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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) Baykal et al., J. Health Sciences and .., May 2022 Favors vitamin D Favors control

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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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: 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 83rd of 115 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 30 sextillion). 27 studies are RCTs, which show efficacy with p=0.00002.
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.
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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.
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Late treatment
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