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The association between vitamin D intake with inflammatory and biochemical indices and mortality in critically ill patients with COVID‐19: A case‐control study

Gholamalizadeh et al., Immunity, Inflammation and Disease, doi:10.1002/iid3.844
Apr 2023  
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Mortality 69% Improvement Relative Risk Vitamin D  Gholamalizadeh et al.  ICU PATIENTS Is very late treatment with vitamin D beneficial for COVID-19? Retrospective 200 patients in Iran Lower mortality with vitamin D (p=0.04) Survival bias may be significant c19early.org Gholamalizadeh et al., Immunity, Infla.., Apr 2023 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
Case control study with 200 critical COVID-19 patients in Iran, showing lower mortality with higher vitamin D supplement intake. Authors do not provide enough information to assess confounding. Authors indicate that treatment was based on the opinion of the treating physician, and include only patients with at least one week in the ICU, however patients that die may have lower vitamin D supplement duration because they are no longer alive.
Cholecalciferol was used in this study. Meta analysis shows that late stage treatment with calcitriol / calcifediol (or paricalcitol, alfacalcidol, etc.) is more effective than cholecalciferol: 69% [47‑82%] lower risk vs. 39% [27‑49%] lower risk. Cholecalciferol requires two hydroxylation steps to become activated - first in the liver to calcifediol, then in the kidney to calcitriol. Calcitriol, paricalcitol, and alfacalcidol are active vitamin D analogs that do not require conversion. This allows them to have more rapid onset of action compared to cholecalciferol. The time delay for cholecalciferol to increase serum calcifediol levels can be 2-3 days, and the delay for converting calcifediol to active calcitriol can be up to 7 days.
This study is excluded in meta analysis: survival bias may significantly affect results.
risk of death, 68.8% lower, OR 0.31, p = 0.04, inverted to make OR<1 favor treatment, model 3, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Gholamalizadeh et al., 26 Apr 2023, Iran, peer-reviewed, 13 authors. Contact: doaei@gums.ac.ir, profmeakbari@gmail.com.
This PaperVitamin DAll
The association between vitamin D intake with inflammatory and biochemical indices and mortality in critically ill patients with COVID‐19: A case‐control study
Maryam Gholamalizadeh, Faezeh Rabbani, Mina Ahmadzadeh, Azadeh Hajipour, Hayehe Musavi, Khadijeh Abbasi Mobarakeh, Zahra Salimi, Bojlul Bahar, Zahra Mahmoodi, Somayeh Gholami, Samaneh Mirzaei Dahka, Saeid Doaei, Mokammad Esmail Akbari
Immunity, Inflammation and Disease, doi:10.1002/iid3.844
Background: The coronavirus disease-2019 (COVID-19) has become a worldwide health issue with widespread hospitalization and dependence on the intensive care unit (ICU). Vitamin D has a key role in modulating immune cells and modulating the inflammatory responses. This study aimed to investigate the association of vitamin D supplementation with inflammatory, biochemical, and mortality indices in critically ill patients with COVID-19. Methods: This case-control study was conducted on critically ill COVID-19 patients hospitalized in the ICU including the survived >30 day patients as the case group and dead patients as the control group. The status of vitamin D
CONFLICT OF INTEREST STATEMENT The authors declare no conflict of interest. ETHICS STATEMENT This study was approved by the Institutional Review Board at Shahid-Beheshti University of Medical Sciences (code: IR.SBMU.CRC.REC.1399.031). All patients signed an informed consent form at baseline. Institutional consent forms were used in this study.
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Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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