Dataset Information

Vitamin D and survival in COVID-19 patients: A quasi-experimental study.

ABSTRACT: Vitamin D may be a central biological determinant of COVID-19 outcomes. The objective of this quasi-experimental study was to determine whether bolus vitamin D3 supplementation taken during or just before COVID-19 was effective in improving survival among frail elderly nursing-home residents with COVID-19. Sixty-six residents with COVID-19 from a French nursing-home were included in this quasi-experimental study. The "Intervention group" was defined as those having received bolus vitamin D3 supplementation during COVID-19 or in the preceding month, and the "Comparator group" corresponded to all other participants. The primary and secondary outcomes were COVID-19 mortality and Ordinal Scale for Clinical Improvement (OSCI) score in acute phase, respectively. Age, gender, number of drugs daily taken, functional abilities, albuminemia, use of corticosteroids and/or hydroxychloroquine and/or antibiotics (i.e., azithromycin or rovamycin), and hospitalization for COVID-19 were used as potential confounders. The Intervention (n = 57; mean ± SD, 87.7 ± 9.3years; 79 %women) and Comparator (n = 9; mean, 87.4 ± 7.2years; 67 %women) groups were comparable at baseline, as were the COVID-19 severity and the use of dedicated COVID-19 drugs. The mean follow-up time was 36 ± 17 days. 82.5 % of participants in the Intervention group survived COVID-19, compared to only 44.4 % in the Comparator group (P = 0.023). The full-adjusted hazard ratio for mortality according to vitamin D3 supplementation was HR = 0.11 [95 %CI:0.03;0.48], P = 0.003. Kaplan-Meier distributions showed that Intervention group had longer survival time than Comparator group (log-rank P = 0.002). Finally, vitamin D3 supplementation was inversely associated with OSCI score for COVID-19 (?=-3.84 [95 %CI:-6.07;-1.62], P = 0.001). In conclusion, bolus vitamin D3 supplementation during or just before COVID-19 was associated in frail elderly with less severe COVID-19 and better survival rate.

SUBMITTER: Annweiler C

PROVIDER: S-EPMC7553119 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Vitamin D and survival in COVID-19 patients: A quasi-experimental study.

Annweiler Cédric C Hanotte Bérangère B Grandin de l'Eprevier Claire C Sabatier Jean-Marc JM Lafaie Ludovic L Célarier Thomas T

The Journal of steroid biochemistry and molecular biology 20201013

Vitamin D may be a central biological determinant of COVID-19 outcomes. The objective of this quasi-experimental study was to determine whether bolus vitamin D3 supplementation taken during or just before COVID-19 was effective in improving survival among frail elderly nursing-home residents with COVID-19. Sixty-six residents with COVID-19 from a French nursing-home were included in this quasi-experimental study. The "Intervention group" was defined as those having received bolus vitamin D3 supp ...[more]

PMID: 33065275

Similar Datasets

Project description:BackgroundThe objective of this quasi-experimental study was to determine whether bolus vitamin D supplementation taken either regularly over the preceding year or after the diagnosis of COVID-19 was effective in improving survival among hospitalized frail elderly COVID-19 patients.MethodsSeventy-seven patients consecutively hospitalized for COVID-19 in a geriatric unit were included. Intervention groups were participants regularly supplemented with vitamin D over the preceding year (Group 1), and those supplemented with vitamin D after COVID-19 diagnosis (Group 2). The comparator group involved participants having received no vitamin D supplements (Group 3). Outcomes were 14-day mortality and highest (worst) score on the ordinal scale for clinical improvement (OSCI) measured during COVID-19 acute phase. Potential confounders were age, gender, functional abilities, undernutrition, cancer, hypertension, cardiomyopathy, glycated hemoglobin, number of acute health issues at admission, hospital use of antibiotics, corticosteroids, and pharmacological treatments of respiratory disorders.ResultsThe three groups (n = 77; mean ± SD, 88 ± 5years; 49% women) were similar at baseline (except for woman proportion, p = 0.02), as were the treatments used for COVID-19. In Group 1 (n = 29), 93.1% of COVID-19 participants survived at day 14, compared to 81.2% survivors in Group 2 (n = 16) (p = 0.33) and 68.7% survivors in Group 3 (n = 32) (p = 0.02). While considering Group 3 as reference (hazard ratio (HR) = 1), the fully-adjusted HR for 14-day mortality was HR = 0.07 (p = 0.017) for Group 1 and HR = 0.37 (p = 0.28) for Group 2. Group 1 had longer survival time than Group 3 (log-rank p = 0.015), although there was no difference between Groups 2 and 3 (log-rank p = 0.32). Group 1, but not Group 2 (p = 0.40), was associated with lower risk of OSCI score ≥5 compared to Group 3 (odds ratio = 0.08, p= 0.03).ConclusionsRegular bolus vitamin D supplementation was associated with less severe COVID-19 and better survival in frail elderly.

Project description:BackgroundIn response to the COVID-19 pandemic, the Bavarian State government announced several COVID-19 mitigation measures beginning on March 16, 2020, which likely led to a reduction in traffic and a subsequent improvement in air quality. In this study, we evaluated the short-term effect of COVID-19 mitigation measures on NO2 concentrations in Munich, Germany.MethodsWe applied two quasi-experimental approaches, a controlled interrupted time-series (c-ITS) approach and a synthetic control (SC) approach. Each approach compared changes occurring in 2020 to changes occurring in 2014-2019, and accounted for weather-related and other potential confounders. We hypothesized that the largest reductions in NO2 concentrations would be observed at traffic sites, with smaller reductions at urban background sites, and even small reductions, if any, at background sites. All hypotheses, as well as the main and additional analyses were defined a priori. We also conducted post-hoc analyses to ensure that observed effects were not due to factors other than the intervention.ResultsMain analyses largely supported our hypotheses. Specifically, at the two traffic sites, using the c-ITS approach we observed reductions of 9.34 ?g/m3 (95% confidence interval: -23.58; 4.90) and 10.02 ?g/m3 (-19.25; -0.79). Using the SC approach we observed reductions of 15.65 ?g/m3 (-27.58; -4.09) and 15.1 ?g/m3 (-24.82; -9.83) at these same sites. We observed effects ranging from smaller in magnitude to no effect at urban background and background sites. Additional analyses showed that the effect was largest in the first two weeks following introduction of measures, and that a 3-day lagged intervention time also showed a larger effect. Post-hoc analyses suggested that at least some of the observed effects may have been attributable to changes in air quality occurring before the intervention, as well as unusually high concentrations in January 2020.ConclusionWe applied two quasi-experimental approaches in assessing the impact of the COVID-19 mitigation measures on NO2 concentrations in Munich. Taking the 2020 pre-intervention average concentrations as a reference, we observed reductions in NO2 concentrations of approximately 15-25% and 24-36% at traffic sites, suggesting that reducing traffic may be an effective measure to reduce NO2 concentrations in heavily trafficked areas by margins which could translate to public health benefits.

Project description:BackgroundPreterm birth is the leading cause of child mortality globally, with many survivors experiencing long-term adverse consequences. Preliminary evidence suggests that numbers of preterm births greatly reduced following implementation of policy measures aimed at mitigating the effects of the COVID-19 pandemic. We aimed to study the impact of the COVID-19 mitigation measures implemented in the Netherlands in a stepwise fashion on March 9, March 15, and March 23, 2020, on the incidence of preterm birth.MethodsWe used a national quasi-experimental difference-in-regression-discontinuity approach. We used data from the neonatal dried blood spot screening programme (2010-20) cross-validated against national perinatal registry data. Stratified analyses were done according to gestational age subgroups, and sensitivity analyses were done to assess robustness of the findings. We explored potential effect modification by neighbourhood socioeconomic status, sex, and small-for-gestational-age status.FindingsData on 1 599 547 singleton neonates were available, including 56 720 births that occurred after implementation of COVID-19 mitigation measures on March 9, 2020. Consistent reductions in the incidence of preterm birth were seen across various time windows surrounding March 9 (± 2 months [n=531 823] odds ratio [OR] 0·77, 95% CI 0·66-0·91, p=0·0026; ± 3 months [n=796 531] OR 0·85, 0·73-0·98, p=0·028; ± 4 months [n=1 066 872] OR 0·84, 0·73-0·97, p=0·023). Decreases in incidence observed following the March 15 measures were of smaller magnitude, but not statistically significant. No changes were observed after March 23. Reductions in the incidence of preterm births after March 9 were consistent across gestational age strata and robust in sensitivity analyses. They appeared confined to neighbourhoods of high socioeconomic status, but effect modification was not statistically significant.InterpretationIn this national quasi-experimental study, initial implementation of COVID-19 mitigation measures was associated with a substantial reduction in the incidence of preterm births in the following months, in agreement with preliminary observations elsewhere. Integration of comparable data from across the globe is needed to further substantiate these findings and start exploring underlying mechanisms.FundingNone.

Project description:BackgroundContinuous remote monitoring of vital signs on the hospital ward gained popularity during the Severe Acute Respiratory Syndrome coronavirus 2 pandemic due to its ability to support early detection of respiratory failure, and the possibility to do so without physical contact between patient and clinician. The effect of continuous monitoring on patient room visits has not been established yet.ObjectivesTo assess the impact of continuous monitoring on the number of patient room visits for patients suspected of Corona Virus Disease 2019 (COVID-19) and the use of personal protection equipment.Design and methodsWe performed a before-after study at a ward with private rooms for patients suspected of COVID-19 at a tertiary hospital in Nijmegen, The Netherlands. Non-participant observers observed hospital staff during day, evening and night shifts to record patient room visits and personal protection equipment usage. After eleven days, wearable continuous vital sign monitoring was introduced. An interrupted time series analysis was applied to evaluate the effect of continuous monitoring on the number of patient room visits, visits for obtaining vital signs (Modified Early Warning Score visits) and the amount of personal protection equipment used.ResultsDuring the 45 day study period, 86 shifts were observed. During each shift, approximately six rooms were included. A total of 2347 patient room visits were recorded. The slope coefficient for the number of patient room visits did not change after introducing continuous vital sign monitoring (B -0.003, 95% confidence interval -0.022/0.016). The slope coefficients of the number of Modified Early Warning Score visits and the amount of personal protection equipment used did not change either (B -0.002, 95% confidence interval -0.021/0.017 and B 0.046, 95% confidence interval -0.008/0.099). The number of Modified Early Warning Score visits did show a decline over the entire study period, however this decline was not influenced by the intervention. Evening and night shifts were associated with fewer patient room visits compared to day shifts.ConclusionIntroduction of continuous vital sign monitoring at a general ward for patients with suspected COVID-19 did not reduce the number of patient room visits or the usage of personal protection equipment by hospital staff. The number of Modified Early Warning Score visits declined over time, but this was not related to the introduction of continuous monitoring. Detailed analysis of the influence of continuous monitoring on the workflow of hospital staff reveals key points to increase efficacy of this intervention.

Dataset Information

Vitamin D and survival in COVID-19 patients: A quasi-experimental study.

Publications

Vitamin D and survival in COVID-19 patients: A quasi-experimental study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets