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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ ICU admission 86% Improvement Relative Risk Oxygen therapy 7% Vitamin D  Karonova et al.  LATE TREATMENT  RCT Is late treatment with vitamin D beneficial for COVID-19? RCT 110 patients in Russia (November 2020 - March 2021) Lower ICU admission with vitamin D (not stat. sig., p=0.11) Karonova et al., Nutrients, June 2022 Favors vitamin D Favors control

Effect of Cholecalciferol Supplementation on the Clinical Features and Inflammatory Markers in Hospitalized COVID-19 Patients: A Randomized, Open-Label, Single-Center Study

Karonova et al., Nutrients, doi:10.3390/nu14132602, NCT05166005
Jun 2022  
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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.
RCT with 56 cholecalciferol and 54 control hospitalized patients with vitamin D insufficiency or deficiency in Russia, showing positive effects on immune status. The median age in the treatment group was 7 years lower and deficiency was less common, while baseline treatment group CT lung involvement and supplemental oxygen use was higher in the treatment group. Treatment increased vitamin D levels and neutrophil and lymphocyte counts, decreased CRP levels, and was associated with a decrease in CD38++CD27 transitional and CD27−CD38+ mature naive B cells and an increase in CD27−CD38− DN B cells.
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 17th of 29 COVID-19 RCTs for vitamin D, which collectively show efficacy with p=0.0000035.
This is the 86th of 119 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 116 sextillion).
risk of ICU admission, 85.9% lower, RR 0.14, p = 0.11, treatment 0 of 56 (0.0%), control 3 of 54 (5.6%), NNT 18, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), day 9.
risk of oxygen therapy, 7.0% lower, RR 0.93, p = 0.85, treatment 27 of 56 (48.2%), control 28 of 54 (51.9%), NNT 27, baseline oxygen supplementation was higher in the treatment group, 38 vs. 32, day 9.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Karonova et al., 23 Jun 2022, Randomized Controlled Trial, Russia, peer-reviewed, 12 authors, study period 30 November, 2020 - 20 March, 2021, dosage 50,000IU days 1, 8, trial NCT05166005 (history). Contact: (corresponding author),,,,,,,,,,,
This PaperVitamin DAll
Effect of Cholecalciferol Supplementation on the Clinical Features and Inflammatory Markers in Hospitalized COVID-19 Patients: A Randomized, Open-Label, Single-Center Study
Tatiana L Karonova, Ksenia A Golovatyuk, Igor V Kudryavtsev, Alena T Chernikova, Arina A Mikhaylova, Arthur D Aquino, Daria I Lagutina, Ekaterina K Zaikova, Olga V Kalinina, Alexey S Golovkin, William B Grant, Evgeny V Shlyakhto
Nutrients, doi:10.3390/nu14132602
Recent studies showed that a low 25-hydroxyvitamin D (25(OH)D) level was associated with a higher risk of morbidity and severe course of COVID-19. Our study aimed to evaluate the effects of cholecalciferol supplementation on the clinical features and inflammatory markers in patients with COVID-19. A serum 25(OH)D level was determined in 311 COVID-19 patients. Among them, 129 patients were then randomized into two groups with similar concomitant medication. Group I (n = 56) received a bolus of cholecalciferol at a dose of 50,000 IU on the first and the eighth days of hospitalization. Patients from Group II (n = 54) did not receive the supplementation. We found significant differences between groups with the preferential increase in serum 25(OH)D level and ∆ 25(OH)D in Group I on the ninth day of hospitalization (p < 0.001). The serum 25(OH)D level on the ninth day was negatively associated with the number of bed days (r = −0.23, p = 0.006); we did not observe other clinical benefits in patients receiving an oral bolus of cholecalciferol. Moreover, in Group I, neutrophil and lymphocyte counts were significantly higher (p = 0.04; p = 0.02), while the C-reactive protein level was significantly lower on the ninth day of hospitalization (p = 0.02). Patients with supplementation of 100,000 IU of cholecalciferol, compared to those without supplementation, showed a decrease in the frequencies of CD38++CD27 transitional and CD27−CD38+ mature naive B cells (p = 0.006 and p = 0.02) and an increase in the level of CD27−CD38− DN B cells (p = 0.02). Thus, the rise in serum 25(OH)D level caused by vitamin D supplementation in vitamin D insufficient and deficient patients may positively affect immune status and hence the course of COVID-19.
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Late treatment
is less effective
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