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c19early.org COVID-19 treatment researchVitamin DVitamin D (more..)
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All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Mortality -22% Improvement Relative Risk Ventilation -27% ICU admission -17% Hospitalization 0% Vitamin D  Al Sulaiman et al.  ICU PATIENTS Is very late treatment with vitamin D beneficial for COVID-19? Retrospective 288 patients in Saudi Arabia (March 2020 - July 2021) Higher mortality (p=0.25) and ICU admission (p=0.069), not sig. c19early.org Al Sulaiman et al., Frontiers in Medic.., Aug 2023 Favors vitamin D Favors control

Survival implications vs. complications: unraveling the impact of vitamin D adjunctive use in critically ill patients with COVID-19—A multicenter cohort study

Al Sulaiman et al., Frontiers in Medicine, doi:10.3389/fmed.2023.1237903
Aug 2023  
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Retrospective 1,435 ICU patients in Saudi Arabia, showing no significant difference in mortality, and longer mechanical ventilation with treatment. Vitamin D patients had higher Q1, median, and Q3 SOFA scores after propensity score matching. 98% of patients were treated with cholecalciferol.
Cholecalciferol was used in this study. Meta analysis shows that late stage treatment with calcitriol / calcifediol (or paricalcitol, alfacalcidol, etc.) is more effective than cholecalciferol: 65% [41‑79%] lower risk vs. 38% [25‑49%] lower risk. Cholecalciferol requires two hydroxylation steps to become activated - first in the liver to calcifediol, then in the kidney to calcitriol. Calcitriol, paricalcitol, and alfacalcidol are active vitamin D analogs that do not require conversion. This allows them to have more rapid onset of action compared to cholecalciferol. The time delay for cholecalciferol to increase serum calcifediol levels can be 2-3 days, and the delay for converting calcifediol to active calcitriol can be up to 7 days.
This is the 114th of 116 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 38 sextillion). 28 studies are RCTs, which show efficacy with p=0.0000081. This study is excluded in the after exclusion results of meta analysis: very late stage study using cholecalciferol instead of calcifediol or calcitriol.
risk of death, 22.0% higher, HR 1.22, p = 0.25, treatment 72 of 144 (50.0%), control 62 of 144 (43.1%).
risk of mechanical ventilation, 27.0% higher, OR 1.27, p = 0.046, treatment 144, control 144, RR approximated with OR.
risk of ICU admission, 17.0% higher, OR 1.17, p = 0.07, treatment 144, control 144, RR approximated with OR.
risk of hospitalization, no change, OR 1.00, p = 1.00, treatment 144, control 144, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Al Sulaiman et al., 14 Aug 2023, retrospective, Saudi Arabia, peer-reviewed, 25 authors, study period March 2020 - July 2021, dosage not specified.
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This PaperVitamin DAll
Late treatment
is less effective
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