Vitamina D na admissão e gravidade da doença em pacientes com COVID-19 na Unidade de Cuidados Intensivos
DOI:
https://doi.org/10.35454/rncm.v6n2.485Palavras-chave:
doença coronavirus 2019, vitamina D, ventilação mecânica, unidade de terapia intensivaResumo
Introdução: a 25-hidroxivitamina D (25(OH)D) reduziria a incidência de infecções respiratórias virais, devido ao seu efeito pleiotrópico na imunomodulação.
Objetivo: investigar a possível associação entre a deficiência grave de 25(OH)D na admissão na unidade de terapia intensiva (UTI) e a gravidade da doença em pacientes com diagnóstico de COVID-19. Determinar se existe uma associação entre deficiência grave de 25(OH)D na admissão, necessidade de ventilação mecânica invasiva, comorbidades e mortalidade.
Métodos: estudo observacional retrospectivo, que incluiu 164 pacientes com diagnóstico de COVID-19 internados na unidade de terapia intensiva que tiveram níveis plasmáticos de 25(OH)D nas primeiras 72 horas de internação.
Resultados: 136 (83%) pacientes apresentaram deficiência de 25(OH)D (<30 ng/mL) e 35 (21%) tiveram 25(OH)D ≤12 ng/m. Pacientes com deficiência grave de 25(OH)D tiveram probabilidade significativamente maior de COVID-19 grave (OR 2,2, IC 95% 1,02 a 5,06, p= 0,049) e apresentaram maior probabilidade de necessitar ventilação mecânica invasiva (OR 2,4, IC 95% 1,09 a 5,58, p=0,036). A mortalidade foi significativamente maior no grupo com deficiência grave de 25(OH)D (40% vs 22%, p=0,03), com OR 2,4, 95% IC 1,07 a 5,32, p=0,031. No modelo multivariado,a história de doença cardiovascular, deficiência grave de 25(OH)D, PaO2/FiO2 e ventilação mecânica invasiva permaneceram significativos.
Conclusão: este estudo confirma que a deficiência grave de vitamina D está associada a uma afetação pulmonar mais grave, aumento da gravidade da doença e risco de morte em pacientes com COVID-19.
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Copyright (c) 2023 Victoria Gonzalez, Cayetano Galletti, Romina Alvarez Vizzoni, Yanina Saldivar, Nicolás Kessler, Francisco Irades, Estefanía Minoldo, Pablo Calcagno, Antonella Aliscioni, Ursula Zaya
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