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0 0.5 1 1.5 2+ Mortality 88% Improvement Relative Risk Vitamin D for COVID-19  Ricci et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 52 patients in Italy Lower mortality with higher vitamin D levels (not stat. sig., p=0.07) Ricci et al., Respiratory Research, Mar 2021 Favors vitamin D Favors control

Circulating Vitamin D levels status and clinical prognostic indices in COVID-19 patients

Ricci et al., Respiratory Research, doi:10.1186/s12931-021-01666-3
Mar 2021  
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Retrospective 52 hospitalized COVID-19 patients showing that vitamin D deficiency is associated with compromised inflammatory responses and higher pulmonary involvement. Vitamin D deficient patients also showed higher mortality, although not quite reaching statistical significance with the small sample size.
This is the 51st of 186 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 179 vigintillion).
risk of death, 87.6% lower, RR 0.12, p = 0.07, high D levels 0 of 30 (0.0%), low D levels 3 of 22 (13.6%), NNT 7.3, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), >10 ng/mL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ricci et al., 3 Mar 2021, retrospective, Italy, peer-reviewed, 15 authors.
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This PaperVitamin DAll
Circulating Vitamin D levels status and clinical prognostic indices in COVID-19 patients
Alberto Ricci, Alessandra Pagliuca, Michela D’ascanio, Marta Innammorato, Claudia De Vitis, Rita Mancini, Simonetta Giovagnoli, Francesco Facchiano, Bruno Sposato, Paolo Anibaldi, Adriano Marcolongo, Chiara De Dominicis, Andrea Laghi, Emanuele Muscogiuri, Salvatore Sciacchitano
Respiratory Research, doi:10.1186/s12931-021-01666-3
Background: Several immune mechanisms activate in COVID-19 pathogenesis. Usually, coronavirus infection is characterized by dysregulated host immune responses, interleukine-6 increase, hyper-activation of cytotoxic CD8 T lymphocytes. Interestingly, Vitamin D deficiency has been often associated with altered immune responses and infections. In the present study, we evaluated Vitamin D plasma levels in patients affected with different lung involvement during COVID-19 infection. Methods: Lymphocyte phenotypes were assessed by flow cytometry. Thoracic CT scan involvement was obtained by an image analysis program. Results: Vitamin D levels were deficient in (80%) of patients, insufficient in (6.5%) and normal in (13.5%). Patients with very low Vitamin D plasma levels had more elevated D-Dimer values, a more elevated B lymphocyte cell count, a reduction of CD8 + T lymphocytes with a low CD4/CD8 ratio, more compromised clinical findings (measured by LIPI and SOFA scores) and thoracic CT scan involvement. Conclusions: Vitamin D deficiency is associated with compromised inflammatory responses and higher pulmonary involvement in COVID-19 affected patients. Vitamin D assessment, during COVID-19 infection, could be a useful analysis for possible therapeutic interventions.
Abbreviations VitD: Vitamin D; CT: Computed tomography; PII: Pulmonary inflammation index; SOFA: Sequential Organ Failure Assessment; LIPI: Lung Immune Prognosis Index; PBMC: Peripheral blood lymphocyte; NLR: Neutrophils and Lymphocytes ratio; dNLR: Derived Neutrophils/ Leucocytes-Neutrophils ratio; TSS: Total severity score. Authors' contributions The authors have made the following declaration about their contributions. Conceived and designed: AR, AP, MD, BS, SG. Development and methodology: CDV, RM, VS, PA, AM, Acquisition of data: MI, CDD, AL, EM. FF. Analysis and interpretation of the results: AR, AP, MD, MI. Writing, review and revision of the manuscript: AR, AP, MD, SS Study supervision: AR, MD. All authors read and approved the final manuscript. Ethics approval and consent to participate The study was approved by our Institutional Ethical Committee (Sapienza University of Rome, Italy) (Prot.# 52SA_2020, RIF. CE 5773_2020), on the basis that it complied with the declaration of Helsinki and that the protocol followed existing good clinical practice guidelines. A written informed consent to participate in the study was obtained from every participant. In case of adults with cognitive decline the consent to participate to the study was given by the legal guardian. An administrative permission to access the clinical/personal patient data used in our research was given by the Health Director of our Hospital, who is also a co-author of the manuscript. Consent for..
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