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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 80% Improvement Relative Risk Mortality (b) 56% Vitamin D for COVID-19  Ling et al.  LATE TREATMENT Is late treatment with vitamin D beneficial for COVID-19? Retrospective 523 patients in the United Kingdom Lower mortality with vitamin D (p=0.001) Ling et al., Nutrients, December 2020 Favors vitamin D Favors control

High-Dose Cholecalciferol Booster Therapy is Associated with a Reduced Risk of Mortality in Patients with COVID-19: A Cross-Sectional Multi-Centre Observational Study

Ling et al., Nutrients, doi:10.3390/nu12123799
Dec 2020  
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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.
80% lower mortality with cholecalciferol booster therapy. Retrospective 986 hospitalized patients in the UK finding that cholecalciferol booster therapy, regardless of baseline serum levels, was associated with a reduced risk of mortality in acute COVID-19 inpatients.
Primary cohort of 444 patients, adjusted mortality odds ratio aOR 0.13, p < 0.001.
Validation cohort of 541 patients, adjusted mortality odds ratio aOR 0.38, p = 0.018.
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 14th 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, 79.8% lower, RR 0.20, p < 0.001, treatment 73, control 253, odds ratio converted to relative risk, primary cohort.
risk of death, 55.5% lower, RR 0.44, p = 0.02, treatment 80, control 443, odds ratio converted to relative risk, validation cohort.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ling et al., 11 Dec 2020, retrospective, United Kingdom, peer-reviewed, 7 authors, dosage 40,000IU weekly, regimen varied with 77% receiving a total of 40,000IU/week.
This PaperVitamin DAll
Ling Mbchb, Eleanor Broad Mbchb, Rebecca Murphy Mbchb, MD Joseph M Pappachan, Satveer Pardesi-Newton Bm, Marie-France Kong, Professor Edward B Jude
Background: The 2019 novel coronavirus disease (Covid-19) worldwide pandemic has posed the most substantial and severe public health issue for several generations, and therapeutic options for it have not yet been optimised. Vitamin D has been proposed in the pharmacological management of Covid-19 by various sources. This study aimed to determine whether Covid-19 disease outcomes were affected by vitamin D status, and to elucidate any predictors of Covid-19 outcomes. Methods: Patients hospitalised with Covid-19 were opportunistically recruited from three different UK hospitals and their data were collected. Logistic regression was used to determine any relationships between vitamin D status and various predictors, including mortality and ventilation, and to determine any relationships between mortality, ventilation, and various predictors. Findings: Vitamin D status was not associated with any outcomes of Covid-19 investigated, following adjustment for age and sex. However, treatment with vitamin D was significantly associated with a reduced risk of death, following adjustment for age and sex (OR adj 0•48, 95% CI 0•32 -0•70, p = 1•79x10 -4 ). This relationship remained significant when also adjusted for baseline vitamin D levels (OR adj 0•47, 95% CI 0•33 -0•70, p = 1•27x10 -4 ). Interpretation: Treatment with vitamin D, regardless of baseline serum vitamin D levels, appears to be associated with a reduced risk of mortality in acute in-patients admitted with Covid-19. Further work on large population studies needs to be carried out to determine adequate serum levels of vitamin D, as well as multi-dose clinical trials of vitamin D treatment to assess maximum efficacy.
CONFLICT OF INTERESTS The authors have no conflicts of interest.
Caccialanza, Laviano, Lobascio, Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol, Nutrition
Calder, Carr, Gombart, Eggersdorfer, Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections, Nutrients
Carter, Baranauskas, Fly, Considerations for Obesity, Vitamin D, and Physical Activity Amid the COVID-19 Pandemic, Obesity (Silver Spring)
Gmmmg, Treatment of Vitamin D Deficiency and Insufficiency in Adults
Grant, Lahore, Mcdonnell, Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths, Nutrients
Hajhashemy, Shahdadian, Ziaei, Saneei, Serum vitamin D levels in relation to abdominal obesity: A systematic review and dose-response meta-analysis of epidemiologic studies, Obes Rev
Hastie, Mackay, Ho, Vitamin D concentrations and COVID-19 infection in UK Biobank, Diabetes Metab Syndr
Iaccarino, Grassi, Borghi, Age and Multimorbidity Predict Death Among COVID-19 Patients: Results of the SARS-RAS Study of the Italian Society of Hypertension, Hypertension
Ilie, Stefanescu, Smith, The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality, Aging Clin Exp Res
Jakovac, COVID-19 and vitamin D-Is there a link and an opportunity for intervention?, Am J Physiol Endocrinol Metab
Lovinsky-Desir, Deshpande, De, TABLE 1. SUMMARY STATISTICS OF THE STUDY POPULATION. Number of participants with available data Age (years), J Allergy Clin Immunol
Meltzer, Best, Zhang, Vokes, Arora et al., Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results, JAMA Netw Open
Merzon, Tworowski, Gorohovski, Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study, FEBS J
Munshi, Hussein, Toraih, Vitamin D insufficiency as a potential culprit in critical COVID-19 patients, J Med Virol
Ons, Deaths involving COVID-19
Panagiotou, Tee, Ihsan, Low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID-19 are associated with greater disease severity, Clin Endocrinol
Pastor-Barriuso, Perez-Gomez, Hernan, SARS-CoV-2 infection fatality risk in a nationwide seroepidemiological study
Rhodes, Subramanian, Laird, Kenny, Editorial: low population mortality from COVID-19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity, Aliment Pharmacol Ther
Sacn, Vitamin, Health, None
Silberstein, Vitamin, A simpler alternative to tocilizumab for trial in COVID-19?, Med Hypotheses
Stein, Shane, Vitamin D in organ transplantation, Osteoporos Int
Teymoori-Rad, Shokri, Salimi, Marashi, The interplay between vitamin D and viral infections, Rev Med Virol
Vimaleswaran, Berry, Lu, Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts, PLoS Med
Vitamin, Level, None, median
Who, International Guidelines for Certification and Classification (Coding) of Covid-19 as Cause of Death
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, 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. FLCCC and WCH provide treatment protocols.
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