scholarly journals Prevalence of Vitamin D Deficiency and Associated Factors in Critically Ill Patients: A Multicenter Observational Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Kuo-Wei Chen ◽  
Chung-Wei Chen ◽  
Kuo-Ching Yuan ◽  
I-Ting Wang ◽  
Fang-Ming Hung ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Associated Factors ◽  
Albumin Level ◽  
Icu Stay ◽  
Vitamin D Levels ◽  
Group 2

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.

scholarly journals Up to 40% of COVID-19 Critically Ill Patients Have Vitamin D Deficiency

2020 ◽  
Author(s):  
Teresa-Maria Tomasa-Irriguible ◽  
Lara Bielsa-Berrocal
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Statistical Significance ◽  
Vitamin D Status ◽  
Reactive Protein ◽  
Vitamin D Levels ◽  
Polymerase Chain ◽  
Potential Strategy

Background: Coronavirus disease (COVID-19) has caused more than 745,000 deaths worldwide. Vitamin D has been identified as a potential strategy to prevent or treat this disease. The purpose of the study was to measure vitamin D at hospital admission of COVID-19; Methods: We included critically ill patients with the polymerase chain reaction positive test for COVID-19, from March to April, 2020. Statistical significance was defined as P < .05. All tests were 2-tailed; Results: A total of 35 patients (median age, 60 years; 26 [74.3%] male) were included. Vitamin D levels were categorized as deficient for 14 participants (40%). Vitamin D deficiency was associated with vitamin A (P= 0.003) and Zinc (P= 0.019) deficiency and lower levels of albumin (P= 0.026) and prealbumin (P= 0.009). Overall, none of the studied variables were associated with vitamin D status: mortality, intensive care unit (ICU) or hospital stay, necessity of vasoactive agents, intubation, prone position, C reactive protein (CRP), Dimer-D, Interleukin 6 levels (IL-6), ferritin levels, or bacterial superinfection; Conclusions: In this single-center, retrospective cohort study, deficient vitamin D status was found in 40% in COVID-19 critically ill patients. However, deficient vitamin D status was not associated with inflammation or outcome.

scholarly journals Bad Prognosis in Critical Ill Patients with COVID-19 during Short-Term ICU Stay Regarding Vitamin D Levels

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1988
Author(s):  
Lourdes Herrera-Quintana ◽  
Yenifer Gamarra-Morales ◽  
Héctor Vázquez-Lorente ◽  
Jorge Molina-López ◽  
José Castaño-Pérez ◽  
...  
Keyword(s):  
Vitamin D ◽  
Critically Ill ◽  
Invasive Mechanical Ventilation ◽  
Lower Percentage ◽  
Critically Ill Patient ◽  
Vitamin D Status ◽  
Short Term ◽  
Icu Stay ◽  
Vitamin D Levels

Background and aims: Vitamin D inadequacy may be involved in the mechanisms of SARS-CoV-2 infection and in potential risk factors for disease propagation or control of coronavirus disease 2019 (COVID-19). This study assessed a short-term evolution of vitamin D status and its influence upon different clinical parameters in critically ill patients with COVID-19. Methods: A prospective analytical study in which 37 critically ill volunteers between 41 and 71 years of age with COVID-19 were evaluated at baseline and three days of intensive care unit (ICU) stay. 25-OH-D3 and 25-OH-D2 were analyzed by liquid chromatography–tandem mass spectrometry and total 25-OH-D levels were calculated as the sum of both. Results: All patients presented low 25-OH-D levels at baseline, decreasing total 25-OH-D (p = 0.011) mainly through 25-OH-D2 (p = 0.006) levels during ICU stay. 25-OH-D2 levels decreased a mean of 41.6% ± 89.6% versus 7.0% ± 23.4% for the 25-OH-D3 form during the ICU stay. Patients who did not need invasive mechanical ventilation presented higher levels of 25-OH-D2 at baseline and follow-up. Lower 25-OH-D and 25-OH-D3 levels were associated with higher D-dimer at baseline (p = 0.003; p = 0.001) and at follow up (p = 0.029), higher procalcitonin levels (p = 0.002; p = 0.018) at follow up, and lower percentage lymphocyte counts (p = 0.044; p = 0.040) during ICU stay. Conclusions: Deficient vitamin D status in critical patients was established at the admission and further worsened after three days of stay. Lower vitamin D levels were related to key altered clinical and biochemical parameters on patients with SARS-CoV-2 infection. Given the different response of the 25-OH-D3 and 25-OH-D2 forms, it would be useful to monitor them on the evolution of the critically ill patient.

scholarly journals Association Between Low Serum Vitamin D Levels and Sepsis: A Single-Center Study in Tehran, Iran

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Masume Bayat ◽  
Latif Gachkar ◽  
Mahya Zahirnia ◽  
Fahimeh Hadavand
Keyword(s):  
Vitamin D ◽  
Severe Sepsis ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Plasma Concentrations ◽  
Serum Vitamin ◽  
Vitamin D Insufficiency ◽  
Serum Vitamin D ◽  
Vitamin D Levels

Background: Vitamin D insufficiency is common in critically ill patients. It is hypothesized that vitamin D deficiency would be associated with sepsis in the critically ill. Thus, the present study aimed to investigate the association between vitamin D and sepsis severity. Method: In this cross-sectional study, patients with sepsis referring to a university hospital in Tehran, Iran, from February 2018 to March 2019 were included. Plasma concentrations of vitamin D in critically ill subjects admitted were assessed. Data were analyzed using SPSS version 20.0. P-values less than 0.05 were considered statistically significant. Results: Among the investigated patients, the mean serum level of vitamin D3 was 19.03 ± 13.08 ng/mL. The prevalence of vitamin D insufficiency in critically ill subjects with sepsis was 100% (150/150). Only sex (P = 0.01) indicated a significant association with vitamin D. Patients suffering from severe sepsis had lower levels of vitamin D compared to the patients with non-severe sepsis (P = 0.07). Conclusions: The present study showed that all critically ill patients studied had vitamin D insufficiency. In line with the biological evidence, the present study suggests that vitamin D deficiency may predispose patients to sepsis. Further studies are needed to establish the causes and mechanisms underlying these interpretations.

scholarly journals CORRELATION OF SERUM VITAMIN D LEVEL WITH MORTALITY IN PATIENTS WITH SEPSIS

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Pramod Sood ◽  
Manpreet Kaur
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Serum Vitamin ◽  
Medical Emergency ◽  
Serum Vitamin D ◽  
Increased Risk ◽  
Vitamin D Levels

Background: Vitamin D insufficiency is a common global phenomenon. Its insufficiency is also reported to be common in hospitalized patients and particularly in critically ill patients. Methods: Following ethical approval, consent will be sought from either the patient or assent from a near relative. Successive patients admitted to the medical emergency and ICU at tertiary care health center who fulfill the following criteria for sepsis, within a 24 h time window, were included in the study. Results: A total of 50 patients were enrolled in the study, 37 (74.00%) were discharged whereas 13(26.00%) patients expired. The majority of patients, irrespective of outcome had Vitamin D deficiency. Although normal Vitamin D levels were observed in relatively higher proportion of patients who were discharged (29 patients) as compared to those who expired (12 patients) yet this difference was not significant statistically (P = 0.481). Conclusion: Vitamin D deficiency leads to increased risk of mortality in the critically ill patients. Keywords: Sepsis, Vitamin D deficiency, Mortality.

scholarly journals Vitamin D deficiency in critically ill patients diagnosed with COVID -19. Are we doing enough? A retrospective analysis of 226 patients.

2020 ◽  
Author(s):  
Tomás Cuñat ◽  
Antonio Ojeda ◽  
Andrea Calvo
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Distress Syndrome ◽  
Renin Angiotensin System ◽  
Angiotensin System ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D

Abstract Vitamin D deficiency is common in critically ill patients, and its role in COVID-19 patients could be important. Its deficiency has been associated with respiratory distress syndrome, pulmonary fibrosis (through activation of the renin-angiotensin system), increased levels of IL-2, and cardiovascular adverse events. Various scientific societies recommend the screening of vitamin D in individuals at risk for deficiency. Despite that, the demographics of Vitamin D levels amongst critically ill patients with a confirmed diagnosis of COVID-19 are currently unknown. We propose a study to determine the prevalence of vitamin D deficiency in a consecutive population of COVID-19 patients admitted to intensive care units and to evaluate its relationship with clinical outcomes. We study 226 COVID-19 patients between March 16 and April 26, 2020. The prevalence of vitamin D deficiency could not be determined because the value of 25-hydroxyvitamin D was obtained in a few patients (17 patients, 7,5%). However, all patients with serum determinations of 25-hydroxyvitamin D presented a level lower than 20 ng/ml and thirteen patients (76,5%) levels < 12,5 ng/ml. We conclude that undiagnosed vitamin D deficiency is common in critically ill COVID-19 patients, and physicians should be conscious of the relevance of its monitoring and supplementation.

The role of IL-6 receptor inhibitor treatment in critical patient monitoring with COVID-19

2021 ◽  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lactate Dehydrogenase ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group 2 ◽  
D Dimer

Objectives: The COVID-19 disease can manifest itself with acute respiratory distress syndrome, renal failure, and septic shock in critically ill patients. There are opinions that there is a correlation between high IL-6 levels and disease severity. In our intensive care unit, we evaluated the changes in the laboratory data and radiological involvement severity of our patients who underwent tocilizumab treatment and examined the appropriate laboratory parameter in the treatment follow-up and its effect on survival. Methods: In the critical patient follow-up of COVID-19, 17 of the 23 patients treated with tocilizumab had a mortal course (Group 1) and the remaining 6 (Group 2) were. The C-reactive protein, lactate dehydrogenase, IL-6, D-dimer, procalcitonin, albumin, and ferritin values, which were routinely screened in our clinic on the day of tocilizumab treatment and the 5th day after, were recorded. Both the change between the two groups and the change between days 1 and 5 were analyzed. Results: A total of 23 patients (55.35 ± 13.31 years) were included in the study. The computed tomography severity score assessed at the intensive care unit admission was statistically significantly higher in Group 2. The procalcitonin and lactate dehydrogenase values measured on day 5 after tocilizumab were significantly lower in Group 2. On the 5th day after treatment, the levels of C-reactive protein, ferritin, chest X-rays, IL-6 and D-dimer statistically significantly changed compared to the first day of the treatment. In correlation with the decrease in PCT as of the 5th day after tocilizumab administration, an increasing tendency was observed in 28-day survival. Conclusion: This study demonstrated that tocilizumab treatment may positively contribute to the treatment by decreasing cytokine levels. PCT and LDH follow-up before and after treatment in critically ill patients who are receiving tocilizumab treatment can give an idea about survival.

Relationship of Vitamin D Deficiency to Clinical Outcomes in Critically Ill Patients

2012 ◽  
Vol 36 (6) ◽  
pp. 713-720 ◽  
Author(s):  
David M. Higgins ◽  
Paul E. Wischmeyer ◽  
Kelly M. Queensland ◽  
Stefan H. Sillau ◽  
Alexandra J. Sufit ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Relationship Of

scholarly journals Is Vitamin D Insufficiency Associated with Mortality of Critically Ill Patients?

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Gulbin Aygencel ◽  
Melda Turkoglu ◽  
Ayse Fitnat Tuncel ◽  
Burcu Arslan Candır ◽  
Yelda Deligoz Bildacı ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Independent Risk Factor ◽  
Vitamin D Insufficiency ◽  
University Hospital ◽  
Median Serum ◽  
Vitamin D Levels ◽  
Sufficient Vitamin

Objective. To evaluate the vitamin D status of our critically ill patients and its relevance to mortality.Patients and Methods. We performed a prospective observational study in the medical intensive care unit of a university hospital between October 2009 and March 2011. Vitamin D levels were measured and insufficiency was defined as <20 ng/mL.Results. Two hundred and one patients were included in the study. The median age was 66 (56–77) and the majority of patients were male (56%). The median serum level of vitamin D was 14,9 ng/mL and 139 (69%) patients were vitamin D insufficient on admission. While we grouped the ICU patients as vitamin D insufficient and sufficient, vitamin D insufficient patients had more severe acute diseases and worse laboratory values on admission. These patients had more morbidities and were exposed to more invasive therapies during stay. The mortality rate was significantly higher in the vitamin D insufficient group compared to the vitamin D sufficient group (43% versus 26%,P=0,027). However, logistic regression analysis demonstrated that vitamin D insufficiency was not an independent risk factor for mortality.Conclusion. Vitamin D insufficiency is common in our critically ill patients (69%), but it is not an independent risk factor for mortality.

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