Review the Research<\/p>\n
Get summaries of key research on vitamin D and COVID-19<\/h5><\/div><\/div><\/div><\/div><\/div>\nPrevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).<\/h1><\/div>Take Home Message<\/span><\/h2><\/div>In elderly patients in Brazil testing positive for COVID-19 admitted to an ICU there was a high prevalence of obesity and low vitamin D levels. Whether or not the obesity and vitamin D levels are directly related to COVID-19 status is difficult to determine but warrants further investigation.<\/p>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/b>Results<\/span><\/h2><\/div><\/div><\/div>\n- The BMI showed the prevalence rate of obesity (BMI \u2265 30 kg\/m2) in 68.7% of the elderly and median BMI of 30.5 (IQR 28.1\u201333) kg\/m2. The findings show that 15.3% of all elderly patients in ICU with SARS-CoV-2 had BMI \u226535 kg\/m2.<\/li>\n
- The serum dosage of 25 OHD performed at the admission to the ICU showed a median value of 16 (IQR 10\u201321) ng\/mL.<\/li>\n
- The prevalence of 25 OHD <30 ng\/mL was 93.8%, 25 OHD <20 ng\/mL was 65.9% and 25 OHD <10 ng\/mL (severe deficiency) was 21%.<\/li>\n
- The prevalence of 25 OHD <30 ng\/mL among the obese elderly was 94.2%.<\/li>\n
- There was a significant negative correlation between BMI and the serum dosage of 25 OHD with statistical significance.<\/li>\n
- There was no correlation between serum 25 OHD and SAPS III and CRP.<\/li>\n
- As for the presence of comorbidities, arterial hypertension (72.2%), diabetes mellitus (40.9%), heart disease (27.3%) and lung diseases like asthma or chronic obstructive pulmonary disease (27.3%) showed the highest prevalence among patients admitted to ICU. Chronic kidney disease (13.1%), neurological diseases (17%) and oncological diseases (7.4%) had a lower prevalence.<\/li>\n<\/ul>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div>![](\"https:\/\/www.vitamindandme.org\/wp-content\/uploads\/2021\/07\/38crop_iStock-665802182-300x300.jpg\" "\\"38crop_iStock-665802182\\"")
<\/span><\/div><\/div><\/div><\/div><\/div>Who<\/span><\/h2><\/div>Patients (176) 60 or older admitted to the ICU who received a diagnosis of acute respiratory distress syndrome defined as a ratio of arterial oxygen tension over fractional inspired oxygen – PaO2\/FiO2 < 300; positive swab from the nasal cavity and oropharynx for detection of viral RNA (ribonucleic acid) for COVID-19 using the reverse-transcription polymerase chain reaction (RT-PCR) technique; computed tomography (CT) scan of the chest showing bilateral interstitial infiltrate pulmonary with a typical \u201cground-glass\u201d pattern.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- This is a descriptive single center study over just one month.<\/li>\n
- There is no COVID-19 negative comparison group therefore, similar vitamin D levels and similar rates of obesity may be common in this group regardless of COVID-19 status.<\/li>\n
- The population included in this study is limited to elderly people with conditions other than obesity, making it difficult to determine if obesity and vitamin D levels are directly related.<\/li>\n
- The study design and small limited sample size make it very difficult to make any conclusions.<\/li>\n<\/ul>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>There is a high prevalence of hypovitaminosis D and obesity among elderly patients and these factors should be investigated in the evolution of severe cases of COVID-19 requiring ICU admission and mechanical ventilation assisted by ARDS. In addition, further investigations are needed to stablish an association between obesity and hypovitaminosis D and clinical outcomes in this specific population.<\/p>\n<\/div><\/div><\/div>
“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>\n- A cross-sectional descriptive study composed of elderly (age \u2265 60 years) in the first 24 hours upon admission to the ICU at Sancta Maggiore Hospital Prevent Senior Private Operative, S\u00e3o Paulo, Brazil.<\/li>\n
- Data collected included demographic data (sex, age); anthropometric data such as weight (kilograms) and height (meters); severity score in the ICU such as SAPS III (Simplified Acute Physiology Score III); measurement of the PaO2\/FiO2 ratio after orotracheal intubation and mechanical ventilation; the presence of comorbidities (systemic arterial hypertension, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, asthma, heart diseases, neurological, oncological and immunosuppressed diseases or who use immunosuppressants); CRP (C-reactive protein) measurement in the first day of hospitalization.<\/li>\n
- The data on weight and height were obtained from a survey with the family member or companion who lived with the elderly. From these data, body mass index (BMI) was calculated by dividing weight by height squared (kg\/m2).<\/li>\n
- The BMI was stratified according to the cutoff points suggested by the Pan American Health Organization for the elderly: BMI \u2264 23 kg\/m2 (low weight), 23\u201328 kg\/m2 (normal weight), 28 to 30 kg\/m2 (overweight) and \u226530 kg\/m2 (obesity).<\/li>\n
- The test requested for the analysis of vitamin D levels was the serum dosage of 25-hydroxy vitamin D (25 OHD), measured by liquid chromatography coupled with tandem mass spectrometry (LC-MS\/MS).<\/li>\n
- The definition of hypovitaminosis D was standardized according to the criteria of the Brazilian Society of Endocrinology and Metabolism (SBEM) defined by a serum level < 20 ng\/mL for general population and <30 ng\/mL for individuals at risk.<\/li>\n
- The cutoff level defined in the study for hypovitaminosis was 25 OHD <30 ng\/mL. Severe deficiency was defined by 25 OHD <10 ng\/mL.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Reference<\/span><\/h2><\/div>Gon\u00e7alves TJM, Gon\u00e7alves SEAB, Guarnieri A, Risegato RC, Guimar\u00e3es MP, de Freitas DC, Razuk-Filho A, Benedito Junior PB, Parrillo EF. Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Nutr ESPEN. 2020 Dec;40:110-114. doi: 10.1016\/j.clnesp.2020.10.008. Epub 2020 Oct 13. PMID: 33183522; PMCID: PMC7552968.<\/p>\n<\/div><\/div><\/div>
Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).<\/h1><\/div>Take Home Message<\/span><\/h2><\/div>In elderly patients in Brazil testing positive for COVID-19 admitted to an ICU there was a high prevalence of obesity and low vitamin D levels. Whether or not the obesity and vitamin D levels are directly related to COVID-19 status is difficult to determine but warrants further investigation.<\/p>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/b>Results<\/span><\/h2><\/div><\/div><\/div>\n- The BMI showed the prevalence rate of obesity (BMI \u2265 30 kg\/m2) in 68.7% of the elderly and median BMI of 30.5 (IQR 28.1\u201333) kg\/m2. The findings show that 15.3% of all elderly patients in ICU with SARS-CoV-2 had BMI \u226535 kg\/m2.<\/li>\n
- The serum dosage of 25 OHD performed at the admission to the ICU showed a median value of 16 (IQR 10\u201321) ng\/mL.<\/li>\n
- The prevalence of 25 OHD <30 ng\/mL was 93.8%, 25 OHD <20 ng\/mL was 65.9% and 25 OHD <10 ng\/mL (severe deficiency) was 21%.<\/li>\n
- The prevalence of 25 OHD <30 ng\/mL among the obese elderly was 94.2%.<\/li>\n
- There was a significant negative correlation between BMI and the serum dosage of 25 OHD with statistical significance.<\/li>\n
- There was no correlation between serum 25 OHD and SAPS III and CRP.<\/li>\n
- As for the presence of comorbidities, arterial hypertension (72.2%), diabetes mellitus (40.9%), heart disease (27.3%) and lung diseases like asthma or chronic obstructive pulmonary disease (27.3%) showed the highest prevalence among patients admitted to ICU. Chronic kidney disease (13.1%), neurological diseases (17%) and oncological diseases (7.4%) had a lower prevalence.<\/li>\n<\/ul>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/span><\/div><\/div><\/div><\/div><\/div>Who<\/span><\/h2><\/div>Patients (176) 60 or older admitted to the ICU who received a diagnosis of acute respiratory distress syndrome defined as a ratio of arterial oxygen tension over fractional inspired oxygen – PaO2\/FiO2 < 300; positive swab from the nasal cavity and oropharynx for detection of viral RNA (ribonucleic acid) for COVID-19 using the reverse-transcription polymerase chain reaction (RT-PCR) technique; computed tomography (CT) scan of the chest showing bilateral interstitial infiltrate pulmonary with a typical \u201cground-glass\u201d pattern.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- This is a descriptive single center study over just one month.<\/li>\n
- There is no COVID-19 negative comparison group therefore, similar vitamin D levels and similar rates of obesity may be common in this group regardless of COVID-19 status.<\/li>\n
- The population included in this study is limited to elderly people with conditions other than obesity, making it difficult to determine if obesity and vitamin D levels are directly related.<\/li>\n
- The study design and small limited sample size make it very difficult to make any conclusions.<\/li>\n<\/ul>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>There is a high prevalence of hypovitaminosis D and obesity among elderly patients and these factors should be investigated in the evolution of severe cases of COVID-19 requiring ICU admission and mechanical ventilation assisted by ARDS. In addition, further investigations are needed to stablish an association between obesity and hypovitaminosis D and clinical outcomes in this specific population.<\/p>\n<\/div><\/div><\/div>
“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>\n- A cross-sectional descriptive study composed of elderly (age \u2265 60 years) in the first 24 hours upon admission to the ICU at Sancta Maggiore Hospital Prevent Senior Private Operative, S\u00e3o Paulo, Brazil.<\/li>\n
- Data collected included demographic data (sex, age); anthropometric data such as weight (kilograms) and height (meters); severity score in the ICU such as SAPS III (Simplified Acute Physiology Score III); measurement of the PaO2\/FiO2 ratio after orotracheal intubation and mechanical ventilation; the presence of comorbidities (systemic arterial hypertension, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, asthma, heart diseases, neurological, oncological and immunosuppressed diseases or who use immunosuppressants); CRP (C-reactive protein) measurement in the first day of hospitalization.<\/li>\n
- The data on weight and height were obtained from a survey with the family member or companion who lived with the elderly. From these data, body mass index (BMI) was calculated by dividing weight by height squared (kg\/m2).<\/li>\n
- The BMI was stratified according to the cutoff points suggested by the Pan American Health Organization for the elderly: BMI \u2264 23 kg\/m2 (low weight), 23\u201328 kg\/m2 (normal weight), 28 to 30 kg\/m2 (overweight) and \u226530 kg\/m2 (obesity).<\/li>\n
- The test requested for the analysis of vitamin D levels was the serum dosage of 25-hydroxy vitamin D (25 OHD), measured by liquid chromatography coupled with tandem mass spectrometry (LC-MS\/MS).<\/li>\n
- The definition of hypovitaminosis D was standardized according to the criteria of the Brazilian Society of Endocrinology and Metabolism (SBEM) defined by a serum level < 20 ng\/mL for general population and <30 ng\/mL for individuals at risk.<\/li>\n
- The cutoff level defined in the study for hypovitaminosis was 25 OHD <30 ng\/mL. Severe deficiency was defined by 25 OHD <10 ng\/mL.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Reference<\/span><\/h2><\/div>Gon\u00e7alves TJM, Gon\u00e7alves SEAB, Guarnieri A, Risegato RC, Guimar\u00e3es MP, de Freitas DC, Razuk-Filho A, Benedito Junior PB, Parrillo EF. Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Nutr ESPEN. 2020 Dec;40:110-114. doi: 10.1016\/j.clnesp.2020.10.008. Epub 2020 Oct 13. PMID: 33183522; PMCID: PMC7552968.<\/p>\n<\/div><\/div><\/div>
Take Home Message<\/span><\/h2><\/div>In elderly patients in Brazil testing positive for COVID-19 admitted to an ICU there was a high prevalence of obesity and low vitamin D levels. Whether or not the obesity and vitamin D levels are directly related to COVID-19 status is difficult to determine but warrants further investigation.<\/p>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/b>Results<\/span><\/h2><\/div><\/div><\/div>\n- The BMI showed the prevalence rate of obesity (BMI \u2265 30 kg\/m2) in 68.7% of the elderly and median BMI of 30.5 (IQR 28.1\u201333) kg\/m2. The findings show that 15.3% of all elderly patients in ICU with SARS-CoV-2 had BMI \u226535 kg\/m2.<\/li>\n
- The serum dosage of 25 OHD performed at the admission to the ICU showed a median value of 16 (IQR 10\u201321) ng\/mL.<\/li>\n
- The prevalence of 25 OHD <30 ng\/mL was 93.8%, 25 OHD <20 ng\/mL was 65.9% and 25 OHD <10 ng\/mL (severe deficiency) was 21%.<\/li>\n
- The prevalence of 25 OHD <30 ng\/mL among the obese elderly was 94.2%.<\/li>\n
- There was a significant negative correlation between BMI and the serum dosage of 25 OHD with statistical significance.<\/li>\n
- There was no correlation between serum 25 OHD and SAPS III and CRP.<\/li>\n
- As for the presence of comorbidities, arterial hypertension (72.2%), diabetes mellitus (40.9%), heart disease (27.3%) and lung diseases like asthma or chronic obstructive pulmonary disease (27.3%) showed the highest prevalence among patients admitted to ICU. Chronic kidney disease (13.1%), neurological diseases (17%) and oncological diseases (7.4%) had a lower prevalence.<\/li>\n<\/ul>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/span><\/div><\/div><\/div><\/div><\/div>Who<\/span><\/h2><\/div>Patients (176) 60 or older admitted to the ICU who received a diagnosis of acute respiratory distress syndrome defined as a ratio of arterial oxygen tension over fractional inspired oxygen – PaO2\/FiO2 < 300; positive swab from the nasal cavity and oropharynx for detection of viral RNA (ribonucleic acid) for COVID-19 using the reverse-transcription polymerase chain reaction (RT-PCR) technique; computed tomography (CT) scan of the chest showing bilateral interstitial infiltrate pulmonary with a typical \u201cground-glass\u201d pattern.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- This is a descriptive single center study over just one month.<\/li>\n
- There is no COVID-19 negative comparison group therefore, similar vitamin D levels and similar rates of obesity may be common in this group regardless of COVID-19 status.<\/li>\n
- The population included in this study is limited to elderly people with conditions other than obesity, making it difficult to determine if obesity and vitamin D levels are directly related.<\/li>\n
- The study design and small limited sample size make it very difficult to make any conclusions.<\/li>\n<\/ul>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>There is a high prevalence of hypovitaminosis D and obesity among elderly patients and these factors should be investigated in the evolution of severe cases of COVID-19 requiring ICU admission and mechanical ventilation assisted by ARDS. In addition, further investigations are needed to stablish an association between obesity and hypovitaminosis D and clinical outcomes in this specific population.<\/p>\n<\/div><\/div><\/div>
“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>\n- A cross-sectional descriptive study composed of elderly (age \u2265 60 years) in the first 24 hours upon admission to the ICU at Sancta Maggiore Hospital Prevent Senior Private Operative, S\u00e3o Paulo, Brazil.<\/li>\n
- Data collected included demographic data (sex, age); anthropometric data such as weight (kilograms) and height (meters); severity score in the ICU such as SAPS III (Simplified Acute Physiology Score III); measurement of the PaO2\/FiO2 ratio after orotracheal intubation and mechanical ventilation; the presence of comorbidities (systemic arterial hypertension, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, asthma, heart diseases, neurological, oncological and immunosuppressed diseases or who use immunosuppressants); CRP (C-reactive protein) measurement in the first day of hospitalization.<\/li>\n
- The data on weight and height were obtained from a survey with the family member or companion who lived with the elderly. From these data, body mass index (BMI) was calculated by dividing weight by height squared (kg\/m2).<\/li>\n
- The BMI was stratified according to the cutoff points suggested by the Pan American Health Organization for the elderly: BMI \u2264 23 kg\/m2 (low weight), 23\u201328 kg\/m2 (normal weight), 28 to 30 kg\/m2 (overweight) and \u226530 kg\/m2 (obesity).<\/li>\n
- The test requested for the analysis of vitamin D levels was the serum dosage of 25-hydroxy vitamin D (25 OHD), measured by liquid chromatography coupled with tandem mass spectrometry (LC-MS\/MS).<\/li>\n
- The definition of hypovitaminosis D was standardized according to the criteria of the Brazilian Society of Endocrinology and Metabolism (SBEM) defined by a serum level < 20 ng\/mL for general population and <30 ng\/mL for individuals at risk.<\/li>\n
- The cutoff level defined in the study for hypovitaminosis was 25 OHD <30 ng\/mL. Severe deficiency was defined by 25 OHD <10 ng\/mL.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Reference<\/span><\/h2><\/div>Gon\u00e7alves TJM, Gon\u00e7alves SEAB, Guarnieri A, Risegato RC, Guimar\u00e3es MP, de Freitas DC, Razuk-Filho A, Benedito Junior PB, Parrillo EF. Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Nutr ESPEN. 2020 Dec;40:110-114. doi: 10.1016\/j.clnesp.2020.10.008. Epub 2020 Oct 13. PMID: 33183522; PMCID: PMC7552968.<\/p>\n<\/div><\/div><\/div>
In elderly patients in Brazil testing positive for COVID-19 admitted to an ICU there was a high prevalence of obesity and low vitamin D levels. Whether or not the obesity and vitamin D levels are directly related to COVID-19 status is difficult to determine but warrants further investigation.<\/p>\n
\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div> \u00a0<\/span><\/p>\n<\/div><\/div><\/div> Patients (176) 60 or older admitted to the ICU who received a diagnosis of acute respiratory distress syndrome defined as a ratio of arterial oxygen tension over fractional inspired oxygen – PaO2\/FiO2 < 300; positive swab from the nasal cavity and oropharynx for detection of viral RNA (ribonucleic acid) for COVID-19 using the reverse-transcription polymerase chain reaction (RT-PCR) technique; computed tomography (CT) scan of the chest showing bilateral interstitial infiltrate pulmonary with a typical \u201cground-glass\u201d pattern.<\/p>\n<\/div><\/div><\/div><\/div><\/div> \u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div> There is a high prevalence of hypovitaminosis D and obesity among elderly patients and these factors should be investigated in the evolution of severe cases of COVID-19 requiring ICU admission and mechanical ventilation assisted by ARDS. In addition, further investigations are needed to stablish an association between obesity and hypovitaminosis D and clinical outcomes in this specific population.<\/p>\n<\/div><\/div><\/div> Gon\u00e7alves TJM, Gon\u00e7alves SEAB, Guarnieri A, Risegato RC, Guimar\u00e3es MP, de Freitas DC, Razuk-Filho A, Benedito Junior PB, Parrillo EF. Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Nutr ESPEN. 2020 Dec;40:110-114. doi: 10.1016\/j.clnesp.2020.10.008. Epub 2020 Oct 13. PMID: 33183522; PMCID: PMC7552968.<\/p>\n<\/div><\/div><\/div><\/b>Results<\/span><\/h2><\/div><\/div><\/div>
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<\/span><\/div><\/div><\/div><\/div><\/div>Who<\/span><\/h2><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>
\n
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>
“<\/span><\/h2><\/div><\/div><\/div>
“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>
Study Design<\/span><\/h2><\/div>
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Reference<\/span><\/h2><\/div>