Low vitamin D at ICU admission is associated with cancer, infections, acute respiratory insufficiency, and liver failure

Gomes, Tatyanne Ln; Fernandes, Renata C.; Vieira, Liana Lima; Schincaglia, Raquel Machado; Mota, João Felipe; Nóbrega, Marciano S.; Pichard, Claude; Pimentel, Gustavo D.

doi:10.1016/j.nut.2018.10.018

Cited by 14 publications

(5 citation statements)

References 53 publications

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“…Jevalikar et al [ 26 ] investigated 410 hospitalized patients with COVID-19, of which 48.2% were with vitamin D deficiency (defined as serum 25(OH)D level < 20 ng/mL), and found serum 25(OH)D levels at admission did not correlate with clinical outcomes, and receiving cholecalciferol did not make any difference to the outcomes. Similar results were also reported by Gomes et al [ 27 ], Maamer et al [ 28 ], and Aygencel et al [ 29 ]. From these available studies, it could be observed that the prevalence of deficient blood 25(OH)D varied, which might be due to different criteria for determining deficient 25(OH)D and different study populations.…”

Section: Discussionsupporting

confidence: 91%

Abnormal blood 25-hydroxyvitamin D in critically ill patients: prevalence, predictors, and its association with in-hospital mortality

Xie

Chen

2022

Eur J Med Res

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Background Abnormal vitamin D is prevalent in critical care settings, but its association with prognosis remains unclear. The study aimed to investigate the prevalence and predictors of abnormal blood 25-hydroxyvitamin D (25(OH)D), as well as its association with prognosis in critically ill patients. Methods Patients aged ≥ 18 years who were once admitted to the intensive care units (ICUs) of the Beth Israel Deaconess Medical Center between 2008 and 2019 with at least one measurement record of blood 25(OH)D were included as study population. Baseline characteristics associated with deficient or elevated blood 25(OH)D were investigated by univariable logistic regression analysis. The association between abnormal blood 25(OH)D and hospital mortality was examined by multivariable logistic regression analysis. Results A total of 1091 patients were included. Deficient 25(OH)D (< 30 ng/mL) was found in 790 (72.41%) patients and 17 (1.56%) were with an elevated level (> 60 ng/mL). A younger age, male, comorbid liver disease, and dialysis were risk factors of deficient blood 25(OH)D, while comorbid myocardial infarction, dementia, and rheumatic disease were protective factors evaluated by univariable logistic regression. Being admitted to cardiac vascular ICU or coronary care unit were associated with increased risk of elevated blood 25(OH)D. Patients with elevated blood 25(OH)D showed non-significantly higher hospital mortality compared to those with normal or deficient blood 25(OH)D (35.29% versus 14.44% and 14.56%, P = 0.058). After adjusted for potential confounding factors, elevated blood 25(OH)D was associated with increased risk of hospital mortality [odds ratio (OR) 3.80, 95% confidence interval (CI) 1.22–11.82, P = 0.021] when compared to those with normal blood 25(OH)D, but there was no significant association between deficient blood 25(OH)D and hospital mortality (OR 1.12, 95% CI 0.74–1.72, P = 0.589). Conclusions These findings suggest deficient blood 25(OH)D was rather common in critically ill patients, but was not an independent risk factor of hospital mortality, while elevated blood 25(OH)D was associated with worse prognosis.

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Section: Discussionsupporting

confidence: 91%

Abnormal blood 25-hydroxyvitamin D in critically ill patients: prevalence, predictors, and its association with in-hospital mortality

Xie

Chen

2022

Eur J Med Res

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“…Although, no negative correlation between blood vitamin D concentration and deaths (r ¼ À0.35, p ¼ 0.12) was found, there is a negative correlation between the vitamin D concentration and the number of case of COVID-19 infected patients in the general population [4]. In previous study, we found that low blood vitamin D (<17.7 ng/mL) concentrations are associated with the ICU clinical outcomes, such as acute respiratory failure, infections and acute liver failure [5].…”

Section: Introductionmentioning

confidence: 78%

Low vitamin D levels and increased neutrophil in patients admitted at ICU with COVID-19

Pimentel

Vega

Pichard

2021

Clinical Nutrition ESPEN

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Background & Aims Systemic inflammation has been reported as a new predictor for COVID-19 outcomes. Thus, we hypothesized that ICU patients infected by COVID-19 had lower blood vitamin D levels and increased systemic inflammation. Therefore, this is the first Brazilian study to evaluate the vitamin D concentrations and NLR as a systemic inflammation in patients infected by COVID-19 admitted in ICU. Methods This cross-sectional study selected twenty-six patients from COVID-19 Data Sharing/FAPESP, Brazil. Twenty-five patients were enrolled from a single hospital and those with blood vitamin D and neutrophil and lymphocyte data were included and had all available data analyzed. Patients were divided in two groups: low vitamin D concentration when ≤ 20 ng/mL (low Vit D group, n= 8, 5M/3F, 62.7±8.4 years old), and normal vitamin D when > 20 ng/mL (normal Vit D group, n= 17, 9M/8F, 74±8.2 years old). Serum 25-hydroxy-vitamin D, C reactive protein (CRP), and count of neutrophils and lymphocytes concentrations were collected from COVID-19 Data Sharing/FAPESP. Statistical analyses were performed using the Prism version 5.0 and Student T test was applied to verify any difference between the groups. Results Low vitamin D group had 15.5±3.3 ng/mL of 25OH Vit D concentrations and normal vitamin D group had 35.9±8.8 ng/mL. Although no difference between groups for CRP concentrations (low Vit D: 4.5±3.3 vs. normal Vit D: 4.2±4.0 mg/dL, p=0.45), we found higher neutrophil count and NLR values in the low Vit D group when compared to normal Vit D group (low Vit D: 6049.8±3719.7 vs. normal Vit D: 3741.8±1704.1 ng/mL, p=0.02) and (low Vit D: 9.0±8.6 vs. normal Vit D: 4.2±4.0 ng/mL, p=0.03), respectively. Conclusion This data sharing-derived cases of COVID-19 in patients admitted at ICU showed that patients infected by COVID-19 had lower serum 25-hydroxy vitamin D and enhanced systemic inflammation when assessed by NLR values.

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“…In recent years, the SOFA score has been widely used in a range of other applications such as in the diagnosis of sepsis and in determining individual treatment strategies or outcomes in patients with sepsis [14]. SOFA has also been used to assess disease severity and predict prognosis in cancer patients [15], acute pancreatitis [16], acute liver failure [17], and acute respiratory distress syndrome (ARDS) [18]. However, the use of SOFA score in assessing the prognosis of patients with AKI undergoing CRRT has not been extensively studied.…”

Section: Introductionmentioning

confidence: 99%

SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

et al. 2020

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Background: Acute kidney injury (AKI) is the most common cause of organ failure in multiple organ dysfunction syndrome (MODS) and is associated with increased mortality. This study aimed at determining the efficacy of sequential organ failure assessment (SOFA), and acute physiology and chronic health evaluation II (APACHE-II) scoring systems in assessing the prognosis of critically ill patients with AKI undergoing continuous renal replacement therapy (CRRT). At present, APACHE-II score and SOFA score were also used to evaluate and predict the prognosis of critically ill patients with AKI. Methods: The predictive value of SOFA and APACHE-II scores for 28-and 90-d mortality in patients with AKI undergoing CRRT were determined by multivariate analysis, sensitivity analysis, and curve-fitting analysis. Results: A total of 836 cases were included in this study. Multivariate Cox logistic regression analysis showed that SOFA scores were associated with 28-and 90-d mortality in patients with AKI undergoing CRRT.

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Low vitamin D at ICU admission is associated with cancer, infections, acute respiratory insufficiency, and liver failure

Cited by 14 publications

References 53 publications

Abnormal blood 25-hydroxyvitamin D in critically ill patients: prevalence, predictors, and its association with in-hospital mortality

Abnormal blood 25-hydroxyvitamin D in critically ill patients: prevalence, predictors, and its association with in-hospital mortality

Low vitamin D levels and increased neutrophil in patients admitted at ICU with COVID-19

SOFA score is superior to APACHE-II score in predicting the prognosis of critically ill patients with acute kidney injury undergoing continuous renal replacement therapy

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