Nutrients (May 2021)

Calcifediol Treatment and Hospital Mortality Due to COVID-19: A Cohort Study

  • Juan F. Alcala-Diaz,
  • Laura Limia-Perez,
  • Ricardo Gomez-Huelgas,
  • Maria D. Martin-Escalante,
  • Begoña Cortes-Rodriguez,
  • Jose L. Zambrana-Garcia,
  • Marta Entrenas-Castillo,
  • Ana I. Perez-Caballero,
  • Maria D. López-Carmona,
  • Javier Garcia-Alegria,
  • Aquiles Lozano Rodríguez-Mancheño,
  • Maria del Sol Arenas-de Larriva,
  • Luis M. Pérez-Belmonte,
  • Irwin Jungreis,
  • Roger Bouillon,
  • Jose Manual Quesada-Gomez,
  • Jose Lopez-Miranda

DOI
https://doi.org/10.3390/nu13061760
Journal volume & issue
Vol. 13, no. 6
p. 1760

Abstract

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Context. Calcifediol has been proposed as a potential treatment for COVID-19 patients. Objective: To compare the administration or not of oral calcifediol on mortality risk of patients hospitalized because of COVID-19. Design: Retrospective, multicenter, open, non-randomized cohort study. Settings: Hospitalized care. Patients: Patients with laboratory-confirmed COVID-19 between 5 February and 5 May 2020 in five hospitals in the South of Spain. Intervention: Patients received calcifediol (25-hydroxyvitamin D3) treatment (0.266 mg/capsule, 2 capsules on entry and then one capsule on day 3, 7, 14, 21, and 28) or not. Main Outcome Measure: In-hospital mortality during the first 30 days after admission. Results: A total of 537 patients were hospitalized with COVID-19 (317 males (59%), median age, 70 years), and 79 (14.7%) received calcifediol treatment. Overall, in-hospital mortality during the first 30 days was 17.5%. The OR of death for patients receiving calcifediol (mortality rate of 5%) was 0.22 (95% CI, 0.08 to 0.61) compared to patients not receiving such treatment (mortality rate of 20%; p 7 mmol/L, respiratory rate ≥ 30/min, systolic blood pressure < 90 mm Hg or diastolic blood pressure ≤ 60 mm Hg, and age ≥ 65 years), acute respiratory distress syndrome (moderate or severe), c-reactive protein, chronic kidney disease, and blood urea nitrogen. In a multivariable logistic regression model, adjusting for confounders, there were significant differences in mortality for patients receiving calcifediol compared with patients not receiving it (OR = 0.16 (95% CI 0.03 to 0.80). Conclusion: Among patients hospitalized with COVID-19, treatment with calcifediol, compared with those not receiving calcifediol, was significantly associated with lower in-hospital mortality during the first 30 days. The observational design and sample size may limit the interpretation of these findings.

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