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Calcifediol Treatment and Hospital Mortality Due to COVID-19: A Cohort Study

1
Internal Medicine Department, IMIBIC/Reina Sofia University Hospital/University of Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain
2
CIBER Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
3
Internal Medicine Department, Regional University Hospital of Málaga, Avenida de Carlos Haya, s/n, 29010 Málaga, Spain
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Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Avenida de Carlos Haya, s/n, 29010 Málaga, Spain
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Internal Medicine Department, Hospital Costa del Sol, Agencia Sanitaria Costa del Sol, 29603 Marbella, Málaga, Spain
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Internal Medicine Department, Alto Guadalquivir Hospital, Andújar, 23740 Jaén, Spain
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Internal Medicine Department, Hospital de Montilla, Agencia Sanitaria Alto Guadalquivir, 14550 Córdoba, Spain
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Pneumology Department, Reina Sofia University Hopital. Avda, Menendez Pidal s/n, 14004 Córdoba, Spain
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Department of Medicine, University of Málaga (UMA), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), 29071 Málaga, Spain
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MIT Computer Science and Artificial Intelligence Laboratory, Cambridge, MA 02139, USA
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Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
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Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Herestraat, ON 1/902, 3000 Leuven, Belgium
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IMIBIC. CIBER de Fragilidad y Envejecimiento Saludable, Hospital Universitario Reina Sofía, Universidad de Córdoba, Fundación Progreso y Salud, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain
*
Author to whom correspondence should be addressed.
Both authors contributed equally to the work as co-first authors.
Both authors contributed equally to the work as co-senior authors.
Academic Editor: Jean Bousquet
Nutrients 2021, 13(6), 1760; https://doi.org/10.3390/nu13061760
Received: 21 April 2021 / Revised: 10 May 2021 / Accepted: 14 May 2021 / Published: 21 May 2021
(This article belongs to the Section Clinical Nutrition)
Context. Calcifediol has been proposed as a potential treatment for COVID-19 patients. Objective: To compare the administration or not of oral calcifediol on mortality risk of patients hospitalized because of COVID-19. Design: Retrospective, multicenter, open, non-randomized cohort study. Settings: Hospitalized care. Patients: Patients with laboratory-confirmed COVID-19 between 5 February and 5 May 2020 in five hospitals in the South of Spain. Intervention: Patients received calcifediol (25-hydroxyvitamin D3) treatment (0.266 mg/capsule, 2 capsules on entry and then one capsule on day 3, 7, 14, 21, and 28) or not. Main Outcome Measure: In-hospital mortality during the first 30 days after admission. Results: A total of 537 patients were hospitalized with COVID-19 (317 males (59%), median age, 70 years), and 79 (14.7%) received calcifediol treatment. Overall, in-hospital mortality during the first 30 days was 17.5%. The OR of death for patients receiving calcifediol (mortality rate of 5%) was 0.22 (95% CI, 0.08 to 0.61) compared to patients not receiving such treatment (mortality rate of 20%; p < 0.01). Patients who received calcifediol after admission were more likely than those not receiving treatment to have comorbidity and a lower rate of CURB-65 score for pneumonia severity ≥ 3 (one point for each of confusion, urea > 7 mmol/L, respiratory rate ≥ 30/min, systolic blood pressure < 90 mm Hg or diastolic blood pressure ≤ 60 mm Hg, and age ≥ 65 years), acute respiratory distress syndrome (moderate or severe), c-reactive protein, chronic kidney disease, and blood urea nitrogen. In a multivariable logistic regression model, adjusting for confounders, there were significant differences in mortality for patients receiving calcifediol compared with patients not receiving it (OR = 0.16 (95% CI 0.03 to 0.80). Conclusion: Among patients hospitalized with COVID-19, treatment with calcifediol, compared with those not receiving calcifediol, was significantly associated with lower in-hospital mortality during the first 30 days. The observational design and sample size may limit the interpretation of these findings. View Full-Text
Keywords: COVID-19; calcifediol; SARS-CoV-2; COVID-19 drug treatment; vitamin D COVID-19; calcifediol; SARS-CoV-2; COVID-19 drug treatment; vitamin D
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MDPI and ACS Style

Alcala-Diaz, J.F.; Limia-Perez, L.; Gomez-Huelgas, R.; Martin-Escalante, M.D.; Cortes-Rodriguez, B.; Zambrana-Garcia, J.L.; Entrenas-Castillo, M.; Perez-Caballero, A.I.; López-Carmona, M.D.; Garcia-Alegria, J.; Lozano Rodríguez-Mancheño, A.; Arenas-de Larriva, M.d.S.; Pérez-Belmonte, L.M.; Jungreis, I.; Bouillon, R.; Quesada-Gomez, J.M.; Lopez-Miranda, J. Calcifediol Treatment and Hospital Mortality Due to COVID-19: A Cohort Study. Nutrients 2021, 13, 1760. https://doi.org/10.3390/nu13061760

AMA Style

Alcala-Diaz JF, Limia-Perez L, Gomez-Huelgas R, Martin-Escalante MD, Cortes-Rodriguez B, Zambrana-Garcia JL, Entrenas-Castillo M, Perez-Caballero AI, López-Carmona MD, Garcia-Alegria J, Lozano Rodríguez-Mancheño A, Arenas-de Larriva MdS, Pérez-Belmonte LM, Jungreis I, Bouillon R, Quesada-Gomez JM, Lopez-Miranda J. Calcifediol Treatment and Hospital Mortality Due to COVID-19: A Cohort Study. Nutrients. 2021; 13(6):1760. https://doi.org/10.3390/nu13061760

Chicago/Turabian Style

Alcala-Diaz, Juan F.; Limia-Perez, Laura; Gomez-Huelgas, Ricardo; Martin-Escalante, Maria D.; Cortes-Rodriguez, Begoña; Zambrana-Garcia, Jose L.; Entrenas-Castillo, Marta; Perez-Caballero, Ana I.; López-Carmona, Maria D.; Garcia-Alegria, Javier; Lozano Rodríguez-Mancheño, Aquiles; Arenas-de Larriva, Maria d.S.; Pérez-Belmonte, Luis M.; Jungreis, Irwin; Bouillon, Roger; Quesada-Gomez, Jose M.; Lopez-Miranda, Jose. 2021. "Calcifediol Treatment and Hospital Mortality Due to COVID-19: A Cohort Study" Nutrients 13, no. 6: 1760. https://doi.org/10.3390/nu13061760

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