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MeSH Disease

Human Phenotype

Transmission

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Seroprevalence
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    Low serum SERO 25-hydroxyvitamin D (25D) levels in patients hospitalised with COVID-19 are associated with greater disease severity: results of a local audit of practice.

    Authors: Grigorios Panagiotou; Su Ann Tee; Yasir Ihsan; Waseem Athar; Gabriella Marchitelli; Donna Kelly; Christopher S. Boot; Nadia Stock; Jim Macfarlane; Adrian R. Martineau; Graham Paul Burns; Richard Quinton

    doi:10.1101/2020.06.21.20136903 Date: 2020-06-23 Source: medRxiv

    Objectives: To audit implementation of a local protocol for the treatment of vitamin D deficiency MESHD ( VDD MESHD) among patients hospitalized for Coronavirus Disease MESHD 2019 (COVID-19), including an assessment of the prevalence SERO of VDD MESHD in these patients, and of potential associations with disease severity and fatality. Design: This was not a study or clinical trial, but rather a retrospective interim audit (Newcastle-upon-Tyne Hospitals Registration No. 10075) of a local clinical care pathway for hospitalized patients with COVID-19-related illness. The Information (Caldicott) Guardian permitted these data to be shared beyond the confines of our institution. Setting: A large tertiary academic NHS Foundation Trust in the North East of England, UK, providing care to COVID-19 patients. Participants: One hundred thirty-four hospitalized patients with documented COVID-19 infection MESHD. Main outcome measures: Adherence to local investigation and treatment protocol; prevalence SERO of VDD MESHD, and relationship of baseline serum SERO 25(OH)D with markers of COVID-19 severity and inpatient fatality versus recovery. Results: 55.8% of eligible patients received Colecalciferol replacement, albeit not always loaded as rapidly as our protocol suggested, and no cases of new hypercalcaemia MESHD occurred following treatment. Patients admitted to ITU were younger than those managed on medical wards (61.1 years +/- 11.8 vs. 76.4 years +/- 14.9, p<0.001), with greater prevalence SERO of hypertension HP hypertension MESHD, and higher baseline respiratory rate, National Early Warning Score-2 and C-reactive protein level. While mean serum SERO 25(OH)D levels were comparable [i.e. ITU: 33.5 nmol/L +/- 16.8 vs. Non-ITU: 48.1 nmol/L +/- 38.2, mean difference for Ln-transformed-25(OH)D: 0.14, 95% Confidence Interval (CI) (-0.15, 0.41), p=0.3], only 19% of ITU patients had 25(OH)D levels greater than 50 nmol/L vs. 60.9% of non-ITU patients (p=0.02). However, we found no association with fatality, potentially due to small sample size, limitations of no-trial data and, potentially, the prompt diagnosis and treatment of VDD MESHD. Conclusions: Subject to the inherent limitations of observational (non-trial) audit data, analysed retrospectively, we found that patients requiring ITU admission were more frequently vitamin D deficient than those managed on medical wards, despite being significantly younger. Larger prospective studies and/or clinical trials are needed to elucidate the role of vitamin D as a preventive and/or therapeutic strategy for mitigating the effects of COVID-19 infection MESHD in patients with VDD MESHD.

    Serum SERO calcium as a biomarker of clinical severity and prognosis in patients with coronavirus disease MESHD 2019: a retrospective cross-sectional study

    Authors: Jia-Kui Sun; Wen-Hao Zhang; Lei Zou; Ying Liu; Jing-Jing Li; Xiao-Hua Kan; Lian Dai; Qian-Kun Shi; Shou-Tao Yuan; Wen-Kui Yu; Hong-Yang Xu; Wei Gu; Jian-Wei Qi

    doi:10.21203/rs.3.rs-17575/v1 Date: 2020-03-14 Source: ResearchSquare

    Background: To investigate the correlations between serum SERO calcium and clinical severity and outcomes in patients with coronavirus disease MESHD 2019 (COVID-19).Methods: In this clinical retrospective study, the levels of serum SERO calcium, hormone levels and clinical laboratory parameters of admission were recorded. The clinical severity and outcome variables were also recorded.Results: From February 10 to February 28 2020, 241 patients were enrolled in this study. Of these patients, 180 (74.7%) had hypocalcemia HP hypocalcemia MESHD on admission. The median serum SERO calcium levels were 2.12 (IQR, 2.04-2.20) mmol/L, median parathyroid hormone (PTH) levels were 55.27 (IQR, 42.73-73.15) pg/mL, median 25-hydroxy-vitamin D (VD) levels were 10.20 (IQR, 8.20-12.65) ng/mL. The serum SERO calcium levels were significantly positive correlated with VD levels (P =0.004), whereas negative correlated with PTH levels (P = 0.048). Patients with lower serum SERO calcium levels (especially ≤2.0 mmol/L) had worse clinical parameters, higher incidence of organ injury septic shock MESHD shock HP and higher 28-day mortality. The areas under the receiver operating characteristic curves of multiple organ dysfunction syndrome MESHD, septic shock MESHD shock HP, and 28-day mortality were 0.923 (P <0.001), 0.905 (P =0.001), and 0.929 (P <0.001), respectively. The overall mortality of COVID-19 was 4.1% (10/241), whereas the mortality of critical patients was up to 40.0% (10/25). Conclusions: Serum SERO calcium was associated with clinical severity and prognosis of patients with COVID-19. Hypocalcemia HP Hypocalcemia MESHD may be associated with imbalanced VD MESHD and PTH.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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