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Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Am+Coll+Nutr 2021 ; 40 (2): 104-110 Nephropedia Template TP
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Vitamin D Deficiency and Low Serum Calcium as Predictors of Poor Prognosis in Patients with Severe COVID-19 #MMPMID33434117
Bennouar S; Cherif AB; Kessira A; Bennouar DE; Abdi S
J Am Coll Nutr 2021[Feb]; 40 (2): 104-110 PMID33434117show ga
BACKGROUND: The severity of Coronavirus Disease 2019 (COVID-19) is a multifactorial condition. An increasing body of evidence argues for a direct implication of vitamin D deficiency, low serum calcium on poor outcomes in COVID-19 patients. This study was designed to investigate the relationship between these two factors and COVID-19 in-hospital mortality. MATERIALS: This is a prospective study, including 120 severe cases of COVID-19, admitted at the department of Reanimation-Anesthesia. Vitamin D was assessed by an immuno-fluoroassay method. Total serum calcium by a colorimetric method, then, corrected for serum albumin levels. The association with in-hospital mortality was assessed using the Kaplan-Meier survival curve, proportional Cox regression analyses and the receiver operating characteristic curve. RESULTS: Hypovitaminosis D and hypocalcemia were very common, occurring in 75% and 35.8% of patients. When analyzing survival, both were significantly associated with in-hospital mortality in a dose-effect manner (p(Log-Rank) = 0.009 and 0.001 respectively). A cutoff value of 39 nmol/l for vitamin D and 2.05 mmol/l for corrected calcemia could predict poor prognosis with a sensitivity of 76% and 84%, and a specificity of 69% and 60% respectively. Hazard ratios were (HR = 6.9, 95% CI [2.0-24.1], p = 0.002 and HR = 6.2, 95% CI [2.1-18.3], p = 0.001) respectively. CONCLUSION: This study demonstrates the high frequency of hypocalcemia and hypovitaminosis D in severe COVID-19 patients and provides further evidence of their potential link to poor short-term prognosis. It is, therefore, possible that the correction of hypocalcemia, as well as supplementation with vitamin D, may improve the vital prognosis.
|Aged[MESH]
|Algeria/epidemiology[MESH]
|COVID-19/blood/complications/*mortality[MESH]
|Calcium/*blood[MESH]
|Female[MESH]
|Hospital Mortality[MESH]
|Hospitalization[MESH]
|Humans[MESH]
|Hypocalcemia/blood/*mortality/virology[MESH]
|Kaplan-Meier Estimate[MESH]
|Male[MESH]
|Middle Aged[MESH]
|Prognosis[MESH]
|Proportional Hazards Models[MESH]
|Prospective Studies[MESH]
|Reference Values[MESH]
|Risk Factors[MESH]
|SARS-CoV-2[MESH]
|Severity of Illness Index[MESH]
|Vitamin D Deficiency/blood/*mortality/virology[MESH]