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0 0.5 1 1.5 2+ Severe case 88% treatment Improvement Relative Risk Death for severe patients 24% levels ICU for severe patients 53% levels Vitamin D for COVID-19  Campi et al.  Prophylaxis Is prophylaxis with vitamin D beneficial for COVID-19? Prospective study of 155 patients in Italy Lower severe cases with vitamin D (p<0.000001) Campi et al., BMC Infectious Diseases, Jun 2021 Favors vitamin D Favors control

Vitamin D and COVID-19 severity and related mortality: a prospective study in Italy

Campi et al., BMC Infectious Diseases, doi:10.1186/s12879-021-06281-7
Jun 2021  
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Prospective study of 103 hospitalized patients in Italy, showing very high prevalence of vitamin D deficiency, and increased severity for lower vitamin D levels. Vitamin D supplementation was significantly less common for cases.
This is the 40th 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 severe case, 88.4% lower, OR 0.12, p < 0.001, treatment 31 of 103 (30.1%) cases, 41 of 52 (78.8%) controls, NNT 2.3, case control OR, vitamin D supplementation, hospitalized patients vs. controls, excluded in exclusion analyses: significant unadjusted differences between groups.
risk of death for severe patients, 24.3% lower, RR 0.76, p = 0.53, high D levels (≥20ng/ml) 6 of 39 (15.4%), low D levels (<20ng/ml) 13 of 64 (20.3%), NNT 20, hospitalized patients, outcome based on serum levels.
risk of ICU for severe patients, 53.1% lower, RR 0.47, p < 0.001, high D levels (≥20ng/ml) 12 of 39 (30.8%), low D levels (<20ng/ml) 42 of 64 (65.6%), NNT 2.9, hospitalized patients, outcome based on serum levels.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Campi et al., 14 Jun 2021, prospective, Italy, peer-reviewed, 21 authors, dosage not specified.
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Vitamin D and COVID-19 severity and related mortality: a prospective study in Italy
Irene Campi, Luigi Gennari, Daniela Merlotti, Christian Mingiano, Alessandro Frosali, Luca Giovanelli, Camilla Torlasco, Martino F Pengo, Francesca Heilbron, Davide Soranna, Antonella Zambon, Marta Di Stefano, Carmen Aresta, Marco Bonomi, Biagio Cangiano, Vittoria Favero, Letizia Fatti, Giovanni Battista Perego, Iacopo Chiodini, Gianfranco Parati, Luca Persani
BMC Infectious Diseases, doi:10.1186/s12879-021-06281-7
Background: Vitamin D deficiency has been suggested to favor a poorer outcome of Coronavirus disease-19 . We aimed to assess if 25-hydroxyvitamin-D (25OHD) levels are associated with interleukin 6 (IL-6) levels and with disease severity and mortality in COVID-19. Methods: We prospectively studied 103 in-patients admitted to a Northern-Italian hospital (age 66.1 ± 14.1 years, 70 males) for severely-symptomatic COVID-19. Fifty-two subjects with SARS-CoV-2 infection but mild COVID-19 symptoms (mildly-symptomatic COVID-19 patients) and 206 subjects without SARS-CoV-2 infection were controls. We measured 25OHD and IL-6 levels at admission and focused on respiratory outcome during hospitalization. Results: Severely-symptomatic COVID-19 patients had lower 25OHD levels (18.2 ± 11.4 ng/mL) than mildly-symptomatic COVID-19 patients and non-SARS-CoV-2-infected controls (30.3 ± 8.5 ng/mL and 25.4 ± 9.4 ng/mL, respectively, p < 0.0001 for both comparisons). 25OHD and IL-6 levels were respectively lower and higher in severely-symptomatic COVID-19 patients admitted to intensive care Unit [(ICU), 14.4 ± 8.6 ng/mL and 43.0 (19.0-56.0) pg/mL, respectively], than in those not requiring ICU admission [22.4 ± 1.4 ng/mL, p = 0.0001 and 16.0 (8.0-32.0) pg/mL, p = 0.0002, respectively]. Similar differences were found when comparing COVID-19 patients who died in hospital [13.2 ± 6.4 ng/mL and 45.0 (28.0-99.0) pg/mL] with survivors [19.3 ± 12.0 ng/mL, p = 0.035 and 21.0 (10.5-45.9) pg/mL, p = 0.018, respectively). 25OHD levels inversely correlated with: i) IL-6 levels (ρ − 0.284, p = 0.004); ii) the subsequent need of the ICU admission [relative risk, RR 0.99, 95% confidence interval (95%CI) 0.98-1.00, p = 0.011] regardless of age, gender, presence of at least 1 comorbidity among obesity, diabetes, arterial hypertension, creatinine, IL-6 and lactate dehydrogenase levels, neutrophil cells, lymphocytes and platelets count; iii) mortality (RR 0.97, 95%CI, 0.95-0.99, p = 0.011) regardless of age, gender, presence of diabetes, IL-6 and C-reactive protein and lactate dehydrogenase levels, neutrophil cells, lymphocytes and platelets count.
Authors' contributions IC1: data collection, analysis and interpretation of the data, preparation of the manuscript. LG1: data collection, analysis and interpretation of the data, preparation of the manuscript. DM: data collection and analysis, preparation of the manuscript. CM data collection and analysis. AF: data collection and analysis. LG2: data collection and analysis. CT: data collection and analysis. MFP: data collection and analysis. FH data collection and analysis. D S: data analysis and statistics. AZ: data analysis and statistics. MD: data collection and analysis. CA: data collection and analysis. MB: data collection and analysis and revision of the manuscript. BC: data collection and analysis. VF: data collection and analysis. LF: data collection and analysis. GBP: data collection and analysis and revision of the manuscript. IC2: data collection, analysis and interpretation of the data, preparation of the manuscript. GP: data collection, analysis and interpretation of the data, preparation of the manuscript. LP: data analysis and interpretation, preparation of the manuscript. All authors have read and approved the final version of the manuscript. Declarations Ethics approval and consent to participate The study was approved by the ethics committee of our Institution (Ethical Committee, Istituto Auxologico Italiano). The participants or their familiar, when needed as in the case of ICU admitted patients, gave written informed consent before taking part in the..
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