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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'abstract': '<jats:title>Abstract</jats:title>\n'
' <jats:sec>\n'
' <jats:title>Objective</jats:title>\n'
' <jats:p>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.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Design</jats:title>\n'
' <jats:p>Quadruple blinded, randomised placebo controlled trial.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Setting</jats:title>\n'
' <jats:p>Norway, 10 November 2020 to 2 June 2021.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Participants</jats:title>\n'
' <jats:p>34\u2009601 adults (aged 18-75 years), not taking daily vitamin D '
'supplements.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Intervention</jats:title>\n'
' <jats:p>5 mL/day of cod liver oil (10 µg of vitamin D, n=17\u2009278) or placebo '
'(n=17\u2009323) for up to six months.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Main outcome measures</jats:title>\n'
' <jats:p>Four co-primary endpoints were predefined: the first was a positive '
'SARS-CoV-2 test result determined by reverse transcriptase-quantitative polymerase chain '
'reaction and the second was serious covid-19, defined as self-reported dyspnoea, admission to '
'hospital, or death. Other acute respiratory infections were indicated by the third and fourth '
'co-primary endpoints: a negative SARS-CoV-2 test result and self-reported symptoms. Side '
'effects related to the supplementation were self-reported. The fallback method was used to '
'handle multiple comparisons.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>Supplementation with cod liver oil was not associated with a reduced risk '
'of any of the co-primary endpoints. Participants took the supplement (cod liver oil or '
'placebo) for a median of 164 days, and 227 (1.31%) participants in the cod liver oil group '
'and 228 (1.32%) participants in the placebo group had a positive SARS-CoV-2 test result '
'(relative risk 1.00, multiple comparison adjusted confidence interval 0.82 to 1.22). Serious '
'covid-19 was identified in 121 (0.70%) participants in the cod liver oil group and in 101 '
'(0.58%) participants in the placebo group (1.20, 0.87 to 1.65). 8546 (49.46%) and 8565 '
'(49.44%) participants in the cod liver oil and placebo groups, respectively, had ≥1 negative '
'SARS-CoV-2 test results (1.00, 0.97 to 1.04). 3964 (22.94%) and 3834 (22.13%) participants in '
'the cod liver oil and placebo groups, respectively, reported ≥1 acute respiratory infections '
'(1.04, 0.97 to 1.11). Only low grade side effects were reported in the cod liver oil and '
'placebo groups.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Conclusion</jats:title>\n'
' <jats:p>Supplementation with cod liver oil in the winter did not reduce the '
'incidence of SARS-CoV-2 infection, serious covid-19, or other acute respiratory infections '
'compared with placebo.</jats:p>\n'
' </jats:sec>\n'
' <jats:sec>\n'
' <jats:title>Trial registration</jats:title>\n'
' <jats:p>\n'
' ClinicalTrials.gov\n'
' <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" '
'xlink:href="NCT04609423" ext-link-type="clintrialgov">NCT04609423</jats:ext-link>\n'
' .\n'
' </jats:p>\n'
' </jats:sec>',
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