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.
Al Sulaiman et al., 14 Aug 2023, retrospective, Saudi Arabia, peer-reviewed, 25 authors, study period March 2020 - July 2021, dosage not specified.