Calcifediol treatment and COVID-19-related outcomes

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  • dc.contributor.author Nogués Solan, Francesc Xavier
  • dc.contributor.author Ovejero Crespo, Diana
  • dc.contributor.author Pineda-Moncusí, Marta
  • dc.contributor.author Bouillon, Roger
  • dc.contributor.author Arenas Jiménez, María Dolores
  • dc.contributor.author Pascual Santos, Julio
  • dc.contributor.author Ribes, Anna
  • dc.contributor.author Guerri-Fernandez, Robert
  • dc.contributor.author Villar García, Judit
  • dc.contributor.author Rial, Abora
  • dc.contributor.author Gimenez-Argente, Carme
  • dc.contributor.author Cos, Maria Lourdes
  • dc.contributor.author Rodriguez-Morera, Jaime
  • dc.contributor.author Campodarve, Isabel
  • dc.contributor.author Quesada-Gómez, J.M.
  • dc.contributor.author García-Giralt, Natalia
  • dc.date.accessioned 2022-03-08T06:50:08Z
  • dc.date.issued 2021
  • dc.description.abstract Context: COVID-19 is a major health problem because of saturation of intensive care units (ICU) and mortality. Vitamin D has emerged as a potential treatment able to reduce the disease severity. Objective: This work aims to elucidate the effect of 25(OH)D3 (calcifediol) treatment on COVID-19-related outcomes. Methods: This observational cohort study was conducted from March to May 2020, among patients admitted to COVID-19 wards of Hospital del Mar, Barcelona, Spain. A total of 930 patients with COVID-19 were included; 92 were excluded because of previous calcifediol intake. Of the remaining 838, a total of 447 received calcifediol (532 μg on day 1 plus 266 μg on days 3, 7, 15, and 30), whereas 391 were not treated at the time of hospital admission (intention-to-treat). Of the latter, 53 patients were treated later during ICU admission and were allocated in the treated group in a second analysis. In healthy individuals, calcifediol is about 3.2-fold more potent on a weight basis than cholecalciferol. Main outcome measures were ICU admission and mortality. Results: ICU assistance was required by 102 (12.2%) participants. Out of 447 patients treated with calcifediol at admission, 20 (4.5%) required the ICU, compared to 82 (21%) out of 391 nontreated (P < .001). Logistic regression of calcifediol treatment on ICU admission, adjusted by age, sex, linearized 25-hydroxyvitamin D levels at baseline, and comorbidities showed that treated patients had a reduced risk of requiring the ICU (odds ratio [OR] 0.13; 95% CI 0.07-0.23). Overall mortality was 10%. In the intention-to-treat analysis, 21 (4.7%) out of 447 patients treated with calcifediol at admission died compared to 62 patients (15.9%) out of 391 nontreated (P = .001). Adjusted results showed a reduced mortality risk with an OR of 0.21 (95% CI, 0.10-0.43). In the second analysis, the obtained OR was 0.52 (95% CI, 0.27-0.99). Conclusion: In patients hospitalized with COVID-19, calcifediol treatment significantly reduced ICU admission and mortality.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Nogues X, Ovejero D, Pineda-Moncusí M, Bouillon R, Arenas D, Pascual J, Ribes A, Guerri-Fernandez R, Villar-Garcia J, Rial A, Gimenez-Argente C, Cos ML, Rodriguez-Morera J, Campodarve I, Quesada-Gomez JM, Garcia-Giralt N. Calcifediol treatment and COVID-19-related outcomes. J Clin Endocrinol Metab. 2021 Sep 27;106(10):e4017-e4027. DOI: 10.1210/clinem/dgab405
  • dc.identifier.doi http://dx.doi.org/10.1210/clinem/dgab405
  • dc.identifier.issn 0021-972X
  • dc.identifier.uri http://hdl.handle.net/10230/52640
  • dc.language.iso eng
  • dc.publisher Oxford University Press
  • dc.relation.ispartof J Clin Endocrinol Metab. 2021 Sep 27;106(10):e4017-e4027
  • dc.rights © Oxford University Press. This is a pre-copyedited, author-produced version of an article accepted for publication in The Journal of clinical endocrinology and metabolism following peer review. The version of record Nogues X, Ovejero D, Pineda-Moncusí M, Bouillon R, Arenas D, Pascual J, Ribes A, Guerri-Fernandez R, Villar-Garcia J, Rial A, Gimenez-Argente C, Cos ML, Rodriguez-Morera J, Campodarve I, Quesada-Gomez JM, Garcia-Giralt N. Calcifediol treatment and COVID-19-related outcomes. J Clin Endocrinol Metab. 2021 Sep 27;106(10):e4017-e4027. DOI: 10.1210/clinem/dgab405 is available online at: https://academic.oup.com/jcem/article/106/10/e4017/6294179.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.subject.keyword COVID-19
  • dc.subject.keyword ICU admission
  • dc.subject.keyword Calcifediol
  • dc.subject.keyword Mortality
  • dc.subject.keyword Vitamin D
  • dc.title Calcifediol treatment and COVID-19-related outcomes
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/acceptedVersion

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Articles (Hospital del Mar Research Institute)