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.

Important missing comments or errors? Let us know.

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.

Contact: rhalwani@sharjah.ac.ae.

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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

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Late treatment
is less effective

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