Prevention of covid-19 and other acute respiratory infections with cod liver oil supplementation, a low dose vitamin D supplement: quadruple blinded, randomised placebo controlled trial

Brunvoll et al., BMJ, doi:10.1136/bmj-2022-071245, NCT04609423

Sep 2022

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RCT 17,278 low-risk patients (zero mortality) treated with 5mL/day cod liver oil (~400IU vitamin D) and 17,323 placebo patients in Norway with, showing no significant differences with treatment. The placebo group had higher vitamin D at baseline, and both groups had comparable vitamin D during treatment (74 vs. 63 nmol/L). 23% of control patients took vitamin D supplements and 62% consumed fatty fish (typically a good source of vitamin D). Adherence was low (<70% for "strict" compliance, which only required >0.5L consumed, or treatment for > "2-3" months).

This is the 22nd of 27 COVID-19 RCTs for vitamin D, which collectively show efficacy with p=0.00002.

This is the 95th of 115 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 30 sextillion).

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risk of ICU admission, 0.3% higher, RR 1.00, p = 1.00, treatment 4 of 17,278 (0.0%), control 4 of 17,323 (0.0%).

risk of hospitalization, 10.9% lower, RR 0.89, p = 1.00, treatment 8 of 17,278 (0.0%), control 9 of 17,323 (0.1%), NNT 17692.

risk of severe case, 20.0% higher, RR 1.20, p = 0.17, treatment 121 of 17,278 (0.7%), control 101 of 17,323 (0.6%).

risk of case, no change, RR 1.00, p = 0.98, treatment 227 of 17,278 (1.3%), control 228 of 17,323 (1.3%), NNT 42377.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Brunvoll et al., 7 Sep 2022, Double Blind Randomized Controlled Trial, placebo-controlled, Norway, peer-reviewed, mean age 44.9, 15 authors, study period 10 November, 2020 - 2 June, 2021, dosage 400IU daily, this trial uses multiple treatments in the treatment arm (combined with cod liver oil) - results of individual treatments may vary, trial NCT04609423 (history).

Contact: arne@meg.no.

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This Paper Vitamin D All

Prevention of covid-19 and other acute respiratory infections with cod liver oil supplementation, a low dose vitamin D supplement: quadruple blinded, randomised placebo controlled trial

Sonja H Brunvoll, Anders B Nygaard, Merete Ellingjord-Dale, Petter Holland, Mette Stausland Istre, Karl Trygve Kalleberg, Camilla L Søraas, Kirsten B Holven, Stine M Ulven, Anette Hjartåker, Trond Haider, Fridtjof Lund-Johansen, John Arne Dahl, Haakon E Meyer, Arne Søraas

BMJ, doi:10.1136/bmj-2022-071245

Objective To determine if daily supplementation with cod liver oil, a low dose vitamin D supplement, in winter, prevents SARS-CoV-2 infection, serious covid-19, or other acute respiratory infections in adults in Norway.

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