ABSTRACT
Objectives: Although 25(OH)D is generally considered the best marker for assessing vitamin D body stores, its role as a marker during acute illness is less well established. Indeed, acute inflammatory insult may reduce circulating 25(OH)D. The objective was to examine serum 25(OH)D levels during the evolution of acute COVID-19 pneumonia.Material and methods: This pilot study was undertaken as a prospective cohort study. Patients with severe COVID-19, defined as clinical signs of pneumonia and respiratory rate > 30 breaths/minute or severe respiratory distress or oxygen saturation < 90% on room air, were admitted to the internal medicine department between 1 November and 31 December. Blood samples were taken on admission (day 0) and every 24 hours for the subsequent four days (days 1-4). Patients were not supplemented with vitamin D preparations during the monitoring period. All patients received 6 milligrams of dexamethasone daily during the monitoring period. Results: 22 patients (6 females, 16 males;median age 60.6 years) were included. On admission, 59% of patients were 25(OH)D sufficient (>30 ng/ml), and 41% of patients had 25(OH)D inadequacy (<30 ng/ml) according to the existing guidelines. A significant fall in mean 25(OH)D concentration from admission to day 2 (first 48 h) was observed (30,7 ng/ml vs. 26,4 ng/ml;p<0.0001). No subsequent significant fall in 25(OH)D concentration was observed between day 2 and 3 (26, 4 ng/ml vs. 25,9 ng/ml;p=0.2300) and day 3 and day 4 (25,8 ng/ml vs. 25,9 ng/ml;p=0.7026). The absolute 25(OH)D change between hospital admission and day 4 was 4.8 ng/mL (p<0.0001) and was not associated with mortality or the need for high flow oxygen (p=0.2113 and p=0.6467, respectively). On day 4, the number of patients with 25(OH)D inadequacy (<30 ng/ml) increased by 18% (p=0.0180). Conclusions: Serum concentration of 25(OH)D decreases significantly during the first 48 hours after hospital admission in acutely ill COVID-19 patients and should be therefore interpreted with caution. Whether low 25(OH)D in COVID-19 reflects tissue level vitamin D deficiency or represents only a laboratory phenomenon remains to be elucidated in prospective randomized trials of vitamin D supplementation.Presentation: Saturday, June 11, 2022 1:30 p.m. - 1:35 p.m., Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
ABSTRACT
Introduction: The COVID pandemic has altered health care delivery, including clinical research, by introduction of measures to reduce COVID. How these measures affect clinical research participation is unclear. Objectives: The purpose of this survey was to document research volunteer's attitudes toward COVID infection control procedures. Methods: Our research program implemented the following: 1. Staff wore masks, disposable gowns, face shields and gloves when with subjects. 2. Subjects were asked if they tested positive or were experiencing COVID symptoms;upon entry their temperature was measured, and hand sanitizer used. 3. Disinfecting was expanded to all scanner room surfaces in contact with humans between each visit. 4. Only 1 subject was allowed in the research office at a time. Staff, when possible, remained > 6 feet away from other persons. As part of a study evaluating total body DXA, community dwelling volunteers completed a self-administered health care delivery preference survey from Dec 2020 to May 2021. A 5-point scale was used to capture responses to 10 questions (Table 1). Responses were tested using Chi Square with age and sex comparisons assessed by ANOVA. Results: Eighty-two adults (41F/41M) mean (SD) age 50.9 (18.3) yrs (range 18-79) without sex difference participated. Participants strongly agreed (84%;p < 0.001) they were more comfortable seeing effort to prevent COVID-19;72% agreed 1 subject, without a companion, should be seen, and 81% strongly agreed masks be required. Seeing staff clean visit space was important to 66%, more so among women (33%) than men (21% (p = 0.007)). Most subjects (83%) reported comfort having elective procedures and did not feel “unclean” or “diseased” (87%) by procedures. Some, 26%, preferred a non-hospital setting, 66% were neutral;those age 50+ (17%) preferred this more (p = 0.004) than younger subjects (5%). Finally, 91% preferred to have a brief test description before visit arrival. Conclusions: In this university-based study, most subjects favored masking, cleaning and limiting personal contact for research visits. Notably, no information regarding vaccination status was exchanged and the study began just as vaccines became available and ended just after all US citizens over age 16 were eligible for vaccination. Thus, it is unknown if vaccination status might alter research participation perception. However, people do prefer that steps are taken to reduce infection in research settings. It seems likely that this would be the case in clinical care settings.