Marta Entrenas-Castillo , Luis Manuel Entrenas-Costa , María P. Pata , Bernabe Jurado Gamez , Cristina Muñoz-Corroto , Cristina Gómez-Rebollo , Estefanía Mira-Padilla , Roger Bouillon , Jose Manuel Quesada-Gomez
{"title":"潜类分析显示，在患者资料中，与 COVID-19 相关的降钙素治疗比糖皮质激素治疗预后更好。","authors":"Marta Entrenas-Castillo , Luis Manuel Entrenas-Costa , María P. Pata , Bernabe Jurado Gamez , Cristina Muñoz-Corroto , Cristina Gómez-Rebollo , Estefanía Mira-Padilla , Roger Bouillon , Jose Manuel Quesada-Gomez","doi":"10.1016/j.jsbmb.2024.106609","DOIUrl":null,"url":null,"abstract":"<div><div>Calcifediol and glucocorticoids have been repositioned for the treatment of COVID-19 and may reduce severity, the need for intensive care unit admission and death.</div></div><div><h3>Objective</h3><div>to identify class or profiles of patients hospitalized and treated with COVID-19 pneumonia using latent class clustering methods to assess the clinical and prognostic relevance of the resulting patients’ profiles. Poor prognosis was defined as death or need for ICU admission, good prognosis, the opposite. With special interest in differential responses to calcifediol.</div></div><div><h3>Setting</h3><div>Reina Sofia University Hospital, Córdoba Spain.</div></div><div><h3>Patients</h3><div>Retrospective observational cohort study of patients admitted for COVID-19. ClinicalTrials.gov public database (NCT05819918). Inclusion criteria: (i) Age ≥ 18 and ≤ 90 years, (ii) Pneumonia characterized by the presence of infiltrates on chest X-ray or CT scan, (iii) SARS-CoV-2 infection, confirmed, and (iv) CURB Scale 65 >1.</div></div><div><h3>Design</h3><div>Latent class analysis, for obtaining homogeneous clusters, without specifying a priori the belonging group, and selecting the optimal number of clusters by minimizing information criteria. Evaluating the differences between groups for each variable by means of chi-square, Fisher's exact test and Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>707 patients hospitalized from 10 March 2020 until 4 March 2022 were included. For the treatment variable, differences were found between class 3 (60 % treated with calcifediol only) and classes 1 (less than 1 % calcifediol only vs. 82 % treated with both), 2 (less than 1 % calcifediol only vs. 82 % treated with both) and 4 (1 % calcifediol only vs. 84 % treated with both). Class 3, (60 % with calcifediol), had a significantly better prognosis compared to patients treated with glucocorticoids alone (OR: 15.2, 95 % CI: [3.73–142], p<0.001) or no treatment (OR: 7.38, 95 % CI: [2.63–30.2], p<0.001).</div></div><div><h3>Conclusions</h3><div>our real-life study shows that calcifediol treatment significantly reduces the need for ICU admission and improved prognosis in patients hospitalized for COVID-19 pneumonia, especially in the profile of patients receiving it without glucocorticoids<del>.</del></div></div>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Latent Class Analysis Reveals, in patient profiles, COVID-19–related better prognosis by calcifediol treatment than glucocorticoids\",\"authors\":\"Marta Entrenas-Castillo , Luis Manuel Entrenas-Costa , María P. Pata , Bernabe Jurado Gamez , Cristina Muñoz-Corroto , Cristina Gómez-Rebollo , Estefanía Mira-Padilla , Roger Bouillon , Jose Manuel Quesada-Gomez\",\"doi\":\"10.1016/j.jsbmb.2024.106609\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Calcifediol and glucocorticoids have been repositioned for the treatment of COVID-19 and may reduce severity, the need for intensive care unit admission and death.</div></div><div><h3>Objective</h3><div>to identify class or profiles of patients hospitalized and treated with COVID-19 pneumonia using latent class clustering methods to assess the clinical and prognostic relevance of the resulting patients’ profiles. Poor prognosis was defined as death or need for ICU admission, good prognosis, the opposite. With special interest in differential responses to calcifediol.</div></div><div><h3>Setting</h3><div>Reina Sofia University Hospital, Córdoba Spain.</div></div><div><h3>Patients</h3><div>Retrospective observational cohort study of patients admitted for COVID-19. ClinicalTrials.gov public database (NCT05819918). Inclusion criteria: (i) Age ≥ 18 and ≤ 90 years, (ii) Pneumonia characterized by the presence of infiltrates on chest X-ray or CT scan, (iii) SARS-CoV-2 infection, confirmed, and (iv) CURB Scale 65 >1.</div></div><div><h3>Design</h3><div>Latent class analysis, for obtaining homogeneous clusters, without specifying a priori the belonging group, and selecting the optimal number of clusters by minimizing information criteria. Evaluating the differences between groups for each variable by means of chi-square, Fisher's exact test and Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>707 patients hospitalized from 10 March 2020 until 4 March 2022 were included. For the treatment variable, differences were found between class 3 (60 % treated with calcifediol only) and classes 1 (less than 1 % calcifediol only vs. 82 % treated with both), 2 (less than 1 % calcifediol only vs. 82 % treated with both) and 4 (1 % calcifediol only vs. 84 % treated with both). Class 3, (60 % with calcifediol), had a significantly better prognosis compared to patients treated with glucocorticoids alone (OR: 15.2, 95 % CI: [3.73–142], p<0.001) or no treatment (OR: 7.38, 95 % CI: [2.63–30.2], p<0.001).</div></div><div><h3>Conclusions</h3><div>our real-life study shows that calcifediol treatment significantly reduces the need for ICU admission and improved prognosis in patients hospitalized for COVID-19 pneumonia, especially in the profile of patients receiving it without glucocorticoids<del>.</del></div></div>\",\"PeriodicalId\":2,\"journal\":{\"name\":\"ACS Applied Bio Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2024-08-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Bio Materials\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0960076024001572\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MATERIALS SCIENCE, BIOMATERIALS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"99","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0960076024001572","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
Latent Class Analysis Reveals, in patient profiles, COVID-19–related better prognosis by calcifediol treatment than glucocorticoids
Calcifediol and glucocorticoids have been repositioned for the treatment of COVID-19 and may reduce severity, the need for intensive care unit admission and death.
Objective
to identify class or profiles of patients hospitalized and treated with COVID-19 pneumonia using latent class clustering methods to assess the clinical and prognostic relevance of the resulting patients’ profiles. Poor prognosis was defined as death or need for ICU admission, good prognosis, the opposite. With special interest in differential responses to calcifediol.
Setting
Reina Sofia University Hospital, Córdoba Spain.
Patients
Retrospective observational cohort study of patients admitted for COVID-19. ClinicalTrials.gov public database (NCT05819918). Inclusion criteria: (i) Age ≥ 18 and ≤ 90 years, (ii) Pneumonia characterized by the presence of infiltrates on chest X-ray or CT scan, (iii) SARS-CoV-2 infection, confirmed, and (iv) CURB Scale 65 >1.
Design
Latent class analysis, for obtaining homogeneous clusters, without specifying a priori the belonging group, and selecting the optimal number of clusters by minimizing information criteria. Evaluating the differences between groups for each variable by means of chi-square, Fisher's exact test and Kruskal-Wallis test.
Results
707 patients hospitalized from 10 March 2020 until 4 March 2022 were included. For the treatment variable, differences were found between class 3 (60 % treated with calcifediol only) and classes 1 (less than 1 % calcifediol only vs. 82 % treated with both), 2 (less than 1 % calcifediol only vs. 82 % treated with both) and 4 (1 % calcifediol only vs. 84 % treated with both). Class 3, (60 % with calcifediol), had a significantly better prognosis compared to patients treated with glucocorticoids alone (OR: 15.2, 95 % CI: [3.73–142], p<0.001) or no treatment (OR: 7.38, 95 % CI: [2.63–30.2], p<0.001).
Conclusions
our real-life study shows that calcifediol treatment significantly reduces the need for ICU admission and improved prognosis in patients hospitalized for COVID-19 pneumonia, especially in the profile of patients receiving it without glucocorticoids.
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