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0 0.5 1 1.5 2+ Mortality 95% Improvement Relative Risk Severe case 78% Vitamin D for COVID-19  Rachman et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Prospective study of 191 patients in Indonesia (Oct 2021 - Feb 2022) Lower mortality (p=0.043) and severe cases (p=0.011) c19early.org Rachman et al., F1000Research, April 2023 Favors vitamin D Favors control

Impact of vitamin D deficiency in relation to the clinical outcomes of hospitalized COVID-19 patients

Rachman et al., F1000Research, doi:10.12688/f1000research.132214.1
Apr 2023  
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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 120 studies, recognized in 8 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19early.org
Prospective study of hospitalized patients in Indonesia, showing higher risk of mortality and severe cases with vitamin D deficiency.
This is the 174th of 196 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 11,637 vigintillion).
risk of death, 94.8% lower, RR 0.05, p = 0.04, high D levels (≥20ng/mL) 0 of 45 (0.0%), low D levels (<20ng/mL) 14 of 146 (9.6%), NNT 10, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of severe case, 77.6% lower, RR 0.22, p = 0.01, high D levels (≥20ng/mL) 2 of 45 (4.4%), low D levels (<20ng/mL) 29 of 146 (19.9%), NNT 6.5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rachman et al., 13 Apr 2023, prospective, Indonesia, peer-reviewed, 4 authors, study period October 2021 - February 2022. Contact: andhika.rachman@office.ui.ac.id.
This PaperVitamin DAll
Impact of vitamin D deficiency in relation to the clinical outcomes of hospitalized COVID-19 patients
Andhika Rachman, Rizky Rahmaniyah, Andi Khomeini, Anggraini Iriani
F1000Research, doi:10.12688/f1000research.132214.1
Background: Vitamin D deficiency is an emerging public health problem that affects more than one billion people worldwide. Vitamin D has been shown to be effective in preventing and reducing the severity of viral respiratory diseases, including influenza. However, the role of vitamin D in COVID-19 infection remains controversial. This study aimed to analyze the impact of vitamin D deficiency on the clinical outcome of hospitalized COVID-19 patients. Methods: A prospective cohort study was conducted among hospitalized COVID-19 patients at two COVID-19 referral hospitals in Indonesia from October 2021 until February 2022. Results: The median serum 25(OH)D level in 191 hospitalized COVID-19 patients was 13.6 [IQR=10.98] ng/mL. The serum 25(OH)D levels were significantly lower among COVID-19 patients with vitamin D deficiency who had cardiovascular disease (p-value=0.04), the use of a ventilator (p-value=0.004), more severe COVID-19 cases (p-value=0.047), and mortality (p-value=0.002). Furthermore, serum 25(OH)D levels were significantly different between patients with mild and severe COVID-19 cases (p-value=0.019). Serum 25(OH)D levels in moderate and severe COVID-19 cases were significantly different (p-value=0.031). Lower serum 25(OH)D levels were significantly associated with an increased number of comorbidities (p-value=0.03), the severity of COVID-19 (p-value=0.002), and the use of mechanical ventilation (p-value=0.032). Mortality was found in 7.3% of patients with deficient vitamin D levels. However, patients with either sufficient or insufficient vitamin D levels did not develop mortality. Conclusions: COVID-19 patients with vitamin D deficiency were significantly associated with having cardiovascular disease, mortality, more severe COVID-19 cases, and the used of mechanical ventilation. Lower serum 25(OH)D levels were associated with an increased Open Peer Review Approval Status AWAITING PEER REVIEW Any reports and responses or comments on the article can be found at the end of the article.
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{ 'DOI': '10.12688/f1000research.132214.1', 'ISSN': ['2046-1402'], 'URL': 'http://dx.doi.org/10.12688/f1000research.132214.1', 'abstract': '<ns4:p><ns4:bold>Background:</ns4:bold> Vitamin D deficiency is an emerging public health ' 'problem that affects more than one billion people worldwide. Vitamin D has been shown to be ' 'effective in preventing and reducing the severity of viral respiratory diseases, including ' 'influenza. However, the role of vitamin D in COVID-19 infection remains controversial. This ' 'study aimed to analyze the impact of vitamin D deficiency on the clinical outcome of ' 'hospitalized COVID-19 patients.</ns4:p><ns4:p> <ns4:bold>Methods:</ns4:bold> A prospective ' 'cohort study was conducted among hospitalized COVID-19 patients at two COVID-19 referral ' 'hospitals in Indonesia from October 2021 until February 2022.</ns4:p><ns4:p> ' '<ns4:bold>Results:</ns4:bold> The median serum 25(OH)D level in 191 hospitalized COVID-19 ' 'patients was 13.6 [IQR=10.98] ng/mL. The serum 25(OH)D levels were significantly lower among ' 'COVID-19 patients with vitamin D deficiency who had cardiovascular disease (p-value=0.04), ' 'the use of a ventilator (p-value=0.004), more severe COVID-19 cases (p-value=0.047), and ' 'mortality (p-value=0.002). Furthermore, serum 25(OH)D levels were significantly different ' 'between patients with mild and severe COVID-19 cases (p-value=0.019). Serum 25(OH)D levels in ' 'moderate and severe COVID-19 cases were significantly different (p-value=0.031).\xa0Lower ' 'serum 25(OH)D levels were significantly associated with an increased number of comorbidities ' '(p-value=0.03), the severity of COVID-19 (p-value=0.002), and the use of mechanical ' 'ventilation (p-value=0.032). Mortality was found in 7.3% of patients with deficient vitamin D ' 'levels. However, patients with either sufficient or insufficient vitamin D levels did not ' 'develop mortality.</ns4:p><ns4:p> <ns4:bold>Conclusions:</ns4:bold> COVID-19 patients with ' 'vitamin D deficiency were significantly associated with having cardiovascular disease, ' 'mortality, more severe COVID-19 cases, and the used of mechanical ventilation. Lower serum ' '25(OH)D levels were associated with an increased number of comorbidities, COVID-19 severity, ' 'and the use of mechanical-ventilation. Thus, we suggest hospitalized COVID-19 patients to ' 'reach a sufficient vitamin D status to improve the clinical outcome of the disease.</ns4:p>', 'assertion': [ { 'URL': 'https://f1000research.com/articles/12-394/v1#article-reports', 'group': {'label': 'Current Referee Status', 'name': 'current-referee-status'}, 'label': 'Referee status', 'name': 'referee-status', 'order': 0, 'value': 'Awaiting Peer Review'}, { 'label': 'Grant Information', 'name': 'grant-information', 'order': 0, 'value': 'This research was funded by Directorate of Research and Development, ' 'Universitas Indonesia’s grant program “Hibah PUTI 2022” (grant number: ' 'ND-5463/UN2.F1.D1.4/PPM.00.00/2022). The funders had no role in study design, ' 'data collection and analysis, decision to publish, or preparation of the ' 'manuscript.'}, { 'label': 'Copyright', 'name': 'copyright-info', 'order': 0, 'value': 'This is an open access article distributed under the terms of the Creative ' 'Commons Attribution Licence, which permits unrestricted use, distribution, and ' 'reproduction in any medium, provided the original work is properly cited.'}], 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-3246-3352', 'affiliation': [], 'authenticated-orcid': False, 'family': 'Rachman', 'given': 'Andhika', 'sequence': 'first'}, {'affiliation': [], 'family': 'Rahmaniyah', 'given': 'Rizky', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Khomeini', 'given': 'Andi', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Iriani', 'given': 'Anggraini', 'sequence': 'additional'}], 'container-title': 'F1000Research', 'container-title-short': 'F1000Res', 'content-domain': {'crossmark-restriction': False, 'domain': ['f1000research.com']}, 'created': {'date-parts': [[2023, 4, 13]], 'date-time': '2023-04-13T14:45:50Z', 'timestamp': 1681397150000}, 'deposited': { 'date-parts': [[2023, 4, 13]], 'date-time': '2023-04-13T14:46:01Z', 'timestamp': 1681397161000}, 'funder': [ { 'award': ['ND-5463/UN2.F1.D1.4/PPM.00.00/2022'], 'name': 'This research was funded by Directorate of Research and Development, Universitas ' 'Indonesia’s grant program “Hibah PUTI 2022”'}], 'indexed': {'date-parts': [[2023, 4, 14]], 'date-time': '2023-04-14T05:01:55Z', 'timestamp': 1681448515963}, 'is-referenced-by-count': 0, 'issued': {'date-parts': [[2023, 4, 13]]}, 'language': 'en', 'license': [ { 'URL': 'http://creativecommons.org/licenses/by/4.0/', 'content-version': 'tdm', 'delay-in-days': 0, 'start': { 'date-parts': [[2023, 4, 13]], 'date-time': '2023-04-13T00:00:00Z', 'timestamp': 1681344000000}}], 'link': [ { 'URL': 'https://f1000research.com/articles/12-394/v1/xml', 'content-type': 'application/xml', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://f1000research.com/articles/12-394/v1/pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://f1000research.com/articles/12-394/v1/iparadigms', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '2560', 'original-title': [], 'page': '394', 'prefix': '10.12688', 'published': {'date-parts': [[2023, 4, 13]]}, 'published-online': {'date-parts': [[2023, 4, 13]]}, 'publisher': 'F1000 Research Ltd', 'reference': [ { 'DOI': '10.3389/fpubh.2021.736665', 'article-title': 'Vitamin D Status and SARS-CoV-2 Infection and COVID-19 Clinical ' 'Outcomes.', 'author': 'I Chiodini', 'doi-asserted-by': 'publisher', 'journal-title': 'Front. 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