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

Autores/as

  • Victoria Gonzalez Mgtr.
  • Cayetano Galletti Med.
  • Romina Alvarez Vizzoni Med.
  • Yanina Saldivar Med.
  • Nicolás Kessler Med.
  • Francisco Irades Med.
  • Estefanía Minoldo Med.
  • Pablo Calcagno Med.
  • Antonella Aliscioni Med.
  • Ursula Zaya Med.

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 Gonzalez, Mgtr.

Cayetano Galletti, Med.

Romina Alvarez Vizzoni, Med.

Yanina Saldivar, Med.

Nicolás Kessler, Med.

Francisco Irades, Med.

Estefanía Minoldo, Med.

Pablo Calcagno, Med.

Antonella Aliscioni, Med.

Ursula Zaya, Med.

Citas

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Publicado

2023-05-24

Cómo citar

Gonzalez, V., 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). https://doi.org/10.35454/rncm.v6n2.485

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