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0 0.5 1 1.5 2+ ICU time 36% Improvement Relative Risk Vitamin D  Saheb Sharif-Askari et al.  ICU PATIENTS Is very late treatment with vitamin D beneficial for COVID-19? Retrospective 45 patients in the USA Shorter ICU admission with vitamin D (p=0.01) Saheb Sharif-Askari et al., Life Scien.., Aug 2022 Favors vitamin D Favors control

Vitamin D modulates systemic inflammation in patients with severe COVID-19

Saheb Sharif-Askari et al., Life Sciences, doi:10.1016/j.lfs.2022.120909
Aug 2022  
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Retrospective 20 ICU patients treated with vitamin D in the UAE, and 25 matched controls, showing significantly shorter ICU stay with treatment. Lower proinflammatory cytokines were associated with lower severity markers. Authors also perform a PBMC In Vitro study, with both the clinical and in vitro studies showing vitamin D attenuated major proinflammatory signaling pathways.
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.
This is the 94th of 118 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 30 sextillion). 29 studies are RCTs, which show efficacy with p=0.0000035.
This study is excluded in the after exclusion results of meta analysis: very late stage study using cholecalciferol instead of calcifediol or calcitriol.
ICU time, 35.7% lower, relative time 0.64, p = 0.01, treatment 20, control 25.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Saheb Sharif-Askari et al., 24 Aug 2022, retrospective, USA, peer-reviewed, 10 authors, dosage 50,000IU days 1, 8, 15.
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This PaperVitamin DAll
Vitamin D modulates systemic inflammation in patients with severe COVID-19
Fatemeh Saheb Sharif-Askari, Shirin Hafezi, Narjes Saheb Sharif-Askari, Hawra Ali Hussain Alsayed, Bushra Mdkhana, Balachandar Selvakumar, Mohamad-Hani Temsah, Basema Saddik, Fatme Al Anouti, Rabih Halwani
Life Sciences, doi:10.1016/j.lfs.2022.120909
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Late treatment
is less effective
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