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Vitamin D Insufficiency is Prevalent in Severe COVID-19

Lau et al., medRxiv, doi:10.1101/2020.04.24.20075838

Apr 2020

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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.

Lower risk for mortality, ICU admission, hospitalization, progression, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments. ^* >10% efficacy, ≥3 studies.

4,500+ studies for 81 treatments. c19early.org

Analysis of 20 hospitalized COVID-19 patients, 13 requiring ICU admission. 84.6% of the ICU patients had low vitamin D levels versus 57.1% of the non-ICU patients.

This is the 1st of 199 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 835,162 vigintillion).

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risk of ICU admission, 45.0% lower, RR 0.55, p = 0.29, high D levels 2 of 5 (40.0%), low D levels 11 of 15 (73.3%), NNT 3.0, >30ng/mL.

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Lau et al., 28 Apr 2020, retrospective, USA, preprint, 7 authors.

This Paper Vitamin D All

Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.04.24.20075838; this version posted April 28, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. Vitamin D insufficiency is prevalent in severe COVID-19 Frank H. Lau, MD, FACS1, Rinku Majumder, PhD2, Radbeh Torabi, MD1, Fouad Saeg, BS3, Ryan Hoffman, BS4, Jeffrey D. Cirillo, PhD5, Patrick Greiffenstein, MD, FACS1 Affiliations: 1. Department of Surgery, Louisiana State University Health Sciences Center New Orleans (LSUHSC-NO) 2. Department of Biochemistry, LSUHSC-NO 3. Tulane School of Medicine 4. LSUHSC-NO School of Medicine 5. Department of Microbial Pathogenesis and Immunology, Texas A&M College of Medicine Corresponding Author: Dr. Frank H. Lau, MD, FACS; Department of Surgery, Louisiana State University Health Sciences Center New Orleans, 1542 Tulane Ave, 7th Floor, New Orleans, LA 70112; email: flau@lsuhsc.edu; phone: (504) 412-1240 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.04.24.20075838; this version posted April 28, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.

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To better ' 'define the VDI-COVID-19 link, we determined the prevalence of VDI among our COVID-19 ' 'intensive care unit (ICU) ' 'patients.MethodsIn an ' 'Institutional Review Board approved study performed at a single, tertiary care academic ' 'medical center, the medical records of COVID-19 patients were retrospectively reviewed. ' 'Subjects were included for whom serum 25-hydroxycholecalcifoerol (25OHD) levels were ' 'determined. COVID-19-relevant data were compiled and analyzed. We determined the frequency of ' 'VDI among COVID-19 patients to evaluate the likelihood of a VDI-COVID-19 ' 'relationship.ResultsTwenty ' 'COVID-19 patients with serum 25OHD levels were identified; 65.0% required ICU admission.The ' 'VDI prevalence in ICU patients was 84.6%, vs. 57.1% in floor patients. Strikingly, 100% of ' 'ICU patients less than 75 years old had VDI. Coagulopathy was present in 62.5% of ICU ' 'COVID-19 patients, and 92.3% were ' 'lymphocytopenic.ConclusionsVDI ' 'is highly prevalent in severe COVID-19 patients. VDI and severe COVID-19 share numerous ' 'associations including hypertension, obesity, male sex, advanced age, concentration in ' 'northern climates, coagulopathy, and immune dysfunction. Thus, we suggest that prospective, ' 'randomized controlled studies of VDI in COVID-19 patients are warranted.', 'DOI': '10.1101/2020.04.24.20075838', 'type': 'posted-content', 'created': {'date-parts': [[2020, 4, 28]], 'date-time': '2020-04-28T20:55:17Z', 'timestamp': 1588107317000}, 'source': 'Crossref', 'is-referenced-by-count': 79, 'title': 'Vitamin D insufficiency is prevalent in severe COVID-19', 'prefix': '10.1101', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-7061-4209', 'authenticated-orcid': False, 'given': 'Frank H.', 'family': 'Lau', 'sequence': 'first', 'affiliation': []}, {'given': 'Rinku', 'family': 'Majumder', 'sequence': 'additional', 'affiliation': []}, {'given': 'Radbeh', 'family': 'Torabi', 'sequence': 'additional', 'affiliation': []}, {'given': 'Fouad', 'family': 'Saeg', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ryan', 'family': 'Hoffman', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jeffrey D.', 'family': 'Cirillo', 'sequence': 'additional', 'affiliation': []}, {'given': 'Patrick', 'family': 'Greiffenstein', 'sequence': 'additional', 'affiliation': []}], 'member': '246', 'reference': [ { 'key': '2020120610550786000_2020.04.24.20075838v1.1', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jama.2020.2648'}, { 'key': '2020120610550786000_2020.04.24.20075838v1.2', 'unstructured': 'Turk, S. 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