Calcifediol or Corticosteroids in the Treatment of COVID-19: An Observational Study.

Autor:	Entrenas-Castillo M; Hospital QuironSalud Córdoba, 14004 Córdoba, Spain.; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain., Entrenas-Costa LM; Hospital QuironSalud Córdoba, 14004 Córdoba, Spain.; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain.; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain., Pata MP; Biostatech, 15782 Santiago de Compostela, Spain., Jurado-Gamez B; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain.; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain., Muñoz-Corroto C; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain., Gomez-Rebollo C; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain., Mira-Padilla E; Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain., Bouillon R; Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, 3000 Leuven, Belgium., Quesada-Gómez JM; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, 14004 Córdoba, Spain.; Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain.; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain.; Departamento de Enfermería, Farmacología y Fisioterapia, Universidad de Córdoba, 14004 Córdoba, Spain.
Jazyk:	angličtina
Zdroj:	Nutrients [Nutrients] 2024 Jun 17; Vol. 16 (12). Date of Electronic Publication: 2024 Jun 17.
DOI:	10.3390/nu16121910
Abstrakt:	Medical treatment of coronavirus 19 disease (COVID-19) is a therapeutic challenge. The available data strongly suggest that calcifediol treatment may reduce the severity of COVID-19, and corticosteroids are the treatment of choice worldwide for severe COVID-19. Both have a very similar action profile, and their combined use in patients may modify the contribution of each administered compound. Objective: To evaluate how treatment with calcifediol and/or corticosteroids in medical practice modified the need for ICU admission, death, or poor prognosis of patients hospitalized with COVID-19 during the first outbreaks. Design, Patients and Setting: A retrospective observational cohort study of patients admitted for COVID-19 to the Pneumology Unit of the Hospital Universitario Reina Sofía (Córdoba, Spain). Interventions: Patients were treated with calcifediol or/and corticosteroids with the best available therapy and standard care, according to clinical practice guidelines. Measurements: Admission to the intensive care unit (ICU) or death during hospitalization and poor prognosis. Results: Seven hundred and twenty-eight patients were included. According to the treatment received, they were included in four groups: calcifediol ( n = 68), glucocorticoids ( n = 112), both ( n = 510), or neither ( n = 38). Of the 578 patients treated with calcifediol, 88 were admitted to the ICU (15%), while of the 150 not treated with calcifediol, 39 required ICU admission (26%) ( p < 0.01). Among the patients taking calcifediol without glucocorticoids, only 4 of 68 (5.8%) required ICU admission, compared to 84 of 510 (16.5%) treated with both ( p = 0.022). Of the 595 patients who had a good prognosis, 568 (82.01%) had received treatment with calcifediol versus the 133 patients with a poor prognosis, of whom 90 (67.66%) had received calcifediol ( p < 0.001). This difference was not found for corticosteroids. Interpretation: The treatment of choice for hospitalized patients with moderate or mild COVID-19 could be calcifediol, not administering corticosteroids, until the natural history of the disease reaches a stage of hyperinflammation.
Databáze:	MEDLINE
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