Yanhua You, Chun Xu, Yuqing Hu, Meng Liang, Qi Sun
{"title":"血液透析患者中维生素D水平和临床参数与COVID-19感染、严重程度和死亡率的关系：一项队列研究","authors":"Yanhua You, Chun Xu, Yuqing Hu, Meng Liang, Qi Sun","doi":"10.1111/hdi.13194","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Vitamin D deficiency is prevalent among patients undergoing hemodialysis. This study aimed to investigate the associations between vitamin D levels and clinical parameters with the risk of COVID-19 infection, severity, and mortality in hemodialysis patients with end-stage kidney disease (ESKD).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective cohort study included 198 hemodialysis patients from a single center. Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL. Vitamin D deficiency and vitamin D supplements were combined to categorize patients into three groups: deficiency, uncertain deficiency, and likely sufficient. COVID-19 infection status, severity, and outcomes were recorded. Statistical analyses were performed to assess the associations between vitamin D levels and COVID-19 severity and mortality.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>Among the 198 patients, 73 patients (37%) were in the deficiency group, 29 patients (15%) had uncertain deficiency, and 96 patients (48%) were likely sufficient. The overall COVID-19 infection rate was 59%. The deficiency group had a similar infection rate (60.3%) compared to those with likely sufficient levels (54.2%). However, the severity and mortality rates of vitamin D deficiency group had a significantly higher rate than those with likely sufficient levels. Multivariate logistic regression analysis showed that vitamin D deficiency and uncertain deficiency group were significantly associated with an increased risk of COVID-19 severity (OR = 22.57, <i>p</i> = 0.01 and OR = 15.8, <i>p</i> = 0.03, respectively). Uncertain deficiency group was significantly associated with an increased risk of COVID-19 mortality (OR = 12.93, <i>p</i> = 0.04), while the deficiency group should similarly trend but did not reach statistical significance.</p>\n </section>\n \n <section>\n \n <h3> Discussion</h3>\n \n <p>Vitamin D deficiency is associated with an increased risk of COVID-19 severity in hemodialysis patients with ESKD. These findings suggest that monitoring and managing vitamin D levels may be important in reducing the risk of COVID-19 severity in this vulnerable population.</p>\n </section>\n </div>","PeriodicalId":12815,"journal":{"name":"Hemodialysis International","volume":"29 1","pages":"63-73"},"PeriodicalIF":1.2000,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Associations of vitamin D levels and clinical parameters with COVID-19 infection, severity and mortality in hemodialysis patients: A cohort study\",\"authors\":\"Yanhua You, Chun Xu, Yuqing Hu, Meng Liang, Qi Sun\",\"doi\":\"10.1111/hdi.13194\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Vitamin D deficiency is prevalent among patients undergoing hemodialysis. This study aimed to investigate the associations between vitamin D levels and clinical parameters with the risk of COVID-19 infection, severity, and mortality in hemodialysis patients with end-stage kidney disease (ESKD).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This retrospective cohort study included 198 hemodialysis patients from a single center. Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL. Vitamin D deficiency and vitamin D supplements were combined to categorize patients into three groups: deficiency, uncertain deficiency, and likely sufficient. COVID-19 infection status, severity, and outcomes were recorded. Statistical analyses were performed to assess the associations between vitamin D levels and COVID-19 severity and mortality.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Findings</h3>\\n \\n <p>Among the 198 patients, 73 patients (37%) were in the deficiency group, 29 patients (15%) had uncertain deficiency, and 96 patients (48%) were likely sufficient. The overall COVID-19 infection rate was 59%. The deficiency group had a similar infection rate (60.3%) compared to those with likely sufficient levels (54.2%). However, the severity and mortality rates of vitamin D deficiency group had a significantly higher rate than those with likely sufficient levels. Multivariate logistic regression analysis showed that vitamin D deficiency and uncertain deficiency group were significantly associated with an increased risk of COVID-19 severity (OR = 22.57, <i>p</i> = 0.01 and OR = 15.8, <i>p</i> = 0.03, respectively). Uncertain deficiency group was significantly associated with an increased risk of COVID-19 mortality (OR = 12.93, <i>p</i> = 0.04), while the deficiency group should similarly trend but did not reach statistical significance.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Discussion</h3>\\n \\n <p>Vitamin D deficiency is associated with an increased risk of COVID-19 severity in hemodialysis patients with ESKD. These findings suggest that monitoring and managing vitamin D levels may be important in reducing the risk of COVID-19 severity in this vulnerable population.</p>\\n </section>\\n </div>\",\"PeriodicalId\":12815,\"journal\":{\"name\":\"Hemodialysis International\",\"volume\":\"29 1\",\"pages\":\"63-73\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-12-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hemodialysis International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/hdi.13194\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hemodialysis International","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hdi.13194","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
维生素D缺乏症在血液透析患者中普遍存在。本研究旨在探讨终末期肾病（ESKD）血液透析患者的维生素D水平和临床参数与COVID-19感染风险、严重程度和死亡率之间的关系。方法：本回顾性队列研究纳入198例来自单一中心的血液透析患者。最后一次测量25-羟基胆骨化醇低于20 ng/mL时确定维生素D缺乏。维生素D缺乏症和维生素D补充剂将患者分为三组：缺乏、不确定缺乏和可能充足。记录COVID-19感染状况、严重程度和结果。进行统计分析以评估维生素D水平与COVID-19严重程度和死亡率之间的关系。结果：198例患者中，73例患者（37%）属于维生素缺乏组，29例患者（15%）缺乏不确定，96例患者（48%）可能充足。新冠肺炎总感染率为59%。缺乏组的感染率（60.3%）与可能足够水平的组（54.2%）相似。然而，维生素D缺乏组的严重程度和死亡率明显高于维生素D充足组。多因素logistic回归分析显示，维生素D缺乏组和不确定缺乏组与COVID-19严重程度风险增加显著相关（OR = 22.57, p = 0.01; OR = 15.8, p = 0.03）。不确定缺乏组与COVID-19死亡风险增加有显著相关（OR = 12.93, p = 0.04），缺乏组也有类似趋势，但未达到统计学意义。讨论：维生素D缺乏与ESKD血液透析患者COVID-19严重程度风险增加有关。这些发现表明，监测和管理维生素D水平可能对降低这一弱势群体患COVID-19严重程度的风险很重要。
Associations of vitamin D levels and clinical parameters with COVID-19 infection, severity and mortality in hemodialysis patients: A cohort study
Introduction
Vitamin D deficiency is prevalent among patients undergoing hemodialysis. This study aimed to investigate the associations between vitamin D levels and clinical parameters with the risk of COVID-19 infection, severity, and mortality in hemodialysis patients with end-stage kidney disease (ESKD).
Methods
This retrospective cohort study included 198 hemodialysis patients from a single center. Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL. Vitamin D deficiency and vitamin D supplements were combined to categorize patients into three groups: deficiency, uncertain deficiency, and likely sufficient. COVID-19 infection status, severity, and outcomes were recorded. Statistical analyses were performed to assess the associations between vitamin D levels and COVID-19 severity and mortality.
Findings
Among the 198 patients, 73 patients (37%) were in the deficiency group, 29 patients (15%) had uncertain deficiency, and 96 patients (48%) were likely sufficient. The overall COVID-19 infection rate was 59%. The deficiency group had a similar infection rate (60.3%) compared to those with likely sufficient levels (54.2%). However, the severity and mortality rates of vitamin D deficiency group had a significantly higher rate than those with likely sufficient levels. Multivariate logistic regression analysis showed that vitamin D deficiency and uncertain deficiency group were significantly associated with an increased risk of COVID-19 severity (OR = 22.57, p = 0.01 and OR = 15.8, p = 0.03, respectively). Uncertain deficiency group was significantly associated with an increased risk of COVID-19 mortality (OR = 12.93, p = 0.04), while the deficiency group should similarly trend but did not reach statistical significance.
Discussion
Vitamin D deficiency is associated with an increased risk of COVID-19 severity in hemodialysis patients with ESKD. These findings suggest that monitoring and managing vitamin D levels may be important in reducing the risk of COVID-19 severity in this vulnerable population.
期刊介绍：
Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis.
The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
