PDF(Pubmed)
Abstract：
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.
METHODS: A retrospective observational cohort study of patients admitted for COVID-19 to the Pneumology Unit of the Hospital Universitario Reina Sofía (Córdoba, Spain).
METHODS: Patients were treated with calcifediol or/and corticosteroids with the best available therapy and standard care, according to clinical practice guidelines.
METHODS: 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.
CONCLUSIONS: 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.
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.
METHODS: A retrospective observational cohort study of patients admitted for COVID-19 to the Pneumology Unit of the Hospital Universitario Reina Sofía (Córdoba, Spain).
METHODS: Patients were treated with calcifediol or/and corticosteroids with the best available therapy and standard care, according to clinical practice guidelines.
METHODS: 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.
CONCLUSIONS: 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.
摘要：
冠状病毒19病(COVID-19)的医学治疗是一项治疗挑战。现有数据强烈表明，骨化二醇治疗可以减轻COVID-19的严重程度，皮质类固醇是世界范围内重症COVID-19的首选治疗方法。两者都有非常相似的行动简介，并且它们在患者中的联合使用可以改变每种施用的化合物的贡献。
目的：评估在医疗实践中使用骨化二醇和/或皮质类固醇治疗如何改变ICU入住的需要，死亡,或首次暴发期间因COVID-19住院的患者预后不良。
方法：一项回顾性观察性队列研究，该研究对因COVID-19入院的患者进行了回顾性观察性队列研究，西班牙)。
方法：患者接受骨化二醇或/和皮质类固醇的最佳治疗和标准治疗，根据临床实践指南。
方法：入住重症监护病房（ICU）或住院期间死亡，预后不良。
结果：纳入了7128名患者。根据所接受的治疗,他们被包括在四组:骨化二醇(n=68)，糖皮质激素（n=112），两者(n=510)，或者都没有（n=38）。在578例接受骨化二醇治疗的患者中，88人入住ICU（15%），而在150例没有用骨化二醇治疗的患者中，39人需要入住ICU(26%)(p<0.01)。在服用骨化二醇而不使用糖皮质激素的患者中，68人中只有4人(5.8%)需要入住ICU，与用两者治疗的510人中的84人（16.5%）相比（p=0.022）。在595例预后良好的患者中，568例（82.01%）接受了骨化二醇治疗，与133例预后不良的患者相比，其中90人(67.66%)接受了骨化二醇(p<0.001)。对于皮质类固醇没有发现这种差异。
结论：对于中度或轻度COVID-19的住院患者，可选择骨化二醇，不服用皮质类固醇,直到疾病的自然史达到过度炎症阶段。
目的：评估在医疗实践中使用骨化二醇和/或皮质类固醇治疗如何改变ICU入住的需要，死亡,或首次暴发期间因COVID-19住院的患者预后不良。
方法：一项回顾性观察性队列研究，该研究对因COVID-19入院的患者进行了回顾性观察性队列研究，西班牙)。
方法：患者接受骨化二醇或/和皮质类固醇的最佳治疗和标准治疗，根据临床实践指南。
方法：入住重症监护病房（ICU）或住院期间死亡，预后不良。
结果：纳入了7128名患者。根据所接受的治疗,他们被包括在四组:骨化二醇(n=68)，糖皮质激素（n=112），两者(n=510)，或者都没有（n=38）。在578例接受骨化二醇治疗的患者中，88人入住ICU（15%），而在150例没有用骨化二醇治疗的患者中，39人需要入住ICU(26%)(p<0.01)。在服用骨化二醇而不使用糖皮质激素的患者中，68人中只有4人(5.8%)需要入住ICU，与用两者治疗的510人中的84人（16.5%）相比（p=0.022）。在595例预后良好的患者中，568例（82.01%）接受了骨化二醇治疗，与133例预后不良的患者相比，其中90人(67.66%)接受了骨化二醇(p<0.001)。对于皮质类固醇没有发现这种差异。
结论：对于中度或轻度COVID-19的住院患者，可选择骨化二醇，不服用皮质类固醇,直到疾病的自然史达到过度炎症阶段。
