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Dexamethasone treatment may mitigate adverse effects of vitamin D deficiency in hospitalized Covid-19 patients.
J Med Virol. 2021 Jul 17 [Online ahead of print]JM

Abstract

AIMS

We have previously demonstrated that vitamin D deficiency might be associated with worse outcomes in hospitalized Covid-19 patients. The aim of our study was to explore this relationship with dexamethasone therapy.

METHODS

We prospectively studied two cohorts of hospitalized Covid-19 patients between March and April and between September and December 2020 (n = 192). Patients were tested for serum 25-hydroxyvitamin D (25-OH-D) levels during admission. The first cohort not treated with dexamethasone (n = 107) was divided into vitamin D deficient (25-OH-D ≤ 30 nmol/L) (n = 47) and replete subgroups (25-OH-D > 30 nmol/L) (n = 60). The second cohort treated with dexamethasone (n = 85) was similarly divided into deficient (25-OH-D ≤ 30 nmol/L) (n = 27) and replete subgroups (25-OH-D > 30 nmol/L) (n = 58). Primary outcome was in-hospital mortality and secondary outcomes were elevation in markers of cytokine storm and ventilatory requirement.

RESULTS

No mortality difference was identified between cohorts and subgroups. The "no dexamethasone" cohort 25-OH-D deplete subgroup recorded significantly higher peak D-Dimer levels (1874 vs. 1233 µgFEU/L) (p = 0.0309), CRP (177 vs. 107.5) (p = 0.0055), and ventilatory support requirement (25.5% vs. 6.67%) (p = 0.007) compared to the replete subgroup. Among the 25-OH-D deplete subgroup higher peak neutrophil counts, peak CRP, peak LDH, peak ferritin, and lower trough lymphocyte counts were observed, without statistical significance. In the "dexamethasone" cohort, there was no apparent association between 25-OH-D deficiency and markers of cytokine storm or ventilatory requirement.

CONCLUSION

Vitamin D deficiency is associated with elevated markers of cytokine storm and higher ventilatory requirements in hospitalized Covid-19 patients. Dexamethasone treatment appears to mitigate adverse effects of vitamin D deficiency.

Authors+Show Affiliations

Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK. Department of Clinical Cardiology, University of Nicosia Medical School, Nicosia, Cyprus.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34273116

Citation

Wenban, Charlotte, et al. "Dexamethasone Treatment May Mitigate Adverse Effects of Vitamin D Deficiency in Hospitalized Covid-19 Patients." Journal of Medical Virology, 2021.
Wenban C, Heer RS, Baktash V, et al. Dexamethasone treatment may mitigate adverse effects of vitamin D deficiency in hospitalized Covid-19 patients. J Med Virol. 2021.
Wenban, C., Heer, R. S., Baktash, V., Kandiah, P., Katsanouli, T., Pandey, A., Goindoo, R., Ajaz, A., Van den Abbeele, K., Mandal, A. K. J., & Missouris, C. G. (2021). Dexamethasone treatment may mitigate adverse effects of vitamin D deficiency in hospitalized Covid-19 patients. Journal of Medical Virology. https://doi.org/10.1002/jmv.27215
Wenban C, et al. Dexamethasone Treatment May Mitigate Adverse Effects of Vitamin D Deficiency in Hospitalized Covid-19 Patients. J Med Virol. 2021 Jul 17; PubMed PMID: 34273116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dexamethasone treatment may mitigate adverse effects of vitamin D deficiency in hospitalized Covid-19 patients. AU - Wenban,Charlotte, AU - Heer,Randeep S, AU - Baktash,Vadir, AU - Kandiah,Pirabakaran, AU - Katsanouli,Theodora, AU - Pandey,Asmita, AU - Goindoo,Ryan, AU - Ajaz,Afiyah, AU - Van den Abbeele,Koenraad, AU - Mandal,Amit K J, AU - Missouris,Constantinos G, Y1 - 2021/07/17/ PY - 2021/06/04/received PY - 2021/07/14/accepted PY - 2021/7/18/pubmed PY - 2021/7/18/medline PY - 2021/7/17/entrez KW - covid-19 KW - cytokine storm KW - dexamethasone KW - ventilation KW - vitamin D JF - Journal of medical virology JO - J Med Virol N2 - AIMS: We have previously demonstrated that vitamin D deficiency might be associated with worse outcomes in hospitalized Covid-19 patients. The aim of our study was to explore this relationship with dexamethasone therapy. METHODS: We prospectively studied two cohorts of hospitalized Covid-19 patients between March and April and between September and December 2020 (n = 192). Patients were tested for serum 25-hydroxyvitamin D (25-OH-D) levels during admission. The first cohort not treated with dexamethasone (n = 107) was divided into vitamin D deficient (25-OH-D ≤ 30 nmol/L) (n = 47) and replete subgroups (25-OH-D > 30 nmol/L) (n = 60). The second cohort treated with dexamethasone (n = 85) was similarly divided into deficient (25-OH-D ≤ 30 nmol/L) (n = 27) and replete subgroups (25-OH-D > 30 nmol/L) (n = 58). Primary outcome was in-hospital mortality and secondary outcomes were elevation in markers of cytokine storm and ventilatory requirement. RESULTS: No mortality difference was identified between cohorts and subgroups. The "no dexamethasone" cohort 25-OH-D deplete subgroup recorded significantly higher peak D-Dimer levels (1874 vs. 1233 µgFEU/L) (p = 0.0309), CRP (177 vs. 107.5) (p = 0.0055), and ventilatory support requirement (25.5% vs. 6.67%) (p = 0.007) compared to the replete subgroup. Among the 25-OH-D deplete subgroup higher peak neutrophil counts, peak CRP, peak LDH, peak ferritin, and lower trough lymphocyte counts were observed, without statistical significance. In the "dexamethasone" cohort, there was no apparent association between 25-OH-D deficiency and markers of cytokine storm or ventilatory requirement. CONCLUSION: Vitamin D deficiency is associated with elevated markers of cytokine storm and higher ventilatory requirements in hospitalized Covid-19 patients. Dexamethasone treatment appears to mitigate adverse effects of vitamin D deficiency. SN - 1096-9071 UR - https://www.unboundmedicine.com/medline/citation/34273116/Dexamethasone_treatment_may_mitigate_adverse_effects_of_vitamin_D_deficiency_in_hospitalised_Covid-19_patients. L2 - https://doi.org/10.1002/jmv.27215 DB - PRIME DP - Unbound Medicine ER -
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