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0 0.5 1 1.5 2+ Mortality -192% Improvement Relative Risk ICU admission 39% Time to discharge 14% Recovery time 14% Recovery time (b) 21% Vitamin D  Sabico et al.  LATE TREATMENT  RCT Is late treatment with vitamin D beneficial for COVID-19? RCT 73 patients in Saudi Arabia (July - November 2020) Higher discharge with vitamin D (not stat. sig., p=0.14) Sabico et al., Nutrients, June 2021 Favors high dose Favors low dose

Effects of a 2-Week 5000 IU versus 1000 IU Vitamin D3 Supplementation on Recovery of Symptoms in Patients with Mild to Moderate Covid-19: A Randomized Clinical Trial

Sabico et al., Nutrients, doi:10.3390/nu13072170
Jun 2021  
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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.
4,000+ studies for 60+ treatments.
Small RCT of 69 hospitalized patients comparing 1,000IU and 5,000IU daily cholecalciferol, showing faster recovery with the higher dose (statistically significant only for cough and ageusia).
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.
risk of death, 192.1% higher, RR 2.92, p = 1.00, treatment 1 of 38 (2.6%), control 0 of 35 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).
risk of ICU admission, 38.9% lower, RR 0.61, p = 0.66, treatment 2 of 36 (5.6%), control 3 of 33 (9.1%), NNT 28.
time to discharge, 14.3% lower, relative time 0.86, p = 0.14, treatment 36, control 33.
recovery time, 14.1% lower, relative time 0.86, p = 0.97, treatment 36, control 33, fever.
recovery time, 20.5% lower, relative time 0.79, p = 0.24, treatment 36, control 33, dyspnea.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sabico et al., 24 Jun 2021, Randomized Controlled Trial, Saudi Arabia, peer-reviewed, 12 authors, study period 29 July, 2020 - 22 November, 2020.
This PaperVitamin DAll
Effects of a 2-Week 5000 IU versus 1000 IU Vitamin D3 Supplementation on Recovery of Symptoms in Patients with Mild to Moderate Covid-19: A Randomized Clinical Trial
Shaun Sabico, Mushira A Enani, Eman Sheshah, Naji J Aljohani, Dara A Aldisi, Naif H Alotaibi, Naemah Alshingetti, Suliman Y Alomar, Abdullah M Alnaami, Osama E Amer, Syed D Hussain, Nasser M Al-Daghri
Nutrients, doi:10.3390/nu13072170
Objective: Vitamin D deficiency has been associated with an increased risk of COVID-19 severity. This multi-center randomized clinical trial aims to determine the effects of 5000 IU versus 1000 IU daily oral vitamin D3 supplementation in the recovery of symptoms and other clinical parameters among mild to moderate COVID-19 patients with sub-optimal vitamin D status. Study Design and Setting: A total of 69 reverse transcriptase polymerase chain reaction (RT-PCR) SARS-CoV-2 positive adults who were hospitalized for mild to moderate COVID-19 disease were allocated to receive once daily for 2 weeks either 5000 IU oral vitamin D3 (n = 36, 21 males; 15 females) or 1000 IU oral vitamin D3 (standard control) (n = 33, 13 males; 20 females). Anthropometrics were measured and blood samples were taken pre-and post-supplementation. Fasting blood glucose, lipids, serum 25(OH)D, and inflammatory markers were measured. COVID-19 symptoms were noted on admission and monitored until full recovery. Results: Vitamin D supplementation for 2 weeks caused a significant increase in serum 25(OH)D levels in the 5000 IU group only (adjusted p = 0.003). Within-group comparisons also showed a significant decrease in BMI and IL-6 levels overtime in both groups (p-values < 0.05) but was not clinically significant in between-group comparisons. Kaplan-Meier survival analysis revealed that the 5000 IU group had a significantly shorter time to recovery (days) than the 1000 IU group in resolving cough, even after adjusting for age, sex, baseline BMI, and D-dimer (6.2 ± 0.8 versus 9.1 ± 0.8; p = 0.039), and ageusia (loss of taste) (11.4 ± 1.0 versus 16.9 ± 1.7; p = 0.035). Conclusion: A 5000 IU daily oral vitamin D3 supplementation for 2 weeks reduces the time to recovery for cough and gustatory sensory loss among patients with sub-optimal vitamin D status and mild to moderate COVID-19 symptoms. The use of 5000 IU vitamin D3 as an adjuvant therapy for COVID-19 patients with suboptimal vitamin D status, even for a short duration, is recommended.
Supplementary Materials: The following are available online at .3390/nu13072170/s1, Table S1 : Baseline Serological Characteristics of Groups.
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Late treatment
is less effective
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