Vitamin D deficiency, secondary hyperparathyroidism and respiratory insufficiency in hospitalized patients with COVID-19
Mazziotti et al.
, Vitamin D deficiency, secondary hyperparathyroidism and respiratory insufficiency in hospitalized patients..
, J Endocrinol. Invest., doi:10.1007/s40618-021-01535-2
Retrospective 348 hospitalized patients in Italy showing vitamin D deficiency associated with acute hypoxemic respiratory failure. Vitamin D supplementation during hospitalization was not significantly associated with mortality or ventilation.
risk of death, 19.0% lower, OR 0.81, p = 0.49, treatment 116, control 232, supplementation, RR approximated with OR.
risk of mechanical ventilation, 67.0% higher, OR 1.67, p = 0.08, treatment 116, control 232, supplementation, RR approximated with OR.
risk of death, 2.4% lower, RR 0.98, p = 0.91, high D levels 187, low D levels 161, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >12ng/mL, control prevalance approximated with overall prevalence, outcome based on serum levels.
risk of acute hypoxemic respiratory failure, 37.0% lower, RR 0.63, p = 0.006, high D levels 72 of 187 (38.5%), low D levels 97 of 161 (60.2%), NNT 4.6, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >12ng/mL, outcome based on serum levels.
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Mazziotti et al., 5 Mar 2021, retrospective, Italy, peer-reviewed, 11 authors, dosage varies.
Abstract: Journal of Endocrinological Investigation (2021) 44:2285–2293
Vitamin D deficiency, secondary hyperparathyroidism and respiratory
insufficiency in hospitalized patients with COVID‑19
G. Mazziotti1,2 · E. Lavezzi2 · A. Brunetti1,2 · M. Mirani2 · G. Favacchio2 · A. Pizzocaro2 · M. T. Sandri3 · A. Di Pasquale4 ·
A. Voza5 · M. Ciccarelli4 · A. G. Lania1,2 · Humanitas COVID19 Task Force
Received: 4 January 2021 / Accepted: 11 February 2021 / Published online: 5 March 2021
© Italian Society of Endocrinology (SIE) 2021
Purpose Hypovitaminosis D has emerged as potential risk factor for severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection in the general population with variable effects on the outcome of the coronavirus disease-19 (COVID-19).
The aim of this retrospective single-center study was to investigate the impact of hypovitaminosis D and secondary hyperparathyroidism on respiratory outcomes of COVID-19.
Methods Three-hundred-forty-eight consecutive patients hospitalized for COVID-19 at the IRCCS Humanitas Research
Hospital, Rozzano, Milan (Italy) were evaluated for arterial partial pressure oxygen (PaO2)/fraction of inspired oxygen
(FiO2) ratio, serum 25hydroxy-vitamin D [25(OH)D], parathyroid hormone (PTH) and inflammatory parameters at study
entry and need of ventilation during the hospital stay.
Results In the entire population, vitamin D deficiency (i.e., 25(OH)D values < 12 ng/mL) was significantly associated with
acute hypoxemic respiratory failure at the study entry [adjusted odds ratio (OR) 2.48, 95% confidence interval 1.29–4.74;
P = 0.006], independently of age and sex of subjects, serum calcium and inflammatory parameters. In patients evaluated for
serum PTH (97 cases), secondary hyperparathyroidism combined with vitamin D deficiency was significantly associated with
acute hypoxemic respiratory failure at study entry (P = 0.001) and need of ventilation during the hospital stay (P = 0.031).
Conclusion This study provides evidence that vitamin D deficiency, when associated with secondary hyperparathyroidism,
may negatively impact the clinical outcome of SARS-CoV-2-related pneumonia.
Keywords PTH · Vitamin D · Hyperparathyroidism · Vitamin D deficiency · COVID-19 · SARS-CoV-2 infection ·
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