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0 0.5 1 1.5 2+ Mortality 50% treatment Improvement Relative Risk Mortality (b) 51% treatment Mortality (c) -8% levels Ventilation 48% levels ICU admission 12% levels Hospitalization 1% levels Vitamin D for COVID-19  Jimenez et al.  Prophylaxis Is prophylaxis with vitamin D beneficial for COVID-19? Retrospective 285 patients in Spain (March - May 2020) Lower mortality with vitamin D (p=0.02) Jimenez et al., Nutrients, July 2021 Favors vitamin D Favors control

Mortality in Hemodialysis Patients with COVID-19, the Effect of Paricalcitol or Calcimimetics

Jimenez et al., Nutrients, doi:10.3390/nu13082559
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.
Retrospective 288 hemodialysis patients in Spain, 137 with existing vitamin D treatments (94 with paricalcitol), showing lower mortality with treatment. There was no significant difference in outcomes based on serum levels, however authors do not separate patients that received vitamin D treatment.
This is the 43rd 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.
risk of death, 50.1% lower, HR 0.50, p = 0.02, treatment 16 of 94 (17.0%), control 65 of 191 (34.0%), NNT 5.9, adjusted per study, paricalcitol treatment, multivariate Cox regression.
risk of death, 50.7% lower, HR 0.49, p = 0.003, all vitamin D derivatives, univariate.
risk of death, 7.7% higher, OR 1.08, p = 0.81, high D levels 50, low D levels 110, >30 vs. <20ng/ml, RR approximated with OR, outcome based on serum levels, excluded in exclusion analyses: many patients received vitamin D treatment.
risk of mechanical ventilation, 47.5% lower, OR 0.53, p = 0.56, high D levels 50, low D levels 110, >30 vs. <20ng/ml, RR approximated with OR, outcome based on serum levels, excluded in exclusion analyses: many patients received vitamin D treatment.
risk of ICU admission, 12.2% lower, OR 0.88, p = 0.87, high D levels 50, low D levels 110, >30 vs. <20ng/ml, RR approximated with OR, outcome based on serum levels, excluded in exclusion analyses: many patients received vitamin D treatment.
risk of hospitalization, 0.8% lower, OR 0.99, p = 0.98, high D levels 50, low D levels 110, >30 vs. <20ng/ml, RR approximated with OR, outcome based on serum levels, excluded in exclusion analyses: many patients received vitamin D treatment.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Jimenez et al., 26 Jul 2021, retrospective, Spain, peer-reviewed, 21 authors, study period 12 March, 2020 - 21 May, 2020, dosage paricalcitol 0.9μg weekly.
This PaperVitamin DAll
Mortality in Hemodialysis Patients with COVID-19, the Effect of Paricalcitol or Calcimimetics
María Dolores Arenas Jimenez, Emilio González-Parra, Marta Riera, Abraham Rincón Bello, Ana López-Herradón, Higini Cao, Sara Hurtado, Silvia Collado, Laura Ribera, Francesc Barbosa, Fabiola Dapena, Vicent Torregrosa, José-Jesús Broseta, Carlos Soto Montañez, Juan F Navarro-González, Rosa Ramos, Jordi Bover, Xavier Nogués-Solan, Marta Crespo, Adriana S Dusso, Julio Pascual
Nutrients, doi:10.3390/nu13082559
Background. In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-19 infection. Some hemodialysis patients receive treatment with drugs for secondary hyperparathyroidism, which have well known pleiotropic effects beyond mineral metabolism. The aim of this study was to evaluate the impact of VD status and the administration of active vitamin D medications, used to treat secondary hyperparathyroidism, on survival in a cohort of COVID-19 positive HD patients. Methods. A cross-sectional retrospective observational study was conducted from 12 March to 21 May 2020 in 288 HD patients with positive PCR for SARS-CoV2. Patients were from 52 different centers in Spain. Results. The percent of HD patients with COVID-19 was 6.1% (288 out of 4743). Mortality rate was 28.4% (81/285). Three patients were lost to follow-up. Serum 25(OH)D (calcidiol) level was 17. 1 [10.6-27.5] ng/mL and was not significantly associated to mortality (OR 0.99 (0.97-1.01), p = 0.4). Patients receiving active vitamin D medications (16/94 (17%) vs. 65/191(34%), p = 0.003), including calcimimetics (4/49 (8.2%) vs. 77/236 (32.6%), p = 0.001), paricalcitol or calcimimetics (19/117 (16.2%) vs. 62/168 (36.9%); p < 0.001), and also those on both paricalcitol and calcimimetics, to treat secondary hyperparathyroidism (SHPTH) (1/26 (3.8%) vs. 80/259 (30.9%), p < 0.001) showed a lower mortality rate than patients receiving no treatment with either drug. Multivariate Cox regression analysis confirmed this increased survival. Conclusions.
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