Vitamin D Deficiency is Associated with Increased COVID-19 Severity: Prospective Screening of At-Risk Groups is Medically Indicated

Pepkowitz et al., Research Square, doi:10.21203/rs.3.rs-83262/v1, Sep 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 125 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.

5,600+ studies for 131 treatments. c19early.org

Retrospective 37 hospitalized patients in the USA, showing higher risk of ICU admission with vitamin D deficiency.

This is the 16th of 217 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 63,753,630,414 vigintillion).

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. Low-cost treatments were excluded, reducing the probability of treatment—especially early—due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.

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risk of ICU admission, 55.8% lower, RR 0.44, p = 0.01, high D levels (≥20ng/mL) 9 of 24 (37.5%), low D levels (<20ng/mL) 11 of 13 (84.6%), NNT 2.1, inverted to make RR<1 favor high D levels (≥20ng/mL).

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

1. c19early.org, c19early.org/soc/usa.html.c19early.org/soc/usa.html.

Pepkowitz et al., 29 Sep 2020, retrospective, USA, preprint, 7 authors.

This Paper Vitamin D All

Vitamin D Deficiency is Associated with Increased COVID-19 Severity: Prospective Screening of At-Risk Groups is Medically Indicated

MD Samuel H Pepkowitz, MD Calvin J Hobel, James M Mirocha Ms, Kimia.Sobhani, Carissa A Huynh Bs, MD Harneet Jawanda, PhD Wohaib Hasan

doi:10.21203/rs.3.rs-83262/v1

Non-classical actions of Vitamin D are involved in regulation of the immune system including a role in mitigation of excessive in ammation. We hypothesized that vitamin D de ciency existing prior to SARS-CoV-2 infection could contribute to patients developing severe pulmonary compromise as a result of dysfunctional hyperin ammation. Serum vitamin D concentrations of patients experiencing such severe COVID-19 manifestations that they required ICU care at any point of their hospitalization were compared to serum vitamin D concentrations of patients achieving discharge without the need for any ICU care. Having serum vitamin D < 20 ng/mL was signi cantly associated with increased COVID-19 severity, p=0.001. It is conjectured that population groups know to have low serum vitamin D should be prospectively screened for de ciency and if found emergently treated. Such action could both decrease the maximum severity suffered by infected individuals and lessen the strain on medical resources by decreasing the percentage of COVID-19 hospital admissions requiring ICU care.

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