tetano
Editor, Senior Moderator
Int J Environ Res Public Health
. 2021 Dec 31;19(1):447.
doi: 10.3390/ijerph19010447.
The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2
Jimmy T Efird[SUP] 1 [/SUP], Ethan J Anderson[SUP] 2 [/SUP], Charulata Jindal[SUP] 3 [/SUP], Thomas S Redding[SUP] 1 [/SUP], Andrew D Thompson[SUP] 1 [/SUP], Ashlyn M Press[SUP] 1 [/SUP], Julie Upchurch[SUP] 1 [/SUP], Christina D Williams[SUP] 1 4 5 [/SUP], Yuk Ming Choi[SUP] 6 [/SUP], Ayako Suzuki[SUP] 1 7 8 [/SUP]
Affiliations
Abstract
This data-based cohort consisted of 26,508 (7%) United States veterans out of the 399,290 who tested positive for SARS-CoV-2 from 1 March to 10 September 2020. We aimed to assess the interaction of post-index vitamin D (Vit D) and corticosteroid (CRT) use on 30-day mortality among hospitalized and non-hospitalized patients with coronavirus disease 2019 (COVID-19). Combination Vit D and CRT drug use was assessed according to four multinomial pairs (-|+, -|-, +|+, +|-). Respective categorical effects were computed on a log-binomial scale as adjusted relative risk (aRR). Approximately 6% of veterans who tested positive for SARS-CoV-2 died within 30 days of their index date. Among hospitalized patients, a significantly decreased aRR was observed for the use of Vit D in the absence of CRTs relative to patients who received CRTs but not Vit D (aRR = 0.30; multiplicity corrected, p = 0.0004). Among patients receiving systemically administered CRTs (e.g., dexamethasone), the use of Vit D was associated with fewer deaths in hospitalized patients (aRR = 0.51) compared with non-hospitalized patients (aRR = 2.5) (P-for-Interaction = 0.0071). Evaluating the effect of modification of these compounds in the context of hospitalization may aid in the management of COVID-19 and provide a better understanding of the pathophysiological mechanisms underlying this and future infectious disease outbreaks.
Keywords: COVID-19; SARS-CoV-2; anti-inflammatory; corticosteroids; cytokine storm; veterans; vitamin D.
. 2021 Dec 31;19(1):447.
doi: 10.3390/ijerph19010447.
The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2
Jimmy T Efird[SUP] 1 [/SUP], Ethan J Anderson[SUP] 2 [/SUP], Charulata Jindal[SUP] 3 [/SUP], Thomas S Redding[SUP] 1 [/SUP], Andrew D Thompson[SUP] 1 [/SUP], Ashlyn M Press[SUP] 1 [/SUP], Julie Upchurch[SUP] 1 [/SUP], Christina D Williams[SUP] 1 4 5 [/SUP], Yuk Ming Choi[SUP] 6 [/SUP], Ayako Suzuki[SUP] 1 7 8 [/SUP]
Affiliations
- PMID: 35010701
- DOI: 10.3390/ijerph19010447
Abstract
This data-based cohort consisted of 26,508 (7%) United States veterans out of the 399,290 who tested positive for SARS-CoV-2 from 1 March to 10 September 2020. We aimed to assess the interaction of post-index vitamin D (Vit D) and corticosteroid (CRT) use on 30-day mortality among hospitalized and non-hospitalized patients with coronavirus disease 2019 (COVID-19). Combination Vit D and CRT drug use was assessed according to four multinomial pairs (-|+, -|-, +|+, +|-). Respective categorical effects were computed on a log-binomial scale as adjusted relative risk (aRR). Approximately 6% of veterans who tested positive for SARS-CoV-2 died within 30 days of their index date. Among hospitalized patients, a significantly decreased aRR was observed for the use of Vit D in the absence of CRTs relative to patients who received CRTs but not Vit D (aRR = 0.30; multiplicity corrected, p = 0.0004). Among patients receiving systemically administered CRTs (e.g., dexamethasone), the use of Vit D was associated with fewer deaths in hospitalized patients (aRR = 0.51) compared with non-hospitalized patients (aRR = 2.5) (P-for-Interaction = 0.0071). Evaluating the effect of modification of these compounds in the context of hospitalization may aid in the management of COVID-19 and provide a better understanding of the pathophysiological mechanisms underlying this and future infectious disease outbreaks.
Keywords: COVID-19; SARS-CoV-2; anti-inflammatory; corticosteroids; cytokine storm; veterans; vitamin D.