Real world evidence of calcifediol or vitamin D prescription and mortality rate of COVID-19 in a retrospective cohort of hospitalized Andalusian patients
Loucera et al.,
Real world evidence of calcifediol or vitamin D prescription and mortality rate of COVID-19 in a retrospective..,
Scientific Reports, doi:10.1038/s41598-021-02701-5 (date from earlier preprint)
Retrospective 15,968 hospitalized patients in Spain showing a significant reduction in mortality associated with the prescription of vitamin D, especially calcifediol, within 15-30 days prior to hospitalization.
risk of death, 33.0% lower, HR 0.67, p = 0.009, treatment 374, control 374, calcifediol, <15 days before hospitalization, Cox model with inverse propensity weighting.
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risk of death, 27.0% lower, HR 0.73, p = 0.02, treatment 439, control 439, calcifediol, <30 days before hospitalization, Cox model with inverse propensity weighting.
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risk of death, 25.0% lower, HR 0.75, p = 0.005, treatment 570, control 570, cholecalciferol, <15 days before hospitalization, Cox model with inverse propensity weighting.
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risk of death, 12.0% lower, HR 0.88, p = 0.11, treatment 802, control 802, cholecalciferol, <30 days before hospitalization, Cox model with inverse propensity weighting.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Loucera et al., 29 Apr 2021, retrospective, propensity score matching, Spain, peer-reviewed, 11 authors, dosage varies (calcifediol).
Abstract: www.nature.com/scientificreports
OPEN
Real world evidence of calcifediol
or vitamin D prescription
and mortality rate of COVID‑19
in a retrospective cohort
of hospitalized Andalusian patients
Carlos Loucera1,2, María Peña‑Chilet1,2,3, Marina Esteban‑Medina1,2,
Dolores Muñoyerro‑Muñiz4, Román Villegas4, Jose Lopez‑Miranda5,6,
Jesus Rodriguez‑Baño2,7,8, Isaac Túnez9,10,11,12, Roger Bouillon13, Joaquin Dopazo1,2,3,14* &
Jose Manuel Quesada Gomez10,15*
COVID-19 is a major worldwide health problem because of acute respiratory distress syndrome, and
mortality. Several lines of evidence have suggested a relationship between the vitamin D endocrine
system and severity of COVID-19. We present a survival study on a retrospective cohort of 15,968
patients, comprising all COVID-19 patients hospitalized in Andalusia between January and November
2020. Based on a central registry of electronic health records (the Andalusian Population Health
Database, BPS), prescription of vitamin D or its metabolites within 15–30 days before hospitalization
were recorded. The effect of prescription of vitamin D (metabolites) for other indication previous to
the hospitalization was studied with respect to patient survival. Kaplan–Meier survival curves and
hazard ratios support an association between prescription of these metabolites and patient survival.
Such association was stronger for calcifediol (Hazard Ratio, HR = 0.67, with 95% confidence interval,
CI, of [0.50–0.91]) than for cholecalciferol (HR = 0.75, with 95% CI of [0.61–0.91]), when prescribed
15 days prior hospitalization. Although the relation is maintained, there is a general decrease of this
effect when a longer period of 30 days prior hospitalization is considered (calcifediol HR = 0.73, with
95% CI [0.57–0.95] and cholecalciferol HR = 0.88, with 95% CI [0.75, 1.03]), suggesting that association
was stronger when the prescription was closer to the hospitalization.
1
Clinical Bioinformatics Area, Fundación Progreso y Salud (FPS), CDCA, Hospital Virgen del Rocio, 41013 Seville,
Spain. 2Institute of Biomedicine of Seville (IBIS), Hospital Virgen del Rocio, 41013 Seville, Spain. 3Bioinformatics
in Rare Diseases (BiER), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), FPS,
Hospital Virgen del Rocio, 41013 Seville, Spain. 4Subdirección Técnica Asesora de Gestión de la Información,
Servicio Andaluz de Salud, Seville, Spain. 5Internal Medicine Department, IMIBIC/Reina Sofia University
Hospital/University of Cordoba, 14004 Córdoba, Spain. 6CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN),
Instituto de Salud Carlos III, 28029 Madrid, Spain. 7Unidad Clínica de Enfermedades Infecciosas, Microbiología
y Medicina Preventiva, Hospital Universitario Virgen Macarena, Seville, Spain. 8Departamento de Medicina,
Universidad de Sevilla, Seville, Spain. 9Departamento de Bioquimica y Biología Molecular, Facultad de Medicina
y Enfermería, Universidad de Córdoba, Córdoba, Spain. 10Instituto Maimónides de Investigacion Biomédica de
Córdoba (IMIBIC), 14004 Córdoba, Spain. 11G. Técnico de Expertos de Andalucía para Estudios de Suplementos
e Intervención Nutricional Frente a Covid-19, SGIDIS, Consejería de Salud y Familias, Junta de Andalucia, Seville,
Spain. 12Secretaria General de Investigación, Desarrollo e Innovación en Salud, Consejería de Salud y Familias de
la Junta de Andalucía, Seville, Spain. 13Clinical and Experimental Endocrinology, Department of Chronic Diseases
and Metabolism,..
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