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0 0.5 1 1.5 2+ Mortality 29% Improvement Relative Risk Vitamin D for COVID-19  Pimental et al.  ICU PATIENTS Are vitamin D levels associated with COVID-19 outcomes? Retrospective 25 patients in Brazil Study underpowered to detect differences Pimental et al., Clinical Nutrition ES.., May 2021 Favors vitamin D Favors control

Low vitamin D levels and increased neutrophil in patients admitted at ICU with COVID-19

Pimental et al., Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2021.05.021
May 2021  
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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 119 studies, recognized in 7 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 25 ICU patients in Brazil, showing vitamin D deficiency associated with higher neutrophil-lymphocyte ratio. There appears to be a typo in the mortality percentage for vitamin D deficiency (20% is not valid for the group size of 8).
This is the 70th of 192 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 611 vigintillion).
risk of death, 29.4% lower, RR 0.71, p = 1.00, high D levels 3 of 17 (17.6%), low D levels 2 of 8 (25.0%), NNT 14, >20ng/mL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pimental et al., 31 May 2021, retrospective, Brazil, peer-reviewed, 3 authors.
This PaperVitamin DAll
Low vitamin D levels and increased neutrophil in patients admitted at ICU with COVID-19
Gustavo D Pimentel, Maria C M Dela Vega, Claude Pichard
Clinical Nutrition ESPEN, doi:10.1016/j.clnesp.2021.05.021
Background & aims: Systemic inflammation has been reported as a new predictor for COVID-19 outcomes. Thus, we hypothesized that ICU patients infected by COVID-19 had lower blood vitamin D levels and increased systemic inflammation. Therefore, this is the first Brazilian study to evaluate the vitamin D concentrations and NLR as a systemic inflammation in patients infected by COVID-19 admitted in ICU. Methods: This cross-sectional study selected twenty-six patients from COVID-19 Data Sharing/FAPESP, Brazil. Twenty-five patients were enrolled from a single hospital and those with blood vitamin D and neutrophil and lymphocyte data were included and had all available data analyzed. Patients were divided in two groups: low vitamin D concentration when 20 ng/mL (low Vit D group, n ¼ 8, 5M/3F, 62.7 ± 8.4 years old), and normal vitamin D when > 20 ng/mL (normal Vit D group, n ¼ 17, 9M/8F, 74 ± 8.2 years old). Serum 25-hydroxy-vitamin D, C reactive protein (CRP), and count of neutrophils and lymphocytes concentrations were collected from COVID-19 Data Sharing/FAPESP. Statistical analyses were performed using the Prism version 5.0 and Student T test was applied to verify any difference between the groups. Results: Low vitamin D group had 15.5 ± 3.3 ng/mL of 25OH Vit D concentrations and normal vitamin D group had 35.9 ± 8.8 ng/mL. Although no difference between groups for CRP concentrations (low Vit D: 4.5 ± 3.3 vs. normal Vit D: 4.2 ± 4.0 mg/dL, p ¼ 0.45), we found higher neutrophil count and NLR values in the low Vit D group when compared to normal Vit D group (low Vit D: 6049.8 ± 3719.7 vs. normal Vit D: 3741.8 ± 1704.1 ng/mL, p ¼ 0.02) and (low Vit D: 9.0 ± 8.6 vs. normal Vit D: 4.2 ± 4.0 ng/mL, p ¼ 0.03), respectively. Conclusion: This data sharing-derived cases of COVID-19 in patients admitted at ICU showed that patients infected by COVID-19 had lower serum 25-hydroxy vitamin D and enhanced systemic inflammation when assessed by NLR values.
Authorship GDP, MCMDV, and CP wrote the article and approved the final version of this manuscript. Funding No funding was received for this work. Declaration of competing interest None declared.
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