Effect of Single High Dose Vitamin D Substitution in Hospitalized COVID-19 Patients with Vitamin D Deficiency on Length of Hospital Stay
Abstract
:1. Introduction
2. Materials and Methods
2.1. Outcomes
2.2. Data Collection and Management
2.3. Statistical Analysis
3. Results
3.1. Clinical Characteristics at Time of Randomization
3.2. Primary Outcome
Post Hoc Analysis
3.3. Secondary Outcomes
4. Discussion
Strengths and Limitations
5. Conclusions
6. Participant Privacy and Confidentiality
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Inclusion Criteria |
Informed consent as documented by signature |
>18 years old |
Ongoing COVID-19 infection (PCR confirmed) |
Hospitalized in one of the participating study centers |
Laboratory-confirmed serum 25(OH)D3 < 50 nmol/L (<20 ng/mL) |
Exclusion criteria |
Known hypersensitivity against one of the used vitamin D3 products |
Active malignancy |
Hypercalcemia defined as serum calcium >2.2 mmol/L |
Granulomatous disease (e.g., sarcoidosis) |
History of renal stones in the past 12 months |
Pregnancy or breastfeeding |
Admission to ICU before inclusion or at day of inclusion |
Baseline Characteristics | N a (Intervention/Control) | Intervention | Control | p-Value | |
---|---|---|---|---|---|
Age | years | 39/39 | 60.49 ± 13.84 | 61.38 ± 15.29 | 0.787 |
Sex | female, % (n) | 39/39 | 35.9 (14) | 17.9 (7) | 0.125 ‡ |
BMI | kg/m2 | 39/38 | 28.55 ± 5.09 | 28.44 ± 5.68 | 0.951 † |
RR | /min | 33/34 | 24 ± 5 | 23 ± 6 | 0.362 † |
SpO2 | % | 37/37 | 92 ± 2.5 | 93 ± 2.5 | 0.119 |
Patient with dyspnea b | % | 6/13 | 92 ± 2.5 | 92 ± 3 | 0.487 |
Oxygen supplementation requirement | % (n) | 38/39 | 37.8 (14) | 62.2 (23) | 0.084 |
Patients with dyspnea b | % (n) | 6/13 | 50 (3) | 71.4 (10) | 0.393 |
O2 -supplementation | L/min | 36/35 | 1.5 (±2) | 2 (±2) | 0.071 † |
Patients with dyspnea b | L/min | 6/13 | 2 ± 2.5 | 3 ± 3 | 0.610 |
Symptom onset to hospitalization | days | 39/39 | 8 ± 4 | 7 ± 4 | 0.335 |
Radiological evidence | % (n) | 39/39 | 100 (39) | 94.9 (37) | 0.152 |
Quality of life c | 26/20 | ||||
SF-12 physical score | 31.39 ± 10.61 | 27.85 ± 11.75 | 0.352 † | ||
SF-12 mental score | 41.76 ± 15.51 | 51.66 ± 8.04 | 0.018 † | ||
Hematology | |||||
Hemoglobin | g/L | 30/34 | 129.67 ± 15.89 | 134.68 ± 15.78 | 0.211 |
RBC | 106/µL | 31/34 | 4.35 ± 0.43 | 4.353 ± 0.74 | 0.440 † |
Leukocytes | 103/µL | 31/34 | 7.11 ± 2.46 | 7.647 ± 3.23 | 0.451 |
Thrombocytes | 103/µL | 30/34 | 244.90 ± 81.02 | 238.56 ± 101.88 | 0.783 |
Blood chemistry | |||||
25(OH)D3 | nmol/L | 37/39 | 31.46 ± 10.95 | 28.54 ± 10.13 | 0.232 |
PTH | pmol/L | 7/6 | 3.14 ± 1.34 | 4.160 ± 3.93 | 0.943 † |
Calcium | mmol/L | 9/13 | 2.15 ± 0.06 | 2.09 ± 0.34 | 0.282 † |
Phosphate | mmol/L | 7/12 | 1.00 ± 0.29 | 0.86 ± 0.27 | 0.570 |
CRP d | mg/L | 28/31 | 96.50 ± 57.07 | 66.67 ± 61.23 | 0.015 † |
Length of Stay in Days | Intervention, n = 39 | Control, n = 39 | p-Value |
---|---|---|---|
Median (IQR) | Median (IQR) | ||
Time from symptom onset to discharge | 16 (9) | 15 (8) | 0.193 † |
Time from hospital admission to discharge | 8 (8) | 8 (6) | 0.924 † |
Time from randomization to discharge | 6 (10) | 6 (6) | 0.920 † |
Length of Stay (Days) When Serum 25(OH) D Level <25 nmol /L, n = 25 | Intervention, n = 12 | Control, n = 13 | p-Value |
---|---|---|---|
Median (IQR) | Median (IQR) | ||
Time from symptom onset to discharge | 15 (11) | 15 (9) | 0.764 † |
Time from hospital admission to discharge | 5.5 (13) | 9 (6) | 0.299 † |
Time from randomization to discharge | 4.5 (13) | 7 (5) | 0.444 † |
COVID-19-Related Complications | Odds Ratio | 95% Confidence Interval | p-Value | |
---|---|---|---|---|
Lower Level | Upper Level | |||
ICU Admission | 1.371 | 0.232 | 4.319 | 1.00 |
ICU Admission COVID-19-related a | 1.371 | 0.286 | 6.576 | 0.693 |
Intubation | 4.343 | 0.463 | 40.749 | 0.199 |
Other complications | 1.542 | 0.243 | 9.776 | 0.646 |
Death | 0.487 | 0.042 | 5.601 | 0.564 |
Serum 25(OH)D Level in nmol/L | N Available (Intervention/Control) a | Intervention | Control | p-Value |
---|---|---|---|---|
25(OH)D level at randomization | 37/39 | 31.46 ± 10.948 [11–44] | 28.54 ± 10.13 [9–45] | 0.232 |
25(OH)D level at discharge | 21/26 | 50.95 ± 16.98 [2–83] | 23.62 ± 8.88 [2–61] | <0.001 *** |
Change 25(OH)D level | 21/26 | 26.35 ± 8.88 [9–45] | −2.73 ± 10.23 [−33–16] | <0.001 *** |
Patients with 25(OH)D level >50 nmol at discharge | 21/26 | 23.1 (9) | 2.6 (1) | 0.003 ‡ ** |
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Jaun, F.; Boesing, M.; Luethi-Corridori, G.; Abig, K.; Bloch, N.; Giezendanner, S.; Grillmayr, V.; Haas, P.; Leuppi-Taegtmeyer, A.B.; Muser, J.; et al. Effect of Single High Dose Vitamin D Substitution in Hospitalized COVID-19 Patients with Vitamin D Deficiency on Length of Hospital Stay. Biomedicines 2023, 11, 1277. https://doi.org/10.3390/biomedicines11051277
Jaun F, Boesing M, Luethi-Corridori G, Abig K, Bloch N, Giezendanner S, Grillmayr V, Haas P, Leuppi-Taegtmeyer AB, Muser J, et al. Effect of Single High Dose Vitamin D Substitution in Hospitalized COVID-19 Patients with Vitamin D Deficiency on Length of Hospital Stay. Biomedicines. 2023; 11(5):1277. https://doi.org/10.3390/biomedicines11051277
Chicago/Turabian StyleJaun, Fabienne, Maria Boesing, Giorgia Luethi-Corridori, Kristin Abig, Nando Bloch, Stéphanie Giezendanner, Victoria Grillmayr, Philippe Haas, Anne B. Leuppi-Taegtmeyer, Jürgen Muser, and et al. 2023. "Effect of Single High Dose Vitamin D Substitution in Hospitalized COVID-19 Patients with Vitamin D Deficiency on Length of Hospital Stay" Biomedicines 11, no. 5: 1277. https://doi.org/10.3390/biomedicines11051277