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All Studies   Meta Analysis    Recent:   

Vitamin D Status and Severe COVID-19 Disease Outcomes in Hospitalized Patients

Pecina et al., Journal of Primary Care & Community Health, doi:10.1177/21501327211041206
Aug 2021  
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0 0.5 1 1.5 2+ Mortality -70% treatment Improvement Relative Risk Ventilation -10% treatment ICU admission -30% treatment Mortality, 20ng/mL 36% levels Ventilation, 20ng/mL 57% levels ICU admission, 20ng/mL -13% levels Vitamin D for COVID-19  Pecina et al.  Prophylaxis Is prophylaxis with vitamin D beneficial for COVID-19? Retrospective 92 patients in the USA Higher mortality with vitamin D (not stat. sig., p=0.52) c19early.org Pecina et al., J. Primary Care & Commu.., Aug 2021 Favors vitamin D Favors control
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
 
*, now known with p < 0.00000000001 from 120 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Retrospective 92 hospitalized patients not showing significant differences in outcomes based on vitamin D status or supplementation.
This is the 48th of 120 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 268 sextillion).
29 studies are RCTs, which show efficacy with p=0.000005.
risk of death, 70.0% higher, OR 1.70, p = 0.52, treatment 29, control 63, supplementation, unadjusted, RR approximated with OR, excluded in exclusion analyses: unadjusted results with no group details.
risk of mechanical ventilation, 10.0% higher, OR 1.10, p = 0.89, treatment 29, control 63, supplementation, unadjusted, RR approximated with OR, excluded in exclusion analyses: unadjusted results with no group details.
risk of ICU admission, 30.0% higher, OR 1.30, p = 0.61, treatment 29, control 63, supplementation, unadjusted, RR approximated with OR, excluded in exclusion analyses: unadjusted results with no group details.
risk of death, 35.9% lower, RR 0.64, p = 0.74, high D levels (≥20ng/mL) 6 of 77 (7.8%), low D levels (<20ng/mL) 1 of 15 (6.7%), inverted to make RR<1 favor high D levels (≥20ng/mL), odds ratio converted to relative risk, multivariable logistic regression, outcome based on serum levels.
risk of mechanical ventilation, 56.9% lower, RR 0.43, p = 0.22, high D levels (≥20ng/mL) 8 of 15 (53.3%), low D levels (<20ng/mL) 4 of 15 (26.7%), inverted to make RR<1 favor high D levels (≥20ng/mL), odds ratio converted to relative risk, multivariable logistic regression, outcome based on serum levels.
risk of ICU admission, 13.1% higher, RR 1.13, p = 0.57, high D levels (≥20ng/mL) 54 of 77 (70.1%), low D levels (<20ng/mL) 9 of 15 (60.0%), inverted to make RR<1 favor high D levels (≥20ng/mL), odds ratio converted to relative risk, multivariable logistic regression, outcome based on serum levels.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pecina et al., 27 Aug 2021, retrospective, USA, peer-reviewed, 4 authors, dosage not specified.
This PaperVitamin DAll
Vitamin D Status and Severe COVID-19 Disease Outcomes in Hospitalized Patients
Jennifer L Pecina, Stephen P Merry, John G Park, Tom D Thacher
Journal of Primary Care & Community Health, doi:10.1177/21501327211041206
Background: Vitamin D deficiency may increase the risk of severe COVID-19 disease. Objectives: To determine if 25-hydroxyvitamin D [25(OH)D] levels in patients hospitalized for COVID-19 were associated with the clinical outcomes of days on oxygen, duration of hospitalization, ICU admission, need for assisted ventilation, or mortality. Methods: We conducted a retrospective study of 92 patients admitted to the hospital with SARS-CoV-2 infection between April 16, 2020 and October 17, 2020. Multivariable regression was performed to assess the independent relationship of 25(OH)D values on outcomes, adjusting for significant covariates and the hospitalization day the level was tested. Results: About 15 patients (16.3%) had 25(OH)D levels <20 ng/mL. Only 1 patient (3.4%) who had documented vitamin D supplementation prior to admission had 25(OH)D <20 ng/mL. Serum 25(OH)D concentrations were not significantly associated with any of our primary outcomes of days on oxygen, duration of hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, or mortality in any of the adjusted multivariable models. Adjusting for the hospital day of 25(OH) D sampling did not alter the relationship of 25(OH)D with any outcomes. Conclusion: Vitamin D status was not related to any of the primary outcomes reflecting severity of COVID-19 in hospitalized patients. However, our sample size may have lacked sufficient power to demonstrate a small effect of vitamin D status on these outcomes.
Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
References
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Amer, Qayyum, Relation between serum 25-hydroxyvitamin D and C-reactive protein in asymptomatic adults (from the continuous National Health and Nutrition Examination Survey 2001 to 2006), Am J Cardiol
Annweiler, Beaudenon, Gautier, COvid-19 and high-dose VITamin D supplementation TRIAL in high-risk older patients (COVIT-TRIAL): study protocol for a randomized controlled trial, Trials
Annweiler, Corvaisier, Gautier, Vitamin D supplementation associated to better survival in hospitalized frail elderly COVID-19 patients: the GERIA-COVID quasi-experimental study, Nutrients
Aranow, Vitamin D and the immune system, J Investig Med
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Cascella, Rajnik, Cuomo, Dulebohn, Napoli, Features, Evaluation, and Treatment of Coronavirus
D'avolio, Avataneo, Manca, 25-Hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS-CoV-2, Nutrients
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Heart, Lung, Blood ; Ginde, Brower, Caterino, Early high-dose vitamin D3 for critically ill, vitamin D-deficient patients, New Engl J Med
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Ilie, Stefanescu, Smith, Va, Eshein et al., logistic regression was used for binary outcomes. Serum 25(OH)D values <20 ng/mL and age >65 years were included in the logistic regression models for ease of interpretation
Khare, Godbole, Pawar, Calcitriol [1,25[OH] 2 D3] pre-and post-treatment suppresses inflammatory response to influenza A (H1N1) infection in human lung A549 epithelial cells, Eur J Nutr
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