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Survival and Mortality in Hospitalized Children with COVID-19: A Referral Center Experience in Yazd, Iran

Shamsi et al., Canadian Journal of Infectious Diseases and Medical Microbiology, doi:10.1155/2023/5205188
Jul 2023  
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Mortality 58% Improvement Relative Risk Vitamin D for COVID-19  Shamsi et al.  LATE TREATMENT Is late treatment with vitamin D beneficial for COVID-19? Retrospective 183 patients in Iran (March 2020 - August 2021) Study underpowered to detect differences c19early.org Shamsi et al., Canadian J. Infectious .., Jul 2023 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
Retrospective 183 hospitalized pediatric COVID-19 patients in Iran, showing no significant difference in mortality with vitamin D in unadjusted results.
Cholecalciferol was used in this study. Meta analysis shows that late stage treatment with calcitriol / calcifediol (or paricalcitol, alfacalcidol, etc.) is more effective than cholecalciferol: 69% [47‑82%] lower risk vs. 39% [27‑49%] lower risk. Cholecalciferol requires two hydroxylation steps to become activated - first in the liver to calcifediol, then in the kidney to calcitriol. Calcitriol, paricalcitol, and alfacalcidol are active vitamin D analogs that do not require conversion. This allows them to have more rapid onset of action compared to cholecalciferol. The time delay for cholecalciferol to increase serum calcifediol levels can be 2-3 days, and the delay for converting calcifediol to active calcitriol can be up to 7 days.
This is the 113th of 122 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 587 sextillion).
30 studies are RCTs, which show efficacy with p=0.0000032.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
Study covers favipiravir, vitamin D, famotidine, HCQ, aspirin, and remdesivir.
risk of death, 57.5% lower, RR 0.42, p = 0.70, treatment 1 of 17 (5.9%), control 23 of 166 (13.9%), NNT 13.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Shamsi et al., 17 Jul 2023, retrospective, Iran, peer-reviewed, 4 authors, study period 1 March, 2020 - 1 August, 2021, dosage not specified. Contact: farimahshamssi@gmail.com.
This PaperVitamin DAll
Survival and Mortality in Hospitalized Children with COVID-19: A Referral Center Experience in Yazd, Iran
Farimah Shamsi, Mehran Karimi, Zahra Nafei, Elahe Akbarian
Canadian Journal of Infectious Diseases and Medical Microbiology, doi:10.1155/2023/5205188
Introduction. COVID-19 prognostic risk factors, therapeutic protocols, and clinical outcomes in pediatric cases are still under investigation. Materials and Methods. Tis historical cohort study evaluated the survival time of hospitalized children (1 month-18 years old) with COVID-19 admitted from March 2020 to August 2021 to an educational hospital in Yazd, Iran. Te follow-up of patients was performed at least one month after discharge. Results. From 183 hospitalized cases, 24 children were deceased. Te median age of patients was 5.41, and 54.2% were male. Te survival rate after one-month follow-up was 0.88, and the most signifcant predictors associated with survival time were the male sex, positive history of hospitalization, lymphopenia, hypoxia, and length of stay more than two weeks using Bayesian Cox regression analysis. Conclusion. Accurate estimation of the impact of predictors on poor outcomes may help healthcare providers use therapeutic protocols based on risk factors and healthcare requirements of each patient to improve their survival.
Conflicts of Interest Te authors declare that they have no conficts of interest.
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Late treatment
is less effective
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