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Effect of Short Term High Dose Oral Vitamin D Therapy on the Inflammatory Markers in Patients with COVID 19 Disease

Lakkireddy et al., Archives of Clinical and Biomedical Research, doi:10.26502/acbr.50170273
Jul 2022  
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Mortality 61% Improvement Relative Risk ICU admission 22% Hospitalization time 7% Vitamin D  Lakkireddy et al.  LATE TREATMENT  RCT Is late treatment with vitamin D beneficial for COVID-19? RCT 87 patients in India Lower mortality with vitamin D (not stat. sig., p=0.27) c19early.org Lakkireddy et al., Archives of Clinica.., Jul 2022 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
RCT 44 treatment and 43 control patients with vitamin D levels <30ng/ml, showing significant reduction in inflammatory markers with treatment of 60,000IU vitamin D per day for 8 days (10 days for BMI >25). Death and ICU admission was lower in the treatment group but not statistically significant. Randomization was simple alternation, with the allocation officer unaware of which group patients were being assigned to as detailed in the study.
An earlier version of this study was censored based on incorrect claims from an anti-treatment researcher. For discussion see1.
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 is the 21st of 30 COVID-19 RCTs for vitamin D, which collectively show efficacy with p=0.0000032.
This is the 92nd of 122 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 587 sextillion).
risk of death, 60.9% lower, RR 0.39, p = 0.27, treatment 2 of 44 (4.5%), control 5 of 43 (11.6%), NNT 14.
risk of ICU admission, 21.8% lower, RR 0.78, p = 0.74, treatment 4 of 44 (9.1%), control 5 of 43 (11.6%), NNT 39.
hospitalization time, 7.1% lower, relative time 0.93, p = 0.90, treatment 44, control 43.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lakkireddy et al., 27 Jul 2022, Randomized Controlled Trial, India, peer-reviewed, mean age 45.5, 9 authors, dosage 60,000IU days 1-8, 8 or 10 days depending on BMI.
This PaperVitamin DAll
Effect of Short Term High Dose Oral Vitamin D Therapy on the Inflammatory Markers in Patients with COVID 19 Disease
Maheshwar Lakkireddy, Srikanth Goud Gadiga, Madhu R D Malathi, Madhu Latha Karra, Issv Prasad Murthy Raju, Sangeetha Chinapaka, Sai Baba Kss, Manohar Kandakatla
Archives of Clinical and Biomedical Research, doi:10.26502/acbr.50170273
Introduction: COVID 19 is known to cause immune dysregulation and vitamin D is a known immunomodulator. This study aims to objectively investigate the effect of short term high dose vitamin D therapy in reducing the inflammatory markers of COVID-19. Materials and Methods: Consented COVID-19 patients with hypovitaminosis D were evaluated for inflammatory markers (N/L ratio, CRP, LDH, IL6, Ferritin) along with vitamin D on 0 th day and 9 th / 11 th day as per their respective BMI category. Subjects were allotted to VD and NVD groups. VD group received Pulse D therapy (a short term high dose supplementation of 60,000 IUs of vitamin D for 8 or 10 days depending upon their BMI) in addition to the standard treatment. NVD group received standard treatment alone. Differences in the variables between the two groups were analysed for statistical significance. Results: Eighty seven out of one hundred and thirty subjects have completed the study (VD:44, NVD:43). Vitamin D level has increased from 15 ng/ml to 81 ng/ml in VD group and highly significant (p<0.01) reduction of all the measured inflammatory markers was noted. Reduction of markers in NVD group was insignificant (p>0.05). The difference in the reduction of markers between the groups (NVD vs VD) was highly significant (p<0.01). Conclusions: Therapeutic improvement in vitamin D to 80-100 ng/ml has significantly reduced the inflammatory markers associated with COVID-19 without any side effects. Hence, adjunctive short term high dose vitamin D therapy can be added safely to the existing treatment protocols of COVID-19 for improved outcomes.
Declaration of Interest/ Competing Interest None. Conflict of Interest Nil The Author Contributions Statement
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Late treatment
is less effective
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