Vitamina D a la admisión y gravedad de la enfermedad en pacientes con COVID-19 en la unidad de cuidados intensivos

Autores/as

  • Victoria Carolina Gonzalez Sanatorio Allende
  • Cayetano Galletti Sanatorio Allende
  • Romina Alvarez Vizzoni Sanatorio Allende
  • Yanina Saldivar Sanatorio Allende
  • Nicolás Kessler Sanatorio Allende
  • Francisco Irades Sanatorio Allende
  • Estefanía Minoldo Sanatorio Allende
  • Pablo Calcagno Sanatorio Allende
  • Antonella Aliscioni Sanatorio Allende
  • Ursula Zaya Sanatorio Allende

DOI:

https://doi.org/10.35454/rncm.v6n2.485

Palabras clave:

enfermedad Coronavirus 2019, Vitamina D, ventilación mecánica, unidad de cuidados intensivos

Resumen

Introducción: la 25-hidroxivitamina D (25(OH)D) disminuiría la incidencia de infecciones respiratorias virales por su efecto pleiotrópico en la inmunomodulación. 

Objetivos: investigar la posible asociación entre deficiencia grave de 25(OH)D a la admisión en la unidad de cuidados intensivos (UCI) y gravedad de la enfermedad en pacientes diagnosticados con enfermedad por coronavirus de 2019 (COVID-19); determinar si existe una asociación entre la deficiencia grave de 25(OH)D a la admisión, el requerimiento de ventilación mecánica invasiva, las comorbilidades y la mortalidad. 

Métodos: estudio retrospectivo observacional, que incluyó a 164 pacientes con diagnóstico de COVID-19 ingresados a la UCI que tuvieran valores plasmáticos de 25(OH)D las primeras 72 horas de internación. 

Resultados: exhibieron deficiencia de 25(OH)D (< 30 ng/ mL) 136 (83 %) pacientes y 35 (21 %) presentaron valores de 25(OH)D ≤ 12 ng/ml. Los pacientes con deficiencia grave de 25(OH)D tuvieron significativamente mayor probabilidad de COVID-19 grave (odds ratio [OR]: 2,2; intervalo de confianza [IC] 95 %: 1,02 a 5,06; p = 0,049) y presentaron mayor probabilidad de requerir ventilación mecánica invasiva (OR: 2,4; IC 95 %: 1,09 a 5,58; p = 0 ,036). La mortalidad fue significativamente mayor en el grupo con deficiencia grave de 25(OH)D (40 % frente a 22 %; p = 0 ,03), con un OR de 2,4; IC 95 %: 1,07 a 5,32; p = 0 ,031. En el modelo multivariado, el antecedente de enfermedad cardiovascular, deficiencia grave de 25(OH)D, presión arterial de oxígeno/fracción inspirada de oxígeno (PaO2/FiO2) y ventilación mecánica invasiva permanecieron significativos. 

Conclusión: este estudio confirma que la deficiencia grave de vitamina D se asocia con una afectación pulmonar más grave, una mayor gravedad de la enfermedad y riesgo de muerte en pacientes con COVID-19. 

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Biografía del autor/a

Victoria Carolina Gonzalez, Sanatorio Allende

Cayetano Galletti, Sanatorio Allende

Romina Alvarez Vizzoni, Sanatorio Allende

Yanina Saldivar, Sanatorio Allende

Nicolás Kessler, Sanatorio Allende

Francisco Irades, Sanatorio Allende

Estefanía Minoldo, Sanatorio Allende

Pablo Calcagno, Sanatorio Allende

Antonella Aliscioni, Sanatorio Allende

Ursula Zaya, Sanatorio Allende

Citas

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Publicado

2023-05-24

Cómo citar

Gonzalez, V. C., Galletti, C., Alvarez Vizzoni, R. ., Saldivar, Y., Kessler, N., Irades, F., Minoldo, E. ., Calcagno, P., Aliscioni, A. ., & Zaya, U. (2023). Vitamina D a la admisión y gravedad de la enfermedad en pacientes con COVID-19 en la unidad de cuidados intensivos. Revista De Nutrición Clínica Y Metabolismo, 6(2), 72–79. https://doi.org/10.35454/rncm.v6n2.485