Vitamin-D levels and intensive care unit outcomes of a cohort of critically ill COVID-19 patients
Orchard et al.,
Vitamin-D levels and intensive care unit outcomes of a cohort of critically ill COVID-19 patients,
Clin Chem Lab Med, doi:10.1515/cclm-2020-1567
Retrospective 165 hospitalized patients with known vitamin D levels, showing an associated between vitamin D deficiency and ICU admission. There was no statistically significant difference in clinical outcomes for ICU patients. It's unclear why authors do not provide clinical outcomes for all patients rather than ICU only.
risk of ICU admission, 58.8% lower, RR 0.41, p = 0.001, high D levels 9 of 40 (22.5%), low D levels 41 of 75 (54.7%), NNT 3.1, all hospitalized patients, >50 nmol/L.
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risk of death, 24.1% lower, RR 0.76, p = 1.00, high D levels 1 of 9 (11.1%), low D levels 6 of 41 (14.6%), NNT 28, ICU patients only, >50 nmol/L.
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risk of mechanical ventilation, 8.9% lower, RR 0.91, p = 0.70, high D levels 6 of 9 (66.7%), low D levels 30 of 41 (73.2%), NNT 15, ICU patients only, >50 nmol/L.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Orchard et al., 19 Jan 2021, retrospective, United Kingdom, peer-reviewed, 7 authors.
Abstract: Clin Chem Lab Med 2021; 59(6): 1155–1163
Laurence Orchard*, Matthew Baldry, Myra Nasim-Mohi, Chantelle Monck, Kordo Saeed,
Michael P. W. Grocott and Dushianthan Ahilanandan on behalf of the University
Hospital Southampton Critical Care Team and the REACT COVID Investigators
Vitamin-D levels and intensive care unit outcomes
of a cohort of critically ill COVID-19 patients
https://doi.org/10.1515/cclm-2020-1567
Received October 21, 2020; accepted December 28, 2020;
published online January 19, 2021
Abstract
Objectives: The pattern of global COVID-19 has caused
many to propose a possible link between susceptibility,
severity and vitamin-D levels. Vitamin-D has known
UHS Critical Care Clinical Team: Dr. Sanjay Gupta, Dr. Julian Nixon,
Professor Michael P W Grocott, Professor Denny ZH Levett, Dr. Michael
Stewart, Dr. Ahilanadan Dushianthan, Dr. David Sparkes, Dr. Robert
Chambers, Dr. Kathleen Nolan, Dr. Suzie Tanser, Dr. Jonathan Fennell,
Dr. Michael Celinski, Dr. Dominic Richardson, Dr. Rebecca Cusack,
Dr. Benjamin Skinner, Dr. Timothy Nicholson-Robert, Dr. Mai
Wakatsuki, Dr. Ben Thomas, Dr. Francois Wessels.
REACT Investigators: Professor Tom Wilkinson, Dr. Anna Freeman,
Dr. Hannah Burke, Dr. Ahilanadan Dushianthan, Dr. Michael Celinski,
Professor James Batchelor, Professor Saul Faust, Professor Gareth
Thomas, Professor Christopher Kip.
*Corresponding author: Dr. Laurence Orchard, General Intensive Care
Unit, University Hospital Southampton NHS Foundation Trust,
Tremona Road, Southampton, UK, Phone: +44 7791190726,
E-mail: laurence.orchard@nhs.net
Matthew Baldry and Myra Nasim-Mohi, General Intensive Care Unit,
University Hospital Southampton NHS Foundation Trust,
Southampton, UK
Chantelle Monck, Southampton Specialist Virology Centre, University
of Southampton School of Medicine, University Hospital Southampton
NHS Foundation Trust, Southampton, UK
Kordo Saeed, Microbiology Innovation and Research Unit, Department
of Microbiology, University Hospital Southampton NHS Foundation
Trust, Southampton, UK; Faculty of Medicine, University of
Southampton University, Hospital Southampton, Southampton, UK
Michael P. W. Grocott and Dushianthan Ahilanandan, General
Intensive Care Unit, University Hospital Southampton NHS Foundation
Trust, Southampton, UK; Faculty of Medicine, University of
Southampton University, Hospital Southampton, Southampton, UK;
and NIHR Southampton Clinical Research Facility and NIHR
Southampton Biomedical Research Centre, University Hospital
Southampton/University of Southampton, Southampton, UK
immune modulatory effects and deficiency has been linked
to increased severity of viral infections.
Methods: We evaluated patients admitted with confirmed
SARS-COV-2 to our hospital between March-June 2020.
Demographics and outcomes were assessed for those
admitted to the intensive care unit (ICU) with normal
(>50 nmol/L) and low (<50 nmol/L) vitamin-D.
Results: There were 646 SARS-COV-2 PCR positive hospitalisations and 165 (25.5%) had plasma vitamin-D
levels. Fifty patients were admitted to ICU. There was no
difference in vitamin-D levels of those hospitalised
(34, IQR 18.5–66 nmol/L) and those admitted to the ICU
(31.5, IQR 21–42 nmol/L). Higher proportion of vitamin-D
deficiency (<50 nmol/L) noted in the ICU group (82.0 vs.
65.2%). Among the ICU patients, low vitamin D level
(<50 nmol/L) was associated with younger age (57 vs. 67
years, p=0.04) and lower cycle threshold (CT) real time
polymerase chain reaction values (RT-PCR)..
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