治疗高剂量维生素D治疗维生素D缺乏的严重COVID-19疾病:随机,双盲,安慰剂对照研究 (SHADE-S)
Ajay Singh1, Ashu Rastogi2, Goverdhan Dutt Puri1
1Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Journal of public health (Oxford, England)
|January 31, 2024
概括
高剂量维生素D (胆酸) 补充剂改善了严重COVID-19患者的器官功能得分和降低了死亡率. 这种干预对维生素D缺乏的人来说是安全和有益的.
科学领域:
- 关键护理医学 关键护理医学
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
背景情况:
- 维生素D具有免疫调节的特性.
- 之前对COVID-19中维生素D补充剂的研究已经产生了混合的结果.
- 研究治疗性维生素D治疗严重COVID-19的随机对照试验有限.
研究的目的:
- 为了评估单次高剂量胆二醇对中度至重度COVID-19患者的顺序器官衰竭评估 (SOFA) 评分的影响.
- 评估胆醇补充剂对28天全因死亡率的影响.
主要方法:
- 一项随机对照试验,涉及90名中度至重度COVID-19患者 (PaO2/FiO2比率<200).
- 参与者接受了0.6百万国际单位口服胆醇或安慰剂.
- 主要结局是第7天SOFA分数的变化.
主要成果:
- 维生素D补充剂显著改善了第7天的SOFA得分 (3对5,P=0.01).
- 在维生素D组中,达到的25(OH) D3水平在维生素D组 (60 ng/ml与4 ng/ml相比) 显著增加.
- 维生素D组的28天全因死亡率较低 (24%对44%,P=0.046).
结论:
- 单次高剂量口服胆醇补充剂在改善SOFA评分和降低中度至重度COVID-19的维生素D缺乏症患者的住院死亡率方面是安全有效的.
- 这种干预措施可能对接受ICU治疗的患者有益.
- 结果表明,维生素D补充可以纳入临床实践,用于严重的COVID-19管理.
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