The Effect of Vitamin D Supplementation on Severe COVID-19 Outcomes in Patients With Vitamin D Insufficiency

Levitus et al., Journal of the Endocrine Society, doi: 10.1210/jendso/bvab048.567, May 2021
Severe case 31% improvement lower risk ← → higher risk Severe case b 40% Severe case c 0% Vitamin D for COVID-19  Levitus et al.  PROPHYLAXIS Is prophylaxis with vitamin D beneficial for COVID-19? Retrospective 129 patients in the USA Lower severe cases with vitamin D (not stat. sig., p=0.25) c19early.org Levitus et al., J. the Endocrine Society, May 2021 0 0.5 1 1.5 2+ RR
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 126 studies, recognized in 18 countries.
Lower risk for mortality, ICU, hospitalization, progression, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,200+ studies for 200+ treatments. c19early.org
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Retrospective 129 hospitalized patients with vitamin D levels measured within 90 days prior to admission, showing lower, but not statistically significant, risk of severe cases with vitamin D supplementation among patients with levels <20ng/mL or <12ng/mL. For <30ng/mL, lower (but not statistically significant) risk was seen overall but not for ≥50,000IU (the sample size is not given, it may be extremely small for this case). Only minimal details for <30ng/mL are provided, and no details for <20ng/mL or <12ng/mL are provided. The potential effect of supplementation on the risk of a case severe enough for hospitalization is not included.
This is the 33rd of 126 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 155 septillion).
30 studies are RCTs, which show efficacy with p=0.0000032.
Standard of Care (SOC) for COVID-19 in the study country, the USA, is very poor with very low average efficacy for approved treatments1. Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
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risk of severe case, 30.8% lower, RR 0.69, p = 0.25, treatment 65, control 64, odds ratio converted to relative risk, ≥1,000IU, control prevalence approximated with overall prevalence.
risk of severe case, 40.0% lower, RR 0.60, p = 0.15, treatment 65, control 64, odds ratio converted to relative risk, ≥5,000IU, control prevalence approximated with overall prevalence.
risk of severe case, no change, RR 1.00, p = 0.92, treatment 65, control 64, odds ratio converted to relative risk, ≥50,000IU, control prevalence approximated with overall prevalence.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Levitus et al., 3 May 2021, retrospective, USA, peer-reviewed, 9 authors, dosage varies.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2025 USA Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR USA favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2025 USA Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria USA favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
The Effect of Vitamin D Supplementation on Severe COVID-19 Outcomes in Patients With Vitamin D Insufficiency
Corinne Levitus, Do, MD Sweta Chekuri, MD Andrei Assa, MD Laurel Mohrmann, MD Alexandra Zindman, MD Vafa Tabatabaie, MD Fabrizio Toscano, Masud Ahmed, MD Sarah W Baron, MD Maria Chang Villacreses, MD Panadeekarn Panjawatanan, MD Rudruidee Karnchanasorn, MD & PhD Horng-Yih Ou, MD Wei Feng, MD Raynald Samoa, MD, PhD Ming Chuang, MD Ken C Chiu
doi:10.1210/jendso/bvab048
patients undergoing RYGB and SG, according to the time of surgery and percent weight loss. Methods: we studied 117 patients (91% female, 51% RYGB, mean age 41.8 ± 6.7 years, mean time of surgery 4.3 ± 3.4 years) who were divided into two groups according to the surgical procedure adopted (SG vs. RYGB). They were evaluated at different times after surgery (1-2 years, > 2 and <5 years and ≥5 years) and according to the percentage of weight loss (10-20%, >20% and <40%, ≥40%). Anthropometric measurements, body composition and BMD, bone parameters (PTH, corrected serum calcium, 25OHD, alkaline phosphatase -AP, C-telopeptide -CTX), and biochemical tests were compared. Results: The prevalence of SHPT (PTH ≥ 65pg/ml) was 26%, higher in the RYGB vs. SG (35% vs. 17%, respectively, p = 0.039), despite no significant differences in serum 25OHD (28.5 ± 7.3 vs. 27.6 ± 7.7 ng/ml, p=0.519) and corrected serum calcium (9.8 ± 0.6 vs. 9.8 ± 0.5 mg/dl, p = 0.466) between the groups. Mean serum PTH, CTX and AP was higher in the RYGB vs. SG (61.3 ± 29.5 vs 49.5 ± 32.3 pg/mL, p = 0.001; 0.596 ± 0.24 vs. 0.463 ± 0.23 ng/mL; 123.9 ± 60.8 vs. 100.7 ± 62.0 U/L, respectively). There were 13.5% decreases in femoral neck BMD in all patients, over the study period. After 5 years of surgery, the RYGB group showed greater bone loss in total body BMD (1.016 vs. 1.151g/cm 2 , -8.1%, p = 0.003) and total femur BMD (1.164 vs. 1.267g/cm 2 , -11.7%, p = 0.007). Mean serum leptin was lower in the RYGB group, when compared to SG (7.6 ± 5.8ng/mL vs. 14.0 ± 9.9, p = 0.001), with no correlation with BMD in any site. There were no significant differences between the RYGB and SG regarding the other metabolic parameters. Conclusion: We found a more deleterious effect of RYGB on bone health up to 5 years postoperatively in comparison with SG.
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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