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Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19

It is unclear whether vitamin D benefits inpatients with COVID-19. Objective: To examine the relationship between vitamin D and COVID-19 outcomes. Design: Cohort study. Setting: National COVID Cohort Collaborative (N3C) database. Patients: 158,835 patients with confirmed COVID-19 and a sub-cohort wi...

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Autores principales: Fairfield, Kathleen M., Murray, Kimberly A., Anzalone, A. Jerrod, Beasley, William, Khodaverdi, Maryam, Hodder, Sally L., Harper, Jeremy, Santangelo, Susan, Rosen, Clifford J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332080/
https://www.ncbi.nlm.nih.gov/pubmed/35893927
http://dx.doi.org/10.3390/nu14153073
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author Fairfield, Kathleen M.
Murray, Kimberly A.
Anzalone, A. Jerrod
Beasley, William
Khodaverdi, Maryam
Hodder, Sally L.
Harper, Jeremy
Santangelo, Susan
Rosen, Clifford J.
author_facet Fairfield, Kathleen M.
Murray, Kimberly A.
Anzalone, A. Jerrod
Beasley, William
Khodaverdi, Maryam
Hodder, Sally L.
Harper, Jeremy
Santangelo, Susan
Rosen, Clifford J.
author_sort Fairfield, Kathleen M.
collection PubMed
description It is unclear whether vitamin D benefits inpatients with COVID-19. Objective: To examine the relationship between vitamin D and COVID-19 outcomes. Design: Cohort study. Setting: National COVID Cohort Collaborative (N3C) database. Patients: 158,835 patients with confirmed COVID-19 and a sub-cohort with severe disease (n = 81,381) hospitalized between 1 January 2020 and 31 July 2021. Methods: We identified vitamin D prescribing using codes for vitamin D and its derivatives. We created a sub-cohort defined as having severe disease as those who required mechanical ventilation or extracorporeal membrane oxygenation (ECMO), had hospitalization >5 days, or hospitalization ending in death or hospice. Using logistic regression, we adjusted for age, sex, race, BMI, Charlson Comorbidity Index, and urban/rural residence, time period, and study site. Outcomes of interest were death or transfer to hospice, longer length of stay, and mechanical ventilation/ECMO. Results: Patients treated with vitamin D were older, had more comorbidities, and higher BMI compared with patients who did not receive vitamin D. Vitamin D treatment was associated with an increased odds of death or referral for hospice (adjusted odds ratio (AOR) 1.10: 95% CI 1.05–1.14), hospital stay >5 days (AOR 1.78: 95% CI 1.74–1.83), and increased odds of mechanical ventilation/ECMO (AOR 1.49: 95% CI 1.44–1.55). In the sub-cohort of severe COVID-19, vitamin D decreased the odds of death or hospice (AOR 0.90, 95% CI 0.86–0.94), but increased the odds of hospital stay longer >5 days (AOR 2.03, 95% CI 1.87–2.21) and mechanical ventilation/ECMO (AOR 1.16, 95% CI 1.12–1.21). Limitations: Our findings could reflect more aggressive treatment due to higher severity. Conclusion: Vitamin D treatment was associated with greater odds of extended hospitalization, mechanical ventilation/ECMO, and death or hospice referral.
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spelling pubmed-93320802022-07-29 Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19 Fairfield, Kathleen M. Murray, Kimberly A. Anzalone, A. Jerrod Beasley, William Khodaverdi, Maryam Hodder, Sally L. Harper, Jeremy Santangelo, Susan Rosen, Clifford J. Nutrients Article It is unclear whether vitamin D benefits inpatients with COVID-19. Objective: To examine the relationship between vitamin D and COVID-19 outcomes. Design: Cohort study. Setting: National COVID Cohort Collaborative (N3C) database. Patients: 158,835 patients with confirmed COVID-19 and a sub-cohort with severe disease (n = 81,381) hospitalized between 1 January 2020 and 31 July 2021. Methods: We identified vitamin D prescribing using codes for vitamin D and its derivatives. We created a sub-cohort defined as having severe disease as those who required mechanical ventilation or extracorporeal membrane oxygenation (ECMO), had hospitalization >5 days, or hospitalization ending in death or hospice. Using logistic regression, we adjusted for age, sex, race, BMI, Charlson Comorbidity Index, and urban/rural residence, time period, and study site. Outcomes of interest were death or transfer to hospice, longer length of stay, and mechanical ventilation/ECMO. Results: Patients treated with vitamin D were older, had more comorbidities, and higher BMI compared with patients who did not receive vitamin D. Vitamin D treatment was associated with an increased odds of death or referral for hospice (adjusted odds ratio (AOR) 1.10: 95% CI 1.05–1.14), hospital stay >5 days (AOR 1.78: 95% CI 1.74–1.83), and increased odds of mechanical ventilation/ECMO (AOR 1.49: 95% CI 1.44–1.55). In the sub-cohort of severe COVID-19, vitamin D decreased the odds of death or hospice (AOR 0.90, 95% CI 0.86–0.94), but increased the odds of hospital stay longer >5 days (AOR 2.03, 95% CI 1.87–2.21) and mechanical ventilation/ECMO (AOR 1.16, 95% CI 1.12–1.21). Limitations: Our findings could reflect more aggressive treatment due to higher severity. Conclusion: Vitamin D treatment was associated with greater odds of extended hospitalization, mechanical ventilation/ECMO, and death or hospice referral. MDPI 2022-07-26 /pmc/articles/PMC9332080/ /pubmed/35893927 http://dx.doi.org/10.3390/nu14153073 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fairfield, Kathleen M.
Murray, Kimberly A.
Anzalone, A. Jerrod
Beasley, William
Khodaverdi, Maryam
Hodder, Sally L.
Harper, Jeremy
Santangelo, Susan
Rosen, Clifford J.
Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19
title Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19
title_full Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19
title_fullStr Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19
title_full_unstemmed Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19
title_short Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19
title_sort association of vitamin d prescribing and clinical outcomes in adults hospitalized with covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332080/
https://www.ncbi.nlm.nih.gov/pubmed/35893927
http://dx.doi.org/10.3390/nu14153073
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