{"id":19934,"date":"2021-03-21T05:30:00","date_gmt":"2021-03-20T21:30:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=19934"},"modified":"2021-03-24T14:21:28","modified_gmt":"2021-03-24T06:21:28","slug":"jama%e5%9c%a8%e7%ba%bf%e8%ae%ba%e6%96%87-%e5%8d%95%e6%ac%a1%e5%a4%a7%e5%89%82%e9%87%8f%e7%bb%b4%e7%94%9f%e7%b4%a0d3%e5%af%b9%e4%b8%ad%e9%87%8d%e5%ba%a6%e6%96%b0%e5%86%a0%e8%82%ba%e7%82%8e%e6%b7%b7","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=19934","title":{"rendered":"[JAMA\u5728\u7ebf\u8bba\u6587]: \u5355\u6b21\u5927\u5242\u91cf\u7ef4\u751f\u7d20D3\u5bf9\u4e2d\u91cd\u5ea6\u65b0\u51a0\u80ba\u708e\u60a3\u8005\u4f4f\u9662\u65e5\u7684\u5f71\u54cd"},"content":{"rendered":"\n

Original Investigation February 17, 2021<\/p>\n\n\n\n

Effect of a Single High Dose of Vitamin D3<\/sub> on Hospital Length of Stay in Patients With Moderate to Severe COVID-19: A Randomized Clinical Trial<\/h1>\n\n\n\n

Igor H. Murai, Alan L. Fernandes, Lucas P. Sales, et al<\/h3>\n\n\n\n

JAMA. <\/em>Published online February 17, 2021. doi:10.1001\/jama.2020.26848<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Importance<\/strong><\/h3>\n\n\n\n

The efficacy of vitamin D3<\/sub> supplementation in coronavirus disease 2019 (COVID-19) remains unclear.<\/p>\n\n\n\n

Objective<\/strong><\/h3>\n\n\n\n

To investigate the effect of a single high dose of vitamin D3<\/sub> on hospital length of stay in patients with COVID-19.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong><\/h3>\n\n\n\n

This was a multicenter, double-blind, randomized, placebo-controlled trial conducted in 2 sites in Sao Paulo, Brazil. The study included 240 hospitalized patients with COVID-19 who were moderately to severely ill at the time of enrollment from June 2, 2020, to August 27, 2020. The final follow-up was on October 7, 2020.<\/p>\n\n\n\n

Interventions<\/strong><\/h3>\n\n\n\n

Patients were randomly assigned to receive a single oral dose of 200\u202f000 IU of vitamin D3<\/sub> (n\u2009=\u2009120) or placebo (n\u2009=\u2009120).<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong><\/h3>\n\n\n\n

The primary outcome was length of stay, defined as the time from the date of randomization to hospital discharge. Prespecified secondary outcomes included mortality during hospitalization; the number of patients admitted to the intensive care unit; the number of patients who required mechanical ventilation and the duration of mechanical ventilation; and serum levels of 25-hydroxyvitamin D, total calcium, creatinine, and C-reactive protein.<\/p>\n\n\n\n

Results<\/strong><\/h3>\n\n\n\n

Of 240 randomized patients, 237 were included in the primary analysis (mean [SD] age, 56.2 [14.4] years; 104 [43.9%] women; mean [SD] baseline 25-hydroxyvitamin D level, 20.9 [9.2] ng\/mL). Median (interquartile range) length of stay was not significantly different between the vitamin D3<\/sub> (7.0 [4.0-10.0] days) and placebo groups (7.0 [5.0-13.0] days) (log-rank P<\/em>\u2009=\u2009.59; unadjusted hazard ratio for hospital discharge, 1.07 [95% CI, 0.82-1.39]; P<\/em>\u2009=\u2009.62). The difference between the vitamin D3 <\/sub>group and the placebo group was not significant for in-hospital mortality (7.6% vs 5.1%; difference, 2.5% [95% CI, \u20134.1% to 9.2%]; P<\/em>\u2009=\u2009.43), admission to the intensive care unit (16.0% vs 21.2%; difference, \u20135.2% [95% CI, \u201315.1% to 4.7%]; P<\/em>\u2009=\u2009.30), or need for mechanical ventilation (7.6% vs 14.4%; difference, \u20136.8% [95% CI, \u201315.1% to 1.2%]; P<\/em>\u2009=\u2009.09). Mean serum levels of 25-hydroxyvitamin D significantly increased after a single dose of vitamin D3<\/sub> vs placebo (44.4 ng\/mL vs 19.8 ng\/mL; difference, 24.1 ng\/mL [95% CI, 19.5-28.7]; P<\/em>\u2009<\u2009.001). There were no adverse events, but an episode of vomiting was associated with the intervention.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong><\/h3>\n\n\n\n

Among hospitalized patients with COVID-19, a single high dose of vitamin D3<\/sub>, compared with placebo, did not significantly reduce hospital length of stay. The findings do not support the use of a high dose of vitamin D3<\/sub> for treatment of moderate to severe COVID-19.<\/p>\n\n\n\n

Trial Registration<\/strong><\/h3>\n\n\n\n

ClinicalTrials.gov Identifier: NCT04449718<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation February 17, 2021 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/19934"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=19934"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/19934\/revisions"}],"predecessor-version":[{"id":20065,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/19934\/revisions\/20065"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=19934"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=19934"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=19934"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}