH-D levels at baseline, decreasing total 25-OH-D (p = 0.011) mainly through 25-OH-D 2 (p = 0.006) levels during ICU stay. 25-OH-D 2 levels decreased a mean of 41.6% ± 89.6% versus 7.0% ± 23.4% for the 25-OH-D 3 form during the ICU stay. Patients who did not need invasive mechanical ventilation presented higher levels of 25-OH-D 2 at baseline and follow-up. Lower 25-OH-D and 25-OH-D 3 levels were associated with higher D-dimer at baseline (p = 0.003; p = 0.001) and at follow up (p = 0.029), higher procalcitonin levels (p = 0.002; p = 0.018) at follow up, and lower percentage lymphocyte counts (p = 0.044; p = 0.040) during ICU stay. Conclusions: Deficient vitamin D status in critical patients was established at the admission and further worsened after three days of stay. Lower vitamin D levels were related to key altered clinical and biochemical parameters on patients with SARS-CoV-2 infection. Given the different response of the 25-OH-D 3 and 25-OH-D 2 forms, it would be useful to monitor them on the evolution of the critically ill patient.
Conflicts of Interest: The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
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'abstract': '<jats:p>Background and aims: Vitamin D inadequacy may be involved in the mechanisms of '
'SARS-CoV-2 infection and in potential risk factors for disease propagation or control of '
'coronavirus disease 2019 (COVID-19). This study assessed a short-term evolution of vitamin D '
'status and its influence upon different clinical parameters in critically ill patients with '
'COVID-19. Methods: A prospective analytical study in which 37 critically ill volunteers '
'between 41 and 71 years of age with COVID-19 were evaluated at baseline and three days of '
'intensive care unit (ICU) stay. 25-OH-D3 and 25-OH-D2 were analyzed by liquid '
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'levels decreased a mean of 41.6% ± 89.6% versus 7.0% ± 23.4% for the 25-OH-D3 form during the '
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'procalcitonin levels (p = 0.002; p = 0.018) at follow up, and lower percentage lymphocyte '
'counts (p = 0.044; p = 0.040) during ICU stay. Conclusions: Deficient vitamin D status in '
'critical patients was established at the admission and further worsened after three days of '
'stay. Lower vitamin D levels were related to key altered clinical and biochemical parameters '
'on patients with SARS-CoV-2 infection. Given the different response of the 25-OH-D3 and '
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'link': [ { 'URL': 'https://www.mdpi.com/2072-6643/13/6/1988/pdf',
'content-type': 'unspecified',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2021, 6, 16]],
'date-time': '2021-06-16T01:33:37Z',
'timestamp': 1623807217000},
'score': 1,
'resource': {'primary': {'URL': 'https://www.mdpi.com/2072-6643/13/6/1988'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2021, 6, 9]]},
'references-count': 64,
'journal-issue': {'issue': '6', 'published-online': {'date-parts': [[2021, 6]]}},
'alternative-id': ['nu13061988'],
'URL': 'http://dx.doi.org/10.3390/nu13061988',
'relation': {},
'ISSN': ['2072-6643'],
'subject': ['Food Science', 'Nutrition and Dietetics'],
'container-title-short': 'Nutrients',
'published': {'date-parts': [[2021, 6, 9]]}}
