tetano
Editor, Senior Moderator
J Endocrinol Invest
. 2021 Mar 5.
doi: 10.1007/s40618-021-01535-2. Online ahead of print.
Vitamin D deficiency, secondary hyperparathyroidism and respiratory insufficiency in hospitalized patients with COVID-19
G Mazziotti[SUP] #[/SUP][SUP] 1 2 [/SUP], E Lavezzi[SUP] #[/SUP][SUP] 3 [/SUP], A Brunetti[SUP] 4 3 [/SUP], M Mirani[SUP] 3 [/SUP], G Favacchio[SUP] 3 [/SUP], A Pizzocaro[SUP] 3 [/SUP], M T Sandri[SUP] 5 [/SUP], A Di Pasquale[SUP] 6 [/SUP], A Voza[SUP] 7 [/SUP], M Ciccarelli[SUP] 6 [/SUP], A G Lania[SUP] 4 3 [/SUP], Humanitas COVID19 Task Force
Affiliations
Abstract
Purpose: Hypovitaminosis D has emerged as potential risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the general population with variable effects on the outcome of the coronavirus disease-19 (COVID-19). The aim of this retrospective single-center study was to investigate the impact of hypovitaminosis D and secondary hyperparathyroidism on respiratory outcomes of COVID-19.
Methods: Three-hundred-forty-eight consecutive patients hospitalized for COVID-19 at the IRCCS Humanitas Research Hospital, Rozzano, Milan (Italy) were evaluated for arterial partial pressure oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio, serum 25hydroxy-vitamin D [25(OH)D], parathyroid hormone (PTH) and inflammatory parameters at study entry and need of ventilation during the hospital stay.
Results: In the entire population, vitamin D deficiency (i.e., 25(OH)D values < 12 ng/mL) was significantly associated with acute hypoxemic respiratory failure at the study entry [adjusted odds ratio (OR) 2.48, 95% confidence interval 1.29-4.74; P = 0.006], independently of age and sex of subjects, serum calcium and inflammatory parameters. In patients evaluated for serum PTH (97 cases), secondary hyperparathyroidism combined with vitamin D deficiency was significantly associated with acute hypoxemic respiratory failure at study entry (P = 0.001) and need of ventilation during the hospital stay (P = 0.031).
Conclusion: This study provides evidence that vitamin D deficiency, when associated with secondary hyperparathyroidism, may negatively impact the clinical outcome of SARS-CoV-2-related pneumonia.
Keywords: COVID-19; Hyperparathyroidism; PTH; Pneumonia; SARS-CoV-2 infection; Vitamin D; Vitamin D deficiency.
. 2021 Mar 5.
doi: 10.1007/s40618-021-01535-2. Online ahead of print.
Vitamin D deficiency, secondary hyperparathyroidism and respiratory insufficiency in hospitalized patients with COVID-19
G Mazziotti[SUP] #[/SUP][SUP] 1 2 [/SUP], E Lavezzi[SUP] #[/SUP][SUP] 3 [/SUP], A Brunetti[SUP] 4 3 [/SUP], M Mirani[SUP] 3 [/SUP], G Favacchio[SUP] 3 [/SUP], A Pizzocaro[SUP] 3 [/SUP], M T Sandri[SUP] 5 [/SUP], A Di Pasquale[SUP] 6 [/SUP], A Voza[SUP] 7 [/SUP], M Ciccarelli[SUP] 6 [/SUP], A G Lania[SUP] 4 3 [/SUP], Humanitas COVID19 Task Force
Affiliations
- PMID: 33666876
- DOI: 10.1007/s40618-021-01535-2
Abstract
Purpose: Hypovitaminosis D has emerged as potential risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the general population with variable effects on the outcome of the coronavirus disease-19 (COVID-19). The aim of this retrospective single-center study was to investigate the impact of hypovitaminosis D and secondary hyperparathyroidism on respiratory outcomes of COVID-19.
Methods: Three-hundred-forty-eight consecutive patients hospitalized for COVID-19 at the IRCCS Humanitas Research Hospital, Rozzano, Milan (Italy) were evaluated for arterial partial pressure oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio, serum 25hydroxy-vitamin D [25(OH)D], parathyroid hormone (PTH) and inflammatory parameters at study entry and need of ventilation during the hospital stay.
Results: In the entire population, vitamin D deficiency (i.e., 25(OH)D values < 12 ng/mL) was significantly associated with acute hypoxemic respiratory failure at the study entry [adjusted odds ratio (OR) 2.48, 95% confidence interval 1.29-4.74; P = 0.006], independently of age and sex of subjects, serum calcium and inflammatory parameters. In patients evaluated for serum PTH (97 cases), secondary hyperparathyroidism combined with vitamin D deficiency was significantly associated with acute hypoxemic respiratory failure at study entry (P = 0.001) and need of ventilation during the hospital stay (P = 0.031).
Conclusion: This study provides evidence that vitamin D deficiency, when associated with secondary hyperparathyroidism, may negatively impact the clinical outcome of SARS-CoV-2-related pneumonia.
Keywords: COVID-19; Hyperparathyroidism; PTH; Pneumonia; SARS-CoV-2 infection; Vitamin D; Vitamin D deficiency.