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Vitamin D Deficiency and Outcome of COVID-19 Patients

Radujkovic et al., Nutrients 2020, 12:9, 2757, doi:10.3390/nu12092757
Sep 2020  
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Mortality 93% Improvement Relative Risk Death/intubation 84% Vitamin D for COVID-19  Radujkovic et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Prospective study of 185 patients in Germany Lower mortality (p=0.001) and death/intubation (p=0.001) c19early.org Radujkovic et al., Nutrients 2020, 2757, Sep 2020 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
Observational study 185 patients in Germany shows an association between vitamin D status and severity and mortality. Adjusted hazard ratio of vitamin D sufficiency for combined mechanical ventilation and death was HR 0.16, p < 0.001, and for death HR 0.068, p < 0.001.
This is the 14th of 211 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 248,027,826 vigintillion).
risk of death, 93.2% lower, HR 0.07, p = 0.001, high D levels 144, low D levels 12, >30nmol/L.
risk of death/intubation, 84.0% lower, HR 0.16, p < 0.001, high D levels 144, low D levels 12, >30nmol/L.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Radujkovic et al., 10 Sep 2020, prospective, Germany, peer-reviewed, 6 authors.
This PaperVitamin DAll
Vitamin D Deficiency and Outcome of COVID-19 Patients
Aleksandar Radujkovic, Theresa Hippchen, Shilpa Tiwari-Heckler, Saida Dreher, Monica Boxberger, Uta Merle
Nutrients, doi:10.3390/nu12092757
Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses an enormous challenge to health care systems throughout the world. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. To explore possible associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients diagnosed with coronavirus disease 2019 (COVID-19) and treated at our center. VitD status at first presentation was assessed retrospectively using accredited laboratory methods. VitD deficiency was defined as serum total 25-hydroxyvitamin D level < 12 ng/mL (<30 nM). Primary endpoint was severe course of disease (i.e., need for invasive mechanical ventilation and/or death, IMV/D). Within a median observation period of 66 days (range 2-92), 23 patients required IMV. A total of 28 patients had IMV/D, including 16 deaths. Ninety-three (50%) patients required hospitalization (inpatient subgroup). A total of 41 (22%) patients were VitD deficient. When adjusted for age, gender, and comorbidities, VitD deficiency was associated with higher risk of IMV/D and death (HR 6.12, 95% CI 2.79-13.42, p < 0.001 and HR 14.73, 95% CI 4.16-52.19, p < 0.001, respectively). Similar correlations were observed in the inpatient subgroup. Our study demonstrates an association between VitD deficiency and severity/mortality of COVID-19, highlighting the need for interventional studies on VitD supplementation in SARS-CoV-2 infected individuals.
Conflicts of Interest: The authors declare no competing financial interest. Appendix A
References
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Rabenberg, Scheidt-Nave, Busch, Rieckmann, Hintzpeter et al., Vitamin D status among adults in Germany-results from the German Health Interview and Examination Survey for Adults (DEGS1), BMC Public Health, doi:10.1186/s12889-015-2016-7
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, doi:10.1111/apt.15777
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