Is vitamin D deficiency related to a higher risk of hospitalization and mortality in veterans with heart failure?

Aparicio‐Ugarriza, Raquel; Salguero, Douglas; Mohammed, Yaqub Nadeem; Ferri‐Guerra, Juliana; Baskaran, Dhanaraj; Mirabbasi, Seyed Abbas; Rodríguez, Alexis; Ruiz, Jorge G.

doi:10.1016/j.maturitas.2019.11.005

Cited by 12 publications

(15 citation statements)

References 32 publications

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“…Clinical Severe cases associated with pneumonia Inverse correlation for CAP [68,69] Increased production of pro-inflammatory cytokines such as IL-6 Inverse correlation [70,71] Increased CRP Inverse correlation [72,73] Increased risk of sepsis Inverse correlation [74,75] Risk of ARDS Inverse correlation [76,77] Risk of heart failure Inverse correlation [78,79] Risk of diabetes mellitus Inverse correlation [67,80] Epidemiological Began in December 2019 in China, spread mainly to northern midlatitude countries Low 25(OH)D values in winter [48,81] Males have higher incidence and much higher CFRs than females Smoking reduces 25(OH)D [82] CFR increases with age Chronic disease rates increase with age; vitamin D plays a role in reducing risk of chronic diseases [83] Higher CFR for diabetics Diabetics may have lower 25(OH)D [84] Higher CFR for diabetics Lower 25(OH)D associated with increased risk of incidence [85] Higher CFR for hypertension Lower 25(OH)D may be associated with increased risk of incidence [86] Higher CFR for cardiovascular disease Lower 25(OH)D associated with increased risk of incidence and death [87] Higher CFR for chronic respiratory disease For COPD patients, 25(OH)D inversely correlated with risk, severity, and exacerbation [88] Found at higher rates in regions with elevated air pollution Air pollution associated with lower 25(OH)D concentrations [89] Note: 25-hydroxyvitamin D ((25(OH)D); acute respiratory distress syndrome (ARDS); community-acquired pneumonia (CAP); case-fatality rate (CFR); interleukin 6 (IL-6); chronic obstructive pulmonary disease (COPD); C-reactive protein (CRP); vitamin D deficiency (VDD). Table 3 lists some findings for vitamin D supplementation in reducing the clinical effects of COVID-19 infection found from treating other diseases.…”

Section: Characteristics Relation To 25(oh)d Referencementioning

confidence: 99%

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

et al. 2020

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The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D 3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D 3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

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Section: Characteristics Relation To 25(oh)d Referencementioning

confidence: 99%

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

et al. 2020

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“…Inverse correlation [70], [71] Increased CRP Inverse correlation [72], [73] Increased risk of sepsis Inverse correlation [74], [75] Risk of ARDS Inverse correlation [76], [77] Risk of heart failure Inverse correlation [78], [79] Risk of diabetes mellitus Inverse correlation [80], [67] Epidemiological characteristics Began in December 2019 in China, spread mainly to northern midlatitude countries Low 25(OH)D values in winter [48], [81] Males have higher incidence and much higher CFRs than females Smoking reduces 25(OH)D [82] CFR increases with age Chronic disease rates increase with age; vitamin D plays a role in reducing risk of chronic diseases [83] Higher CFR for diabetics Diabetics may have lower 25(OH)D [84] Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 30 March 2020 doi:10.20944/preprints202003.0235.v2…”

Section: Clinical and Epidemiological Findings Regarding Covid-19mentioning

confidence: 99%

Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

Grant

Lahore

McDonnell

et al. 2020

Preprint

579

595

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The world is in the grips of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increase concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D [25(OH)D] concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/ml (100–150 nmol/l). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

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“…The majority of these studied the outcomes in terms of hospitalizations, risk of mortality, impact on LVEF, and effect on physical activity. A recent study reported vitamin D deficiency as an independent risk factor for hospitalization in patients with CHF [ 13 ]. Furthermore, this risk was more consistent in frail veterans when compared to non-frail veterans.…”

Section: Reviewmentioning

confidence: 99%

“…Furthermore, this risk was more consistent in frail veterans when compared to non-frail veterans. An important aspect of this study was that its results failed to show any relationship between mortality and deficiency [ 13 ]. The main reasons for this lack of effect on mortality may be due to the small sample size and short follow-up period [ 13 ].…”

Section: Reviewmentioning

confidence: 99%

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Role of Vitamin D Supplementation in Heart Failure Patients With Vitamin D Deficiency and Its Effects on Clinical Outcomes: A Literature Review

Busa

Dardeir

Marudhai

et al. 2020

Cureus

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Vitamin D deficiency has become a global pandemic affecting approximately one billion people worldwide. Much attention has been paid to the association of low serum 25-hydroxyvitamin D (25(OH)D) levels and various chronic diseases, especially heart failure (HF). A clear role of vitamin D deficiency has been established, with increased mortality and morbidity in heart failures. However, previous randomized control trials have failed to show improvement in clinical outcomes with calciferol supplementation in these patients. Therefore, it is still unclear whether calciferol therapy can be added to the standard care in congestive heart failure (CHF) patients with deficiency. Hence, to evaluate the role of vitamin D supplementation in CHF patients with low serum 25(OH)D, we conducted an extensive search in the PubMed and Google Scholar databases using various combinations of keywords. All potentially eligible studies that evaluated the effects of vitamin D supplementation on clinical outcomes in HF patients were retrieved and extensively studied. We also checked the references of all eligible studies to identify additional relevant publications. In this study, we reviewed various mechanisms of vitamin D affecting the cardiovascular system and examined the impact of deficiency on heart failures in terms of mortality and hospitalizations. In conclusion, vitamin D supplementation has failed to improve the clinical outcomes in HF patients. The possible long-term benefits of supplementation cannot be excluded. Therefore, for future clinical trials, we recommend considering large sample sizes, longer follow-up durations, along with optimal dosage and appropriate dosing frequency.

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Is vitamin D deficiency related to a higher risk of hospitalization and mortality in veterans with heart failure?

Cited by 12 publications

References 32 publications

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

Role of Vitamin D Supplementation in Heart Failure Patients With Vitamin D Deficiency and Its Effects on Clinical Outcomes: A Literature Review

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