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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 25% Improvement Relative Risk Vitamin D for COVID-19  Güven et al.  ICU PATIENTS Is very late treatment with vitamin D beneficial for COVID-19? Retrospective 175 patients in Turkey Lower mortality with vitamin D (not stat. sig., p=0.32) c19early.org Güven et al., European J. Clinical Nut.., Jul 2021 Favors vitamin D Favors control

The effect of high-dose parenteral vitamin D3 on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study

Güven et al., European Journal of Clinical Nutrition, doi:10.1038/s41430-021-00984-5
Jul 2021  
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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 119 studies, recognized in 7 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments. c19early.org
Retrospective 175 ICU patients, 113 treated with a single dose of 300,000IU intramuscular cholecalciferol, showing lower mortality with treatment, but not reaching statistical significance. Calcifediol or calcitriol, which avoids several days delay in conversion, may be more successful, especially with this very late stage usage.
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: 65% [41‑79%] lower risk vs. 39% [26‑49%] 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 is the 42nd of 119 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 116 sextillion). 29 studies are RCTs, which show efficacy with p=0.0000035.
This study is excluded in the after exclusion results of meta analysis: very late stage, ICU patients.
risk of death, 24.8% lower, RR 0.75, p = 0.32, treatment 43 of 113 (38.1%), control 30 of 62 (48.4%), NNT 9.7, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Güven et al., 23 Jul 2021, retrospective, Turkey, peer-reviewed, 2 authors, dosage 300,000IU single dose.
This PaperVitamin DAll
The effect of high-dose parenteral vitamin D3 on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: an observational cohort study
Mehmet Güven, Hamza Gültekin
European Journal of Clinical Nutrition, doi:10.1038/s41430-021-00984-5
BACKGROUND: In many studies, vitamin D has been found to be low in COVID-19 patients. In this study, we aimed to investigate the relationship between clinical course and inhospital mortality with parenteral administration of high-dose vitamin D 3 within the first 24 h of admission to patients who were hospitalized in the intensive care unit (ICU) because of COVID-19 with vitamin D deficiency. METHODS: This study included 175 COVID-19 patients with vitamin D deficiency [25(OH) D <12 ng/mL] who were hospitalized in the ICU. Vitamin D 3 group (n = 113) included patients who received a single dose of 300,000 IU vitamin D3 intramuscularly. Vitamin D 3 was not administered to the control group (n = 62). RESULTS: Median C-reactive protein level was 10.8 mg/dL in the vitamin D 3 group and 10.6 mg/dL in the control group (p = 0.465). Thirty-nine percent (n = 44) of the patients in the vitamin D 3 group were intubated endotracheally, and 50% (n = 31) of the patients in the control group were intubated endotracheally (p = 0.157). Parenteral vitamin D 3 administration was not associated with inhospital mortality by multivariate logistic regression analysis. According to Kaplan-Meier survival analysis, the median survival time was 16 d in the vitamin D3 group and 17 d in the control group (log-rank test, p = 0.459). CONCLUSION: In this study, which was performed for the first time in the literature, it was observed that high-dose parenteral vitamin D 3 administration in critical COVID-19 patients with vitamin D deficiency during admission to the ICU did not reduce the need for intubation, length of hospital stay, and inhospital mortality.
COMPETING INTERESTS The authors declare no competing interests. ADDITIONAL INFORMATION Supplementary information The online version contains supplementary material available at https://doi.org/10.1038/s41430-021-00984-5. Correspondence and requests for materials should be addressed to M.G. Reprints and permission information is available at http://www.nature.com/ reprints Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Late treatment
is less effective
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