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Mirijello A, Piscitelli P, d'Angelo C, Tosoni A, De Cosmo S. Extraosseous effects of vitamin D: a role in the prevention and treatment of COVID-19? Intern Emerg Med 2022; 17:949-951. [PMID: 35349004 PMCID: PMC8960676 DOI: 10.1007/s11739-022-02973-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Antonio Mirijello
- Department of Medical Sciences, Internal Medicine Unit, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 71013, San Giovanni Rotondo, Italy.
| | - Pamela Piscitelli
- Department of Medical Sciences, Internal Medicine Unit, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 71013, San Giovanni Rotondo, Italy
| | - Cristina d'Angelo
- "Gli Angeli di Padre Pio", Fondazione Centri di Riabilitazione Padre Pio Onlus, Viale Padre Pio, 24, 71013, San Giovanni Rotondo, Italy
| | - Alberto Tosoni
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, 00168, Rome, Italy
| | - Salvatore De Cosmo
- Department of Medical Sciences, Internal Medicine Unit, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini, 71013, San Giovanni Rotondo, Italy
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Chen KW, Chen CW, Yuan KC, Wang IT, Hung FM, Wang AY, Wang YC, Kuo YT, Lin YC, Shih MC, Kung YC, Ruan SY, Chiu CT, Chao A, Han YY, Kuo LK, Yeh YC. Prevalence of Vitamin D Deficiency and Associated Factors in Critically Ill Patients: A Multicenter Observational Study. Front Nutr 2021; 8:768804. [PMID: 34966771 PMCID: PMC8710763 DOI: 10.3389/fnut.2021.768804] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/22/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Vitamin D deficiency is common in the general population worldwide, and the prevalence and severity of vitamin D deficiency increase in critically ill patients. The prevalence of vitamin D deficiency in a community-based cohort in Northern Taiwan was 22.4%. This multicenter cohort study investigated the prevalence of vitamin D deficiency and associated factors in critically ill patients in Northern Taiwan. Methods: Critically ill patients were enrolled and divided into five groups according to their length of stay at intensive care units (ICUs) during enrolment as follows: group 1, <2 days with expected short ICU stay; group 2, <2 days with expected long ICU stay; group 3, 3-7 days; group 4, 8-14 days; and group 5, 15-28 days. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) level < 20 ng/ml, and severe vitamin D deficiency was defined as a 25(OH)D level < 12 ng/ml. The primary analysis was the prevalence of vitamin D deficiency. The exploratory analyses were serial follow-up vitamin D levels in group 2, associated factors for vitamin D deficiency, and the effect of vitamin D deficiency on clinical outcomes in critically ill patients. Results: The prevalence of vitamin D deficiency was 59% [95% confidence interval (CI) 55-62%], and the prevalence of severe vitamin D deficiency was 18% (95% CI 15-21%). The median vitamin D level for all enrolled critically ill patients was 18.3 (13.7-23.9) ng/ml. In group 2, the median vitamin D levels were <20 ng/ml during the serial follow-up. According to the multivariable analysis, young age, female gender, low albumin level, high parathyroid hormone (PTH) level, and high sequential organ failure assessment (SOFA) score were significantly associated risk factors for vitamin D deficiency. Patients with vitamin D deficiency had longer ventilator use duration and length of ICU stay. However, the 28- and 90-day mortality rate were not associated with vitamin D deficiency. Conclusions: This study demonstrated that the prevalence of vitamin D deficiency is high in critically ill patients. Age, gender, albumin level, PTH level, and SOFA score were significantly associated with vitamin D deficiency in these patients.
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Affiliation(s)
- Kuo-Wei Chen
- Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chung-Wei Chen
- Department of Surgical Intensive Care Unit, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Kuo-Ching Yuan
- Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - I-Ting Wang
- Division of Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Fang-Ming Hung
- Department of Surgical Intensive Care Unit, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - An-Yi Wang
- Department of Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yin-Chin Wang
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Ting Kuo
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Che Lin
- Department of Environment and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chieh Shih
- Department of Public Health, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chung Kung
- Division of Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Sheng-Yuan Ruan
- Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Tang Chiu
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Anne Chao
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yin-Yi Han
- Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Kuo Kuo
- Division of Critical Care Medicine, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Yu-Chang Yeh
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
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[Effect of COVID-19 on dietotherapeutic prescription during the first half of 2020 in the Community of Madrid]. NUTR HOSP 2021; 38:1138-1143. [PMID: 34670393 DOI: 10.20960/nh.03758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Objectives: the aim of the study was to analyze the impact of COVID-19 on enteral nutrition prescription in the Community of Madrid during the first semester of 2020. Material and Methods: this is a descriptive study of enteral nutrition prescription in the first semester of 2020 and its comparison with the first semester of 2019. We included all the prescriptions in public hospitals of the Community of Madrid as recorded in public electronic databases. Results: there was an 8 % increase in the number of enteral nutrition prescriptions in March 2020 when compared with the previous months (p < 0.001). Then, in April and May 2020 we observed a 9 % decrease in enteral nutrition prescriptions (p < 0.001). Total costs in enteral nutrition showed a similar pattern, with an increase in March 2020 (p < 0.001) and a decrease in April and May 2020 (p < 0.001). When analyzing the data by patient age, those above 75 y.o. showed the highest decrease in enteral nutrition prescriptions (33.1 % higher than for those under 75 y.o.) in April and May 2020 (p < 0.001). Conclusions: the irruption of COVID-19 had a relevant impact on enteral nutrition prescription, especially among the elderly. Follow-up is needed to assess the long-term consequences of this in nutritional therapy.
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Delta-Procalcitonin and Vitamin D Can Predict Mortality of Internal Medicine Patients with Microbiological Identified Sepsis. ACTA ACUST UNITED AC 2021; 57:medicina57040331. [PMID: 33915819 PMCID: PMC8066199 DOI: 10.3390/medicina57040331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 12/29/2022]
Abstract
Background: The management of septic patients hospitalized in Internal Medicine wards represents a challenge due to their complexity and heterogeneity, and a high mortality rate. Among the available prognostic tools, procalcitonin (PCT) is considered a marker of bacterial infection. Furthermore, an association between vitamin D deficiency and poor sepsis-related outcomes has been described. Objectives: To evaluate the prognostic accuracy of two consecutive PCT determinations (Delta-PCT) and of vitamin D levels in predicting mortality in a population of patients with microbiological identified sepsis admitted to Internal Medicine wards. Methods: This is a sub-analysis of a previous prospective study. A total of 80 patients had at least two available consecutive PCT determinations, while 63 had also vitamin D. Delta-PCT was defined as a reduction of PCT > 50% after 48 h, >75% after 72 h, and >85% after 96 h. Mortality rate at 28- and 90-days were considered as main outcome. Results: Mortality rate was 18.7% at 28-days and 30.0% at 90-days. Baseline PCT levels did not differ between survived and deceased patients (28-days: p = 0.525; 90-days: p = 0.088). A significantly higher proportion of survived patients showed Delta-PCT (28-days: p = 0.002; 90-days: p < 0.001). Delta-PCT was associated with a lower 28-days (p = 0.007; OR = 0.12, 95%CI 0.02–0.46) and 90-days mortality (p = 0.001; OR = 0.17, 95%CI 0.06–0.48). A significantly higher proportion of deceased patients showed severe vitamin D deficiency (28-days: p = 0.047; 90-days: p = 0.049). Severe vitamin D deficiency was associated with a higher 28-days (p = 0.058; OR = 3.95, 95%CI 1.04–19.43) and 90-days mortality (p = 0.054; OR = 2.94, 95%CI 1.00–9.23). Conclusions: Delta-PCT and vitamin D represent two useful tests for predicting prognosis of septic patients admitted to Internal Medicine wards.
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