The Journal of Steroid Biochemistry and Molecular Biology ( IF 3.813 ) Pub Date : 2020-10-13 , DOI: 10.1016/j.jsbmb.2020.105771 Cédric Annweiler; Bérangère Hanotte; Claire Grandin de l’Eprevier; Jean-Marc Sabatier; Ludovic Lafaie; Thomas Célarier
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 ± 17days. 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 (β=-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.
维生素D可能是COVID-19结果的重要生物学决定因素。这项准实验研究的目的是确定在COVID-19期间或之前补充维生素D3是否能有效改善体弱的COVID-19老年养老院居民的生存率。这项准实验研究包括来自法国养老院的66名COVID-19居民。“干预组”被定义为在COVID-19或前一个月内接受了大剂量维生素D3补充的人群，“比较组”对应于所有其他参与者。主要和次要结局分别是急性期的COVID-19死亡率和临床改善序贯量表（OSCI）评分。年龄，性别，每日服用的药物数量，功能能力，白蛋白血症，皮质类固醇和/或羟氯喹和/或抗生素（即阿奇霉素或罗瓦霉素）的使用，以及COVID-19的住院治疗是潜在的混杂因素。干预组（n = 57；平均数±SD，87.7±9.3年； 79％妇女）和比较组（n = 9；均数87.4±7.2年； 67％妇女）在基线时具有可比性，COVID-19严重性和专用COVID-19药物的使用。平均随访时间为36±17天。干预组中82.5％的患者存活于COVID-19，而比较组中只有44.4％（P = 0.023）。根据维生素D3的补充，死亡率的完全调整后的危险比为HR = 0.11 [95％CI：0.03; 0.48]，P = 0.003。Kaplan-Meier分布显示干预组的生存时间比比较组更长（对数秩P = 0.002）。最后，补充维生素D3与COVID-19的OSCI得分呈负相关（β= -3.84 [95％CI：-6.07; -1.62]，P = 0.001）。总之，在体弱的老年人中，在COVID-19期间或之前补充大剂量维生素D3与较不严重的COVID-19和较高的生存率相关。