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A combined role for low vitamin D and low albumin circulating levels as strong predictors of worse outcome in COVID-19 patients

Sanson et al., Irish Journal of Medical Science (1971 -), doi:10.1007/s11845-022-02952-9
Feb 2022  
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0 0.5 1 1.5 2+ NIV/IMV/death 64% Improvement Relative Risk Vitamin D for COVID-19  Sanson et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Prospective study of 69 patients in Italy (March - September 2020) Lower progression with higher vitamin D levels (p=0.031) c19early.org Sanson et al., Irish J. Medical Science, Feb 2022 Favors vitamin D Favors control
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
 
*, now known with p < 0.00000000001 from 120 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Prospective study of 69 hospitalized COVID-19 pneumonia patients, showing higher risk of combined NIV/IMV/60-day death with low vitamin D levels.
This is the 121st of 198 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 361,397 vigintillion).
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
NIV/IMV/death, 64.0% lower, RR 0.36, p = 0.03, high D levels (≥30ng/mL) 2 of 9 (22.2%), low D levels (<30ng/mL) 37 of 60 (61.7%), NNT 2.5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sanson et al., 19 Feb 2022, prospective, Italy, peer-reviewed, 13 authors, study period March 2020 - September 2020.
This PaperVitamin DAll
A combined role for low vitamin D and low albumin circulating levels as strong predictors of worse outcome in COVID-19 patients
Gianfranco Sanson, Amedeo De Nicolò, Verena Zerbato, Ludovica Segat, Raffaella Koncan, Stefano Di Bella, Jessica Cusato, Alessandra Di Masi, Andrea Palermo, Pietro Caironi, Pierlanfranco D’agaro, Roberto Luzzati, Antonio D’avolio
Irish Journal of Medical Science (1971 -), doi:10.1007/s11845-022-02952-9
Purpose We aimed to assess the combined role of vitamin D and albumin serum levels as predictors of COVID-19 disease progression. Methods We conducted a prospective observational study on adult patients hospitalized for SARS-CoV-2 pneumonia (March-September 2020). Vitamin D and albumin serum levels were measured on admission. These variables were categorized in albumin < 3.5 or ≥ 3.5 g/dL and vitamin D < 30 ng/mL or ≥ 30 ng/mL. We excluded patients with known bone diseases, renal failure, hypercalcemia and/or treated with antiepileptic drugs and steroids, and patients who received previous vitamin D supplementation. A composite outcome including any ventilatory support, PaO 2 /FiO 2 ratio, and 60-day mortality was defined. Results Sixty-nine patients were enrolled, of whom 50% received non-invasive (NIV) or invasive mechanical ventilation (IMV), 10% died, whereas 89% and 66% presented low albumin and low vitamin D serum levels, respectively. No correlation between vitamin D and albumin levels was found. In multivariable logistic regression analyses adjusted for sex and age-corrected comorbidities, patients having albumin < 3.5 g/dL and vitamin D < 30 ng/mL showed a significant increased risk for all study outcomes, namely NIV/IMV (OR 3.815; 95% CI 1.122-12.966; p = 0.032), NIV/IMV or death (OR 3.173; 95% CI 1.002-10.043; p = 0.049) and PaO 2 /FIO 2 ≤ 100 (OR 3.410; 95% CI 1.138-10.219; p = 0.029). Conclusion The measurement of both vitamin D and serum albumin levels on COVID-19 patients' admission, and their combined evaluation, provides a simple prognostic tool that could be employed to guide prompt clinical decisions.
Conflict of interest The authors declare no competing interests. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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