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All Studies   Meta Analysis    Recent:   

Low 25-Hydroxyvitamin D Levels on Admission to the Intensive Care Unit May Predispose COVID-19 Pneumonia Patients to a Higher 28-Day Mortality Risk: A Pilot Study on a Greek ICU Cohort

Vassiliou et al., Nutrients, doi:10.3390/nu12123773
Dec 2020  
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Mortality 91% Improvement Relative Risk Vitamin D for COVID-19  Vassiliou et al.  ICU PATIENTS Are vitamin D levels associated with COVID-19 outcomes? Prospective study of 30 patients in Greece Lower mortality with higher vitamin D levels (p=0.042) c19early.org Vassiliou et al., Nutrients, December 2020 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. * >10% efficacy, ≥3 studies.
4,800+ studies for 98 treatments. c19early.org
Small prospective study of 30 ICU patients, showing higher mortality risk for low vitamin D levels. When divided into two groups at the median level, there was 5 of 15 deaths for the low vitamin D group compared to 0 of 15 in the high vitamin D group.
This is the 32nd of 204 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 107,767,362 vigintillion).
risk of death, 90.9% lower, RR 0.09, p = 0.04, high D levels 0 of 15 (0.0%), low D levels 5 of 15 (33.3%), NNT 3.0, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), >15.2ng/mL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Vassiliou et al., 9 Dec 2020, prospective, Greece, peer-reviewed, 6 authors.
This PaperVitamin DAll
Abstract: Hellenic Journal of Cardiology 62 (2021) 381e383 Contents lists available at ScienceDirect Hellenic Journal of Cardiology journal homepage: http://www.journals.elsevier.com/ hellenic-journal-of-cardiology/ Correspondence Vitamin D deficiency correlates with a reduced number of natural killer cells in intensive care unit (ICU) and non-ICU patients with COVID-19 pneumonia Keywords: COVID-19 Vitamin D Natural killer cells Regulation of immune function continues to be one of the most well-recognised extra-skeletal actions of vitamin D. In vitro data have shown that vitamin D modulates immune cells and induces immune tolerance, while in vivo data from animal studies and from vitamin D supplementation human studies have shown beneficial effects of vitamin D on immune function, particularly in the context of autoimmunity.1 In the present study, we examined whether vitamin D deficiency modulates the number of immune cells in COVID-19 patients. This observational, single-centre study included consecutive COVID-19 intensive care unit (ICU) patients (N ¼ 29) and consecutive patients hospitalised in a specialised non-ICU COVID-19 ward (N ¼ 10) who were discharged from the hospital without being transferred to the ICU, from March 18th 2020 to May 25th 2020. The study was approved by the Hospital's Research Ethics Committee (129/19-3-2020), and all procedures carried out on patients were in compliance with the Helsinki Declaration. Informed written consent was obtained from all patients or patients' next-ofkin. Total 25-hydroxyvitamin D was measured on hospital admission using the electrochemiluminescence immunoassay method (Cobas E602, Roche Diagnostics International Ltd). Immune phenotyping was performed by flow cytometric analysis (Navios EX flow cytometer, Beckman Coulter). Vitamin D levels positively correlated with subpopulations of immune cells, namely, cytotoxic T cells (rs ¼ 0.344, p ¼ 0.032), natural killer (NK) cells (rs ¼ 0.496, p ¼ 0.001), NK-T cells (rs ¼ 0.325, p ¼ 0.044) and regulatory T cells (rs ¼ 0.333, p ¼ 0.038). With respect to all other clinical and laboratory parameters, vitamin D levels correlated only with albumin (rs ¼ 0.387, p ¼ 0.018). To further explore these associations, we divided our cohort into two groups based on their vitamin D levels; we classified them as vitamin D deficient (19.9 ng/ml, N ¼ 32) and vitamin D insufficient (20-29.9 ng/ml, N ¼ 7). Demographics, clinical and biochemical characteristics on hospital admission and important outcomes Peer review under responsibility of Hellenic Society of Cardiology. of the two patient groups are listed in Table 1. As expected, hypertension was the most common comorbidity.2 The two groups differed only in the number of NK cells (Table 1 and Figure 1). Cytotoxic T cells, NK-T cells and regulatory T cells did not differ in the two groups. It should also be noted that the two patient groups did not differ with respect to hospital mortality or disease severity. The beneficial effects of vitamin D on protective immunity are due in part to its effects on the innate immune system. In vitro studies have reported contradictory results on the role of vitamin D on NK cell function, but whether vitamin D induces or inhibits NK cell function in vivo remains unclear.3 NK cells are a type of cytotoxic lymphocytes that are critical to the innate immune system and secrete many cytokines and chemokines. Despite their vital role in viral infections, the contribution of NK cells in..
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Based on 25(OH)D levels, patients were stratified in two groups: ' 'higher and lower than the median value of the cohort (15.2 ng/mL). The two groups did not ' 'differ in their demographic or clinical characteristics. All patients who died within 28 days ' 'belonged to the low vitamin D group. Survival analysis showed that the low vitamin D group ' 'had a higher 28-day survival absence probability (log-rank test, p = 0.01). Critically ill ' 'COVID-19 patients who died in the ICU within 28 days appeared to have lower ICU admission ' '25(OH)D levels compared to survivors. When the cohort was divided at the median 25(OH)D ' 'value, the low vitamin D group had an increased risk of 28-day mortality. It seems plausible, ' 'therefore, that low 25(OH)D levels may predispose COVID-19 patients to an increased 28-day ' 'mortality risk.</jats:p>', 'DOI': '10.3390/nu12123773', 'type': 'journal-article', 'created': {'date-parts': [[2020, 12, 9]], 'date-time': '2020-12-09T14:17:58Z', 'timestamp': 1607523478000}, 'page': '3773', 'source': 'Crossref', 'is-referenced-by-count': 38, 'title': 'Low 25-Hydroxyvitamin D Levels on Admission to the Intensive Care Unit May Predispose COVID-19 ' 'Pneumonia Patients to a Higher 28-Day Mortality Risk: A Pilot Study on a Greek ICU Cohort', 'prefix': '10.3390', 'volume': '12', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-4984-0476', 'authenticated-orcid': False, 'given': 'Alice G.', 'family': 'Vassiliou', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-7306-713X', 'authenticated-orcid': False, 'given': 'Edison', 'family': 'Jahaj', 'sequence': 'additional', 'affiliation': []}, {'given': 'Maria', 'family': 'Pratikaki', 'sequence': 'additional', 'affiliation': []}, {'given': 'Stylianos E.', 'family': 'Orfanos', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-2219-7292', 'authenticated-orcid': False, 'given': 'Ioanna', 'family': 'Dimopoulou', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-2508-500X', 'authenticated-orcid': False, 'given': 'Anastasia', 'family': 'Kotanidou', 'sequence': 'additional', 'affiliation': []}], 'member': '1968', 'published-online': {'date-parts': [[2020, 12, 9]]}, 'reference': [ {'key': 'ref1', 'doi-asserted-by': 'publisher', 'DOI': '10.1097/CCM.0b013e31829eb7af'}, {'key': 'ref2', 'doi-asserted-by': 'publisher', 'DOI': '10.1126/science.1123933'}, {'key': 'ref3', 'doi-asserted-by': 'publisher', 'DOI': '10.4049/jimmunol.179.4.2060'}, {'key': 'ref4', 'doi-asserted-by': 'publisher', 'DOI': '10.4049/jimmunol.173.5.2909'}, {'key': 'ref5', 'doi-asserted-by': 'publisher', 'DOI': '10.7861/clinmed.2020-0301'}, {'key': 'ref6', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.cct.2020.106176'}, {'key': 'ref7', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jama.2012.5669'}, {'key': 'ref8', 'doi-asserted-by': 'publisher', 'DOI': '10.1210/jc.2010-2704'}, {'key': 'ref9', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.medidd.2020.100064'}, {'key': 'ref10', 'doi-asserted-by': 'publisher', 'DOI': '10.1007/s40618-020-01370-x'}, {'key': 'ref11', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/s41598-020-77093-z'}, {'key': 'ref12', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/nu12092757'}, {'key': 'ref13', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/jmv.26360'}, {'key': 'ref14', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.virusres.2020.198148'}, {'key': 'ref15', 'doi-asserted-by': 'publisher', 'DOI': '10.1111/cen.14276'}, {'key': 'ref16', 'doi-asserted-by': 'publisher', 'DOI': '10.3389/fpubh.2020.00513'}, {'key': 'ref17', 'doi-asserted-by': 'publisher', 'DOI': '10.1371/journal.pone.0239799'}, {'key': 'ref18', 'doi-asserted-by': 'publisher', 'DOI': '10.1007/s00394-020-02429-4'}, {'key': 'ref19', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jsbmb.2020.105771'}, {'key': 'ref20', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/nu12113377'}, {'key': 'ref21', 'doi-asserted-by': 'publisher', 'DOI': '10.1111/febs.15495'}, {'key': 'ref22', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/nu12051359'}], 'container-title': 'Nutrients', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.mdpi.com/2072-6643/12/12/3773/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2020, 12, 10]], 'date-time': '2020-12-10T06:40:30Z', 'timestamp': 1607582430000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.mdpi.com/2072-6643/12/12/3773'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 12, 9]]}, 'references-count': 22, 'journal-issue': {'issue': '12', 'published-online': {'date-parts': [[2020, 12]]}}, 'alternative-id': ['nu12123773'], 'URL': 'http://dx.doi.org/10.3390/nu12123773', 'relation': {}, 'ISSN': ['2072-6643'], 'subject': ['Food Science', 'Nutrition and Dietetics'], 'container-title-short': 'Nutrients', 'published': {'date-parts': [[2020, 12, 9]]}}
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