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All Studies   Meta Analysis    Recent:   

Correlation of vitamin D level with the clinical-radiological severity of COVID-19 in geriatric patients

Baykal et al., Journal of Health Sciences and Medicine, doi:10.32322/jhsm.1063405
May 2022  
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0 0.5 1 1.5 2+ Mortality 22% treatment Improvement Relative Risk ICU admission 59% treatment Mortality, 20ng/mL -8% levels ICU admission, 20ng/mL 5% levels Progression 6% levels Vitamin D for COVID-19  Baykal et al.  LATE TREATMENT Is late treatment with vitamin D beneficial for COVID-19? Retrospective 75 patients in Turkey (April 2020 - March 2021) Lower ICU admission with vitamin D (p=0.005) c19early.org Baykal et al., J. Health Sciences and .., May 2022 Favors vitamin D Favors control
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
 
*, now known with p < 0.00000000001 from 120 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Retrospective 75 patients in Turkey showing lower ICU admission with vitamin D treatment in unadjusted results subject to confounding by time and indication (treatment was given to patients with low levels and only during a certain period). There was no significant difference in outcomes based on vitamin D levels.
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: 69% [47‑82%] lower risk vs. 39% [26‑49%] 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.
Bolus treatment is less effective. Pharmacokinetics and the potential side effects of high bolus doses suggest that ongoing treatment spread over time is more appropriate. Research has confirmed that lower dose regular treatment with vitamin D is more effective than intermittent high-dose bolus treatment for various conditions, including rickets and acute respiratory infections1,2. The biological mechanisms supporting these findings involve the induction of enzymes such as 24-hydroxylase and fibroblast growth factor 23 (FGF23) by high-dose bolus treatments. These enzymes play roles in inactivating vitamin D, which can paradoxically reduce levels of activated vitamin D and suppress its activation for extended periods post-dosage. Evidence indicates that 24-hydroxylase activity may remain elevated for several weeks following a bolus dose, leading to reduced levels of the activated form of vitamin D. Additionally, FGF23 levels can increase for at least three months after a large bolus dose, which also contributes to the suppression of vitamin D activation1.
This is the 83rd of 120 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 268 sextillion).
29 studies are RCTs, which show efficacy with p=0.000005.
risk of death, 22.2% lower, RR 0.78, p = 0.43, treatment 7 of 18 (38.9%), control 28 of 56 (50.0%), NNT 9.0, excluded in exclusion analyses: unadjusted results with no group details; significant confounding by time possible due to separation of groups in different time periods.
risk of ICU admission, 59.4% lower, RR 0.41, p = 0.005, treatment 5 of 18 (27.8%), control 39 of 57 (68.4%), NNT 2.5, excluded in exclusion analyses: unadjusted results with no group details; significant confounding by time possible due to separation of groups in different time periods.
risk of death, 8.0% higher, RR 1.08, p = 0.80, high D levels (≥20ng/mL) 11 of 20 (55.0%), low D levels (<20ng/mL) 28 of 55 (50.9%), outcome based on serum levels.
risk of ICU admission, 4.8% lower, RR 0.95, p = 1.00, high D levels (≥20ng/mL) 9 of 20 (45.0%), low D levels (<20ng/mL) 26 of 55 (47.3%), NNT 44, outcome based on serum levels.
risk of progression, 6.1% lower, RR 0.94, p = 0.77, high D levels (≥20ng/mL) 14 of 20 (70.0%), low D levels (<20ng/mL) 41 of 55 (74.5%), NNT 22, severe/critical, outcome based on serum levels.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Baykal et al., 30 May 2022, retrospective, Turkey, peer-reviewed, 2 authors, study period 1 April, 2020 - 1 March, 2021, dosage 300,000IU single dose. Contact: drhusnubaykal@hotmail.com.
This PaperVitamin DAll
Correlation of vitamin D level with the clinical-radiological severity of COVID-19 in geriatric patients
Hüsnü Baykal, Ayşe Füsun Ülger
Journal of Health Sciences and Medicine, doi:10.32322/jhsm.1063405
Objective: This study was planned to investigate the effect of 25-OH-Vitamin D (Vit D) deficiency on clinical and radiological findings of coronavirus disease-2019 (COVID-19) in geriatric patients hospitalized due to COVID-19. Material and Method: Seventy-five patients who were treated for COVID-19 were reviewed retrospectively, and grouped in relation with their ages [(1) 65-74, (2) 75-84, (3) >84 years] and the severity of Vit D deficiency [(1) severe deficiency: <10 ng/ mL, (2) moderate deficiency: 10-20 ng/mL, (3) minor deficiency: 21-30 ng/mL, (4) normal: >30 ng/mL]. The complaints on admission, comorbidities, intensive care unit (ICU) need, length of hospital stay, laboratory data, and mortality of the ones who had and did not have Vit D replacement (n=18/75) were recorded. The patients were analyzed for COVID-19 severity using radiological and clinical markers. Results: Moderate Vit D deficiency (10-20 ng/mL) was frequently detected. When the disease severity and Vit D levels were analyzed, it was found that the disease was more severe (46.6%) in the Vit D <10 ng/ml group, and milder (37.5%) in the >30 ng/ml group, but there was no statistically significant difference among the groups. Low or high Vit D levels did not show any significant correlations with the severity of pneumonia or the thorax CT findings. The intensive care unit (ICU) admission rate was significantly lower in those who had Vit D replacement (p<0.001). Conclusion: The ICU admission rate was lower in patients who had Vit D replacement, however, serum Vit D concentrations were not correlated with COVID-19 severity or mortality risk.
References
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The complaints ' 'on admission, comorbidities, intensive care unit (ICU) need, length of hospital stay, ' 'laboratory data, and mortality of the ones who had and did not have Vit D replacement ' '(n=18/75) were recorded. The patients were analyzed for COVID-19 severity using radiological ' 'and clinical markers. &#x0D;\n' 'Results: Moderate Vit D deficiency (10-20 ng/mL) was frequently detected. When the disease ' 'severity and Vit D levels were analyzed, it was found that the disease was more severe ' '(46.6%) in the Vit D 30 ng/ml group, but there was no statistically significant difference ' 'among the groups. Low or high Vit D levels did not show any significant correlations with the ' 'severity of pneumonia or the thorax CT findings. 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A cohort ' 'study to evaluate the effect of combination Vitamin D, Magnesium and ' 'Vitamin B12 (DMB) on progression to severe outcome in older COVID-19 ' 'patients. medRxiv 2020', 'DOI': '10.1101/2020.06.01.20112334'}, { 'key': 'ref37', 'doi-asserted-by': 'crossref', 'unstructured': 'Murai IH, Fernandes AL, Sales LP, Pinto AJ, Goessler KF, Duran CS. ' 'Effect of a single high dose of vitamin D3 on hospital length of stay in ' 'patients with moderate to severe COVID-19: a randomized clinical trial. ' 'JAMA 2021; 17: 2021.', 'DOI': '10.1001/jama.2020.26848'}], 'container-title': 'Journal of Health Sciences and Medicine', 'original-title': [], 'language': 'en', 'deposited': { 'date-parts': [[2022, 5, 31]], 'date-time': '2022-05-31T09:48:18Z', 'timestamp': 1653990498000}, 'score': 1, 'resource': {'primary': {'URL': 'https://dergipark.org.tr/en/doi/10.32322/jhsm.1063405'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 5, 30]]}, 'references-count': 37, 'journal-issue': {'issue': '3', 'published-online': {'date-parts': [[2022, 5, 30]]}}, 'URL': 'http://dx.doi.org/10.32322/jhsm.1063405', 'relation': {}, 'ISSN': ['2636-8579'], 'subject': ['General Medicine'], 'container-title-short': 'J Health Sci Med / JHSM', 'published': {'date-parts': [[2022, 5, 30]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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