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0 0.5 1 1.5 2+ Death at day 26 71% Improvement Relative Risk Death at day 10 90% Vitamin D for COVID-19  Carpagnano et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 42 patients in Italy Lower mortality with higher vitamin D levels (p=0.05) c19early.org Carpagnano et al., J. Endocrinol. Inve.., Aug 2020 Favors vitamin D Favors control

Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19

Carpagnano et al., J. Endocrinol. Invest., 2020, Aug 9, 1-7, doi:10.1007/s40618-020-01370-x
Aug 2020  
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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 8 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19early.org
Retrospective study 42 patients with acute respiratory failure, 81% with low vitamin D levels.
After 10 days, patients with severe vitamin D deficiency had a 50% probability of dying, while those with vitamin D ≥ 10 ng/mL had a 5% mortality risk, RR 0.1, p = 0.019.
This is the 8th of 196 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 11,637 vigintillion).
risk of death at day 26, 70.6% lower, RR 0.29, p = 0.0499, high D levels 5 of 34 (14.7%), low D levels 4 of 8 (50.0%), NNT 2.8, >30 ng/mL.
risk of death at day 10, 90.0% lower, RR 0.10, p = 0.02, high D levels 2 of 34 (5.9%), low D levels 4 of 8 (50.0%), NNT 2.3, adjusted per study, >30 ng/mL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Carpagnano et al., 9 Aug 2020, retrospective, Italy, peer-reviewed, 10 authors.
This PaperVitamin DAll
Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19
G E Carpagnano, V Di Lecce, V N Quaranta, A Zito, E Buonamico, E Capozza, A Palumbo, G Di Gioia, V N Valerio, O Resta
Journal of Endocrinological Investigation, doi:10.1007/s40618-020-01370-x
Purpose Hypovitaminosis D is a highly spread condition correlated with increased risk of respiratory tract infections. Nowadays, the world is in the grip of the Coronavirus disease 19 (COVID 19) pandemic. In these patients, cytokine storm is associated with disease severity. In consideration of the role of vitamin D in the immune system, aim of this study was to analyse vitamin D levels in patients with acute respiratory failure due to COVID-19 and to assess any correlations with disease severity and prognosis. Methods In this retrospective, observational study, we analysed demographic, clinical and laboratory data of 42 patients with acute respiratory failure due to COVID-19, treated in Respiratory Intermediate Care Unit (RICU) of the Policlinic of Bari from March, 11 to April 30, 2020. Results Eighty one percent of patients had hypovitaminosis D. Based on vitamin D levels, the population was stratified into four groups: no hypovitaminosis D, insufficiency, moderate deficiency, and severe deficiency. No differences regarding demographic and clinical characteristics were found. A survival analysis highlighted that, after 10 days of hospitalization, severe vitamin D deficiency patients had a 50% mortality probability, while those with vitamin D ≥ 10 ng/mL had a 5% mortality risk (p = 0.019). Conclusions High prevalence of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure, treated in a RICU. Patients with severe vitamin D deficiency had a significantly higher mortality risk. Severe vitamin D deficiency may be a marker of poor prognosis in these patients, suggesting that adjunctive treatment might improve disease outcomes.
Author contributions GEC and VDL, made substantial contribution to the conception and design of the work, VDL, EB, EC, GDG, AP, VNV to the data acquisition, VDL, EC, VQ, to the analysis, and VQ, AZ, GEC, OR to the interpretation. GEC, VDL, EB, VQ, EC helped in drafting the article and OR revised it critically for important intellectual content. All authors gave the final approval of the version to be published and agreed for the accuracy or integrity of any part of the work. Funding This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector. Availability of data and material The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Compliance with ethical standards Conflict of interest All authors disclose no interests related to the present work. Ethics approval The study was approved by the Institutional Review Board of Teaching Hospital Policlinico of Bari (Ethical Committee No. 6380). The procedures used in this study adhere to the tenets of the Declaration of Helsinki. Research involving human participants and/or animals The study was approved by our local ethical committee and informed consent was obtained. Informed consent Informed consent was obtained from all individual participants included in the study. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which..
References
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Martineau, Jolliffe, Greenberg, Aloia, Bergman et al., Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis, Health Technol Assess
Panfili, Roversi, Argenio, Rossi, Cappa et al., Possibile role of vitamin D in Covid-19 infection in pediatric population, J Endocrinol Invest
Vincent, Moreno, Takala, Willatts, Mendonça et al., The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine, Intensive Care Med
Wang, Nestel, Bourdeau, Nagai, Wang et al., Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression, J Immunol
Yang, Yu, Xu, Shu, Xia et al., Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study, Lancet Respir Med, doi:10.1016/S2213-2600(20)30079-5
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In consideration of the role of vitamin D in the immune system, aim of ' 'this study was to analyse vitamin D levels in patients with acute respiratory failure due to ' 'COVID-19 and to assess any correlations with disease severity and prognosis.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>In this retrospective, observational study, we analysed demographic, ' 'clinical and laboratory data of 42 patients with acute respiratory failure due to COVID-19, ' 'treated in Respiratory Intermediate Care Unit (RICU) of the Policlinic of Bari from March, 11 ' 'to April 30, 2020.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>Eighty one percent of patients had hypovitaminosis D. Based on ' 'vitamin D levels, the population was stratified into four groups: no hypovitaminosis D, ' 'insufficiency, moderate deficiency, and severe deficiency. 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