| Autor: |
Efird JT; Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA., Anderson EJ; College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA., Jindal C; Harvard Medical School, Harvard University, Boston, MA 02115, USA., Redding TS; Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA., Thompson AD; Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA., Press AM; Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA., Upchurch J; Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA., Williams CD; Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA.; Department of Medicine, Duke University, Durham, NC 27710, USA.; Duke Cancer Institute, Duke University, Durham, NC 27710, USA., Choi YM; Signify Health, Dallas, TX 75244, USA., Suzuki A; Cooperative Studies Program Epidemiology Center, Durham VA Health Care System, Durham, NC 27705, USA.; Division of Gastroenterology, Duke University, Durham, NC 27710, USA.; The Division of Gastroenterology, Durham VA Medical Center, Durham, NC 27705, USA. |
| Abstrakt: |
This data-based cohort consisted of 26,508 (7%) United States veterans out of the 399,290 who tested positive for SARS-CoV-2 from 1 March to 10 September 2020. We aimed to assess the interaction of post-index vitamin D (Vit D) and corticosteroid (CRT) use on 30-day mortality among hospitalized and non-hospitalized patients with coronavirus disease 2019 (COVID-19). Combination Vit D and CRT drug use was assessed according to four multinomial pairs (-|+, -|-, +|+, +|-). Respective categorical effects were computed on a log-binomial scale as adjusted relative risk (aRR). Approximately 6% of veterans who tested positive for SARS-CoV-2 died within 30 days of their index date. Among hospitalized patients, a significantly decreased aRR was observed for the use of Vit D in the absence of CRTs relative to patients who received CRTs but not Vit D (aRR = 0.30; multiplicity corrected, p = 0.0004). Among patients receiving systemically administered CRTs (e.g., dexamethasone), the use of Vit D was associated with fewer deaths in hospitalized patients (aRR = 0.51) compared with non-hospitalized patients (aRR = 2.5) ( P -for-Interaction = 0.0071). Evaluating the effect of modification of these compounds in the context of hospitalization may aid in the management of COVID-19 and provide a better understanding of the pathophysiological mechanisms underlying this and future infectious disease outbreaks. |
