Journal article
The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2
International journal of environmental research and public health, Vol.19(1), p.447
01/01/2022
DOI: 10.3390/ijerph19010447
PMCID: PMC8744830
PMID: 35010701
Abstract
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.
Details
- Title: Subtitle
- The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2
- Creators
- Jimmy T. Efird - Durham VA Hlth Care Syst, Cooperat Studies Program Epidemiol Ctr, Durham, NC 27705 USAEthan J. Anderson - Univ Iowa, Coll Pharm, Iowa City, IA 52242 USACharulata Jindal - Harvard UniversityThomas S. Redding - Durham VA Hlth Care Syst, Cooperat Studies Program Epidemiol Ctr, Durham, NC 27705 USAAndrew D. Thompson - Durham VA Hlth Care Syst, Cooperat Studies Program Epidemiol Ctr, Durham, NC 27705 USAAshlyn M. Press - Durham VA Hlth Care Syst, Cooperat Studies Program Epidemiol Ctr, Durham, NC 27705 USAJulie Upchurch - Durham VA Hlth Care Syst, Cooperat Studies Program Epidemiol Ctr, Durham, NC 27705 USAChristina D. Williams - Durham VA Hlth Care Syst, Cooperat Studies Program Epidemiol Ctr, Durham, NC 27705 USAYuk Ming Choi - Signify (Netherlands)Ayako Suzuki - Durham VA Hlth Care Syst, Cooperat Studies Program Epidemiol Ctr, Durham, NC 27705 USA
- Resource Type
- Journal article
- Publication Details
- International journal of environmental research and public health, Vol.19(1), p.447
- DOI
- 10.3390/ijerph19010447
- PMID
- 35010701
- PMCID
- PMC8744830
- NLM abbreviation
- Int J Environ Res Public Health
- ISSN
- 1661-7827
- eISSN
- 1660-4601
- Publisher
- Mdpi
- Number of pages
- 19
- Grant note
- FY2021 ORD-COVID-19-8900-02 / Veterans Affairs (VA) Clinical Science Research and Development COVID Rapid Response program Durham VA Medical Center and Durham Cooperative Studies Program Epidemiology Center; US Department of Veterans Affairs
- Language
- English
- Date published
- 01/01/2022
- Academic Unit
- Pharmaceutical Sciences and Experimental Therapeutics; Fraternal Order of Eagles Diabetes Research Center; Health, Sport, and Human Physiology
- Record Identifier
- 9984366015702771
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