High-dose vitamin D versus placebo to prevent complications in COVID-19 patients: Multicentre randomized controlled clinical trial.

BACKGROUND: The role of oral vitamin D3 supplementation for hospitalized patients with COVID-19 remains to be determined. The study was aimed to evaluate whether vitamin D3 supplementation could prevent respiratory worsening among hospitalized patients with COVID-19. METHODS AND FINDINGS: We designed a multicentre, randomized, double-blind, sequential, placebo-controlled clinical trial. The study was conducted in 17 second and third level hospitals, located in four provinces of Argentina, from 14 August 2020 to 22 June 2021. We enrolled 218 adult patients, hospitalized in general wards with SARS-CoV-2 confirmed infection, mild-to-moderate COVID-19 and risk factors for disease progression. Participants were randomized to a single oral dose of 500 000 IU of vitamin D3 or matching placebo. Randomization ratio was 1:1, with permuted blocks and stratified for study site, diabetes and age (≤60 vs >60 years). The primary outcome was the change in the respiratory Sepsis related Organ Failure Assessment score between baseline and the highest value recorded up to day 7. Secondary outcomes included the length of hospital stay; intensive care unit admission; and in-hospital mortality. Overall, 115 participants were assigned to vitamin D3 and 105 to placebo (mean [SD] age, 59.1 [10.7] years; 103 [47.2%] women). There were no significant differences in the primary outcome between groups (median [IQR] 0.0 [0.0-1.0] vs 0.0 [0.0-1.0], for vitamin D3 and placebo, respectively; p = 0.925). Median [IQR] length of hospital stay was not significantly different between vitamin D3 group (6.0 [4.0-9.0] days) and placebo group (6.0 [4.0-10.0] days; p = 0.632). There were no significant differences for intensive care unit admissions (7.8% vs 10.7%; RR 0.73; 95% CI 0.32 to 1.70; p = 0.622), or in-hospital mortality (4.3% vs 1.9%; RR 2.24; 95% CI 0.44 to 11.29; p = 0.451). There were no significant differences in serious adverse events (vitamin D3 = 14.8%, placebo = 11.7%). CONCLUSIONS: Among hospitalized patients with mild-to-moderate COVID-19 and risk factors, a single high oral dose of vitamin D3 as compared with placebo, did not prevent the respiratory worsening. TRIAL REGISTRATION: ClincicalTrials.gov Identifier: NCT04411446.

Recuperación cardiovascular pediátrica: relevamiento estadístico 2009 - 2012 / Pediatric cardiovascular recovery: statistical survey 2009 - 2012

INTRODUCCION: Las cardiopatías congénitas son una patología prevalente en nuestra comunidad generando una importante demanda que requiere una respuesta rápida y efectiva para lograr mejores resultados en los tratamientos. Esta necesidad ha sido cubierta en gran medida desde la implementación del Plan Nacer (Cardiopatías Congénitas), con un gran impacto en la disminución de la mortalidad infantil. En el siguiente trabajo se comunican los resultados de las cirugías cardiovasculares en cardiopatías congénitas en el Hospital de Alta Complejidad El Cruce. Dr. Néstor Carlos Kirchner. MATERIALES Y METODOS: Los datos se identificaron por medio de la revisión de la Historia Clínica Digital en el Sistema SIGHEOS. RESULTADOS: los resultados obtenidos durante el período julio 2009 - octubre 2012 se realizaron 64 cirugías cardiovasculares. Diez cirugías fueron en neonatos, treinta y seis en pacientes de 31 días a 1 año y dieciocho en mayores de 1 año. Se concluye con que el crecimiento de los Servicios de Cirugía Cardiovascular Pediátrica y Recuperación Cardiovascular Pediátrica, ha sido exponencial desde el inicio de la realización de la primera cirugía en el año 2009. Desde el inicio de las actividades del servicio de Cirugía Cardiovascular Pediátrica y de Recuperación Cardiovascular Pediátrica en UCIP (Unidad Cuidados Intensivos Pediátricos), tanto el número, como la complejidad de las patologías operadas han ido en aumento.

INTRODUCTION: Congenital heart disease is a disease prevalent in our community generating significant demand that requires a rapid and effective response to achieve better results in treatment. This need has been met largely from the implementation of the Plan nacer (congenital heart disease), with a great impact on reducing child mortality. In this paper, we report the results of cardiovascular surgery in congenital heart disease in the High Complexity Hospital El Cruce. Dr. néstor Carlos Kirchner. MATERIAL AND METHODS: review of Medical records. SIGHEOS System. RESULTS: During the period July 2009 - 64 October 2012 cardiovascular surgeries were performed. Ten surgeries were in neonates, thirty-six patients under one year and eighteen in over 1 year.