Navegando por Autor "Baggio, Janaína"
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Artigo Effect of a single high dose of vitamin D3 on cytokines, chemokines, and growth factor in patients with moderate to severe COVID-19(The American Journal of Clinical Nutrition, 2022-03) Reis, Bruna Zavarize; Fernandes, Alan Lins; Murai, Igor Hisashi; Sales, Lucas Peixoto; Santos, Mayara Diniz; Pinto, Ana Jéssica; Goessler, Karla Fabiana; Duran, Camila da Silva Cendon; Silva, Carla Baleeiro Rodrigues; Franco, André Silva; Macêdo, Marina Barguil; Dalmolin, Henrique Helson Herter; Baggio, Janaína; Balbi, Guilherme Guimarães Moreira; Antonangelo, Leila; Caparbo, Valéria de Falco; Gualano, Bruno; Pereira, Rosa Maria RodriguesBackground: The modulating effect of vitamin D on cytokine concentrations in severe coronavirus disease 2019 (COVID-19) remains unknown. Objectives: We aimed to investigate the effect of a single high dose of vitamin D3 on cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19. Methods: This is a post hoc, ancillary, and exploratory analysis from a multicenter, double-blind, placebo-controlled, randomized clinical trial. Patients with moderate to severe COVID-19 were recruited from 2 hospitals in São Paulo, Brazil. Of 240 randomly assigned patients, 200 were assessed in this study and randomly assigned to receive a single oral dose of 200,000 IU vitamin D3 (n = 101) or placebo (n = 99). The primary outcome was hospital length of stay, which has been published in our previous study. The prespecified secondary outcomes were serum concentrations of IL-1β, IL-6, IL-10, TNF-α, and 25-hydroxyvitamin D. The post hoc exploratory secondary outcomes were IL-4, IL-12p70, IL-17A, IFN-γ , granulocyte-macrophage colony-stimulating factor (GM-CSF), IL-8, IFN-inducible protein-10 (IP-10), macrophage inflammatory protein-1β (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and leukocyte count. Generalized estimating equations for repeated measures, with Bonferroni’s adjustment, were used for testing all outcomes. Results: The study included 200 patients with a mean ± SD age of 55.5 ± 14.3 y and BMI of 32.2 ± 7.1 kg/m2, of which 109 (54.5%) were male. GM-CSF concentrations showed a significant group-by-time interaction effect (P = 0.04), although the betweengroup difference at postintervention after Bonferroni’s adjustment was not significant. No significant effects were observed for the other outcomes. Conclusions: The findings do not support the use of a single dose of 200,000 IU vitamin D3, compared with placebo, for the improvement of cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19. This trial was registered at clinicaltrials.gov as NCT04449718. Am J Clin Nutr 2022;115:790–798Artigo Influence of vitamin D status on hospital length of stay and prognosis in hospitalized patients with moderate to severe COVID-19: a multicenter prospective cohort study(American Journal of Clinical Nutrition, 2021-08) Reis, Bruna Zavarize; Fernandes, Alan Lins; Sales, Lucas Peixoto; Santos, Mayara Diniz; Santos, Caroline C. dos; Pinto, Ana Jéssica; Goessler, Karla Fabiana; Franco, Andre Silva; Duran, Camila da Silva Cendon; Silva, Carla Baleeiro Rodrigues; Macêdo, Marina Barguil; Dalmolin, Henrique Helson Herter; Baggio, Janaína; Balbi, Guilherme Guimarães Moreira; Antonangelo, Leila; Caparbo, Valéria de Falco; Gualano, Bruno; Murai, Igor Hisashi; Pereira, Rosa Maria RodriguesBackground: Vitamin D acts as a mediator in the immune system regulating antiviral mechanisms and inflammatory processes. Vitamin D insufficiency has been suggested as a potential risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection, although its impact on the prognosis of hospitalized patients with coronavirus disease 2019 (COVID-19) remains unclear. Objective: This multicenter prospective cohort study was designed to investigate whether serum 25-hydroxyvitamin D [25(OH)D] concentration is associated with hospital length of stay and prognosis in hospitalized patients with COVID-19. Methods: Patients with moderate to severe COVID-19 (n = 220) were recruited from 2 hospitals in Sao Paulo, Brazil. Serum 25(OH)D concentrations were categorized as follows: <10 ng/mL, 10 to <20 ng/mL, 20 to <30 ng/mL, and ≥30 ng/mL, and <10 ng/mL and ≥10 ng/mL. The primary outcome was hospital length of stay and the secondary outcomes were the rate of patients who required invasive mechanical ventilation and mortality. Results: There were no significant differences in hospital length of stay when the 4 25(OH)D categories were compared (P = 0.120). Patients exhibiting 25(OH)D <10 ng/mL showed a trend (P = 0.057) for longer hospital length of stay compared with those with 25(OH)D ≥10 ng/mL [9.0 d (95% CI: 6.4, 11.6 d) vs. 7.0 d (95% CI: 6.6, 7.4 d)]. The multivariable Cox proportional hazard models showed no significant associations between 25(OH)D and primary or secondary outcomes. Conclusions: Among hospitalized patients with moderate to severe COVID-19, those with severe 25(OH)D deficiency (<10 ng/mL) exhibited a trend for longer hospital length of stay compared with patients with higher 25(OH)D concentrations. This association was not significant in the multivariable Cox regression model. Prospective studies should test whether correcting severe 25(OH)D deficiency could improve the prognosis of patients with COVID-19. Am J Clin Nutr 2021;114:598–604