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Medscape
8 minutes ago
- Medscape
Low Vitamin D May Raise COVID-19 Hospitalisation Risk
TOPLINE: An analysis of over 150,000 participants found that insufficient and deficient levels of vitamin D were associated with an increased risk for COVID-19 hospitalisation but not with the risk for COVID-19 infection; however, no significant associations were found among participants with a prior cancer diagnosis. METHODOLOGY: Researchers in London used data from the UK Biobank cohort to assess the association between levels of vitamin D (insufficient and deficient vs normal) and both COVID-19 infection and hospitalisation. They included a total of 151,543 participants (mean age, 56 years; 53% women), with a subset of 24,400 participants diagnosed with cancer prior to 2019. Serum vitamin D levels were measured at baseline between 2006 and 2010 (deficiency, < 24 nmol/L; insufficiency, 25-50 nmol/L; and normal, > 50 nmol/L); all had at least one positive COVID-19 polymerase chain reaction test. Endpoints were first COVID-19 infection (measured using the positive polymerase chain reaction test result) and COVID-19 hospitalisation (measured using hospital admission records). TAKEAWAY: Among overall participants, 14% had at least one positive COVID-19 test result, of whom 11% were hospitalised; in the cancer cohort, 11% of participants tested positive for COVID-19 and 14% of them were hospitalised. Vitamin D insufficiency and deficiency were associated with 19% and 36% higher odds of COVID-19 hospitalisation, respectively, than normal levels of vitamin D (P < .001 for both); however, no association was found between low levels of vitamin D and COVID-19 infection. Sensitivity analyses showed that among Black and Asian participants, low levels of vitamin D were linked to an increased risk for COVID-19 infection but not to increased hospitalisation rates. Among the subset of patients with cancer, levels of vitamin D were not significantly associated with COVID-19 outcomes. IN PRACTICE: "[The study] results highlight the complex role of VitD [vitamin D] in COVID-19 outcomes and the varying impact it has across different population subgroups," the authors wrote. SOURCE: This study was led by Maria J. Monroy-Iglesias, Transforming Outcomes through Research, Centre for Cancer, Society, and Public Health, School of Cancer and Pharmaceutical Sciences, King's College London, London, England. It was published online on July 18, 2025, in PLoS One. LIMITATIONS: Vitamin D levels were measured at baseline (between 2006 and 2010) over a decade before the COVID-19 pandemic, which may have led to the misclassification of participants' vitamin D status. This study could not account for seasonal variations in vitamin D levels. Subgroup analyses were limited by small sample sizes. The study cohort was not fully representative of the UK population, and potential bias may have arisen from differential access to COVID-19 testing. DISCLOSURES: This study did not receive any specific funding. The authors declared having no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
8 minutes ago
- Medscape
Polymyalgia Rheumatica Not Linked to Increased Mortality
TOPLINE: In a long-term follow-up study, patients with isolated polymyalgia rheumatica (PMR) and biopsy-confirmed giant cell arteritis (GCA) had no increased all-cause mortality compared with matched individuals; men with PMR showed lower mortality. METHODOLOGY: Researchers assessed long-term all-cause mortality in patients with PMR using data from a prospective, population-based inception cohort in Norway between 1987 and 1997 that was followed for 38 years. They included 274 patients with isolated PMR (mean age at diagnosis, 71.9 years; 66.1% women) and 63 patients with GCA (mean age at diagnosis, 71.6 years; 76.2% women), of whom 22 had coexisting PMR and GCA. PMR was defined with the fulfilment of criteria suggested by Bird and colleagues, and the diagnosis of GCA was confirmed with a positive temporal artery biopsy. Each case of PMR and GCA was matched with 15 individuals from the population registry on the basis of sex, age at inclusion, and residency, resulting in a total of 4110 and 945 individuals, respectively. Mortality and survival were assessed using the standard mortality ratio (SMR), with patients being followed up till death or until December 2024. TAKEAWAY: Among all patients with PMR, 96% had died by the end of the study, with a mean follow-up duration of 14 years and a maximum of 35.3 years. All-cause mortality in patients with PMR or GCA did not differ significantly from that in matched individuals. Men with PMR had significantly lower all-cause mortality (SMR, 0.77; 95% CI, 0.62-0.95); no significant sex-related differences were observed in patients with GCA. The overall cumulative survival in patients with PMR or GCA was not significantly different from that in the matched individuals. IN PRACTICE: "Our findings align with previous evidence reinforcing that isolated PMR does not significantly impact survival negatively, offering reassurance to both patients and clinicians regarding its long-term prognosis," the authors wrote. SOURCE: This study was led by Stig Tengesdal, Sørlandet Hospital, Kristiansand, Norway. It was published online on July 21, 2025, in Arthritis Research & Therapy. LIMITATIONS: The Bird's criteria may have relatively poor specificity for PMR. The prevalence of large vessel vasculitis may have been underestimated in the PMR cohort. Cases of malignancy could not be identified and excluded as data from medical charts were limited. DISCLOSURES: This study did not receive any specific funding. The authors declared having no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
8 minutes ago
- Medscape
Older Breast Cancer Patients Face Inconsistent Bone Care
TOPLINE: Bone health management for older women with breast cancer receiving aromatase inhibitors (AIs) varied substantially across five UK hospitals. Despite the higher risk for fractures, women older than 80 years were less likely to receive DEXA scans or bisphosphonates, highlighting the urgent need for standardised bone monitoring and treatment in frail older patients. METHODOLOGY: This secondary analysis of the multicentre Age Gap study included 529 women (age, ≥ 70 years) with oestrogen receptor-positive early breast cancer who received AIs, either as primary or adjuvant treatment, at five hospitals in the UK. Researchers collected comprehensive data including the type of endocrine therapy, DEXA scan results, bisphosphonate usage, calcium and vitamin D supplementation, and the incidence of fractures during or after AI therapy. Frailty was assessed using a modified Rockwood Frailty Index, with scores being calculated across 75 variables to categorise patients as robust (< 0.08), prefrail (0.08-0.25), or frail (> 0.25). TAKEAWAY: Overall, 67% of patients had baseline DEXA scans. Of these, 42% were osteopenic and 18% osteoporotic. Scans were more common in 70- to 79-year-olds than in those aged 80 years or older and in women undergoing surgery than in those undergoing primary endocrine therapy, with marked variation across centres (P < .001 for all). Among patients receiving AI therapy, 43% were prescribed bisphosphonates, especially those who had surgery (hazard ratio [HR], 1.36; P = .04) and those aged 70-79 years (HR, 1.31; P = .02); 33% had vitamin D plus calcium along with bisphosphonates. During follow-up, 23% of patients had fractures, with significant variation across centres (P = .02), and 38% of these patients had received prior bisphosphonates. Although 94% of patients were frail or prefrail, frailty did not correlate with baseline hip (P = .10) or spine (P = .89) T scores. Bisphosphonates plus AIs were prescribed in 70% of non-frail participants vs 43% of prefrail and 47% of frail participants (P = .02). IN PRACTICE: "Patient's age and general health influence bone health decision making, with older and frailer patients often receiving non-standard care. Despite national and international recommendations, there is still wide variation in bone health management, highlighting the need for further education and standardised bone health care in older women with breast cancer," the authors wrote. SOURCE: This study was led by Elisavet Theodoulou, University of Sheffield, Sheffield, England. It was published online on July 18, 2025, in the Journal of Geriatric Oncology. LIMITATIONS: The study's inclusion of only five hospital sites limited the ability to draw broader conclusions about bone health management practices across a wider range of centres. Additionally, the interpretation of the results was complicated by the introduction of adjuvant bisphosphonates during the study period, making the cohort unstable in terms of bisphosphonate usage indications. DISCLOSURES: The Age Gap study was supported by the National Institute for Health and Care Research Programme Grants for Applied Research. The authors declared having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
