A randomized pilot study using calcitriol in hospitalized COVID-19 patients
MD Yasmine M Elamir, MD Hajira Amir, MD Steven Lim, MD Yesha Patel Rana, Carolina Gonzalez Lopez, MD Natalia Viera Feliciano, MD Ali Omar, MD William Paul Grist, MD Michael A Via
Bone, doi:10.1016/j.bone.2021.116175
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ACKNOWLEDGEMENTS There are no acknowledgements. that were also given losartan suggests that vitamin D functions, in part, by up-regulating the pulmonary renin/angiotensin system to mitigate lung damage. (19) This same system is disrupted by COVID-19 infection. (20) Human trials with cholecalciferol therapy for ARDS have mixed results. In a randomized trial, patients that underwent esophagectomy demonstrated a transient reduction in markers of ARDS with 300,000 IU treatment of cholecalciferol compared to placebo. (21) The authors argue that declining levels of VDBP that were observed in this trial may explain the short-lived benefit of cholecalciferol that was observed. In another randomized trial of 475 mechanically ventilated ICU patients given 540,000 units cholecalciferol vs placebo, a 44% reduction in hospital mortality was observed in the cholecalciferol treated patients among the subgroup of patients with 25-hydroxyvitamin D levels less than 12 ng/ml. (22) In addition, the cholecalciferol treated patients demonstrated a further reduction in mortality that persisted for 6 months of follow up. ( 22 ) A larger, multicenter trial is currently underway. (23) Limitations of our trial include lack of a placebo and lack of blinding. It is unlikely this would affect the SaO2/FIO2 endpoint. Additionally, 25-hydroxyvitamin D levels were not measured in our study. Enrollment of patients without regard to vitamin D status strengthens the generalizability of the results...
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