Role of vitamin-D supplementation in COVID-19 patients

Salman et al., Biological and Clinical Sciences Research Journal, doi:10.54112/bcsrj.v2023i1.322, Jun 2023
Mortality 60% improvement lower risk ← → higher risk Ventilation 17% ICU admission 12% Hospitalization time 18% Recovery time 22% Vitamin D  Salman et al.  LATE TREATMENT RCT Is late treatment with vitamin D beneficial for COVID-19? RCT 300 patients in Pakistan (January - May 2021) Shorter hospitalization (p=0.001) and faster recovery (p=0.001) c19early.org Salman et al., Biological and Clinical.., Jun 2023 0 0.5 1 1.5 2+ RR
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 126 studies, recognized in 18 countries.
Lower risk for mortality, ICU, hospitalization, progression, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,300+ studies for 210+ treatments. c19early.org
Meta Analysis
RCT 300 hospitalized COVID-19 patients in Pakistan receiving either 4,000 IU vitamin D3 supplementation or standard care daily for 14 days. The vitamin D group had significantly faster time to clinical improvement (7 vs 9 days) and shorter length of stay (9 vs 11 days). 65% of patients were vitamin D deficient at baseline.
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: 66% [47‑78%] lower risk vs. 42% [31‑52%] 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 28th of 30 COVID-19 RCTs for vitamin D, which collectively show efficacy with p=0.0000032.
This is the 112th of 126 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 155 septillion).
Important missing comments or errors? Let us know.
risk of death, 60.0% lower, RR 0.40, p = 0.07, treatment 6 of 150 (4.0%), control 15 of 150 (10.0%), NNT 17.
risk of mechanical ventilation, 16.7% lower, RR 0.83, p = 0.55, treatment 25 of 150 (16.7%), control 30 of 150 (20.0%), NNT 30.
risk of ICU admission, 12.5% lower, RR 0.88, p = 0.85, treatment 14 of 150 (9.3%), control 16 of 150 (10.7%), NNT 75.
hospitalization time, 18.2% lower, relative time 0.82, p = 0.001, treatment 150, control 150.
recovery time, 22.2% lower, relative time 0.78, p = 0.001, treatment 150, control 150.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Salman et al., 16 Jun 2023, Randomized Controlled Trial, Pakistan, peer-reviewed, 6 authors, study period January 2021 - May 2021, dosage 4,000IU days 1-14. Contact: aymun.u@gmail.com.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org December 2025 Pakistan Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR Pakistan favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org December 2025 Pakistan Russia Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines Spain Brazil Italy France Japan Canada China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Zambia Fiji Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria Pakistan favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
ROLE OF VITAMIN-D SUPPLEMENTATION IN COVID-19 PATIENTS
M Salman, S Zaman, U Aymun, S Khawar, I Khan, A Karim
Biological and Clinical Sciences Research Journal, doi:10.54112/bcsrj.v2023i1.322
COVID-19 has become a global pandemic and has affected millions of people worldwide. While there is still much to learn about the virus, it is clear that individuals with weakened immune systems and pre-existing health conditions are at higher risk of severe illness and death. The study's main objective is to find the role of Vitamin-D supplementation in COVID-19 patients. The study included 300 COVID-19 patients admitted to a tertiary care hospital between January 2021 and May 2021. Using computer-generated randomization, participants were randomly assigned to either the intervention group or the control group. The intervention group received a daily dose of 4000 IU of Vitamin D3 for 14 days, while the control group received standard care without Vitamin D supplementation. Per hospital guidelines, all patients received standard medical treatment for COVID-19, including oxygen therapy, antiviral therapy, and corticosteroids. The study showed that Vitamin D supplementation significantly reduced the time to clinical improvement in COVID-19 patients. The median time to clinical improvement was 7 days in the intervention group, compared to 9 days in the control group (p <0.001). The intervention group also had a significantly shorter length of hospital stay, with a median of 9 days, compared to 11 days in the control group (p <0.001). In conclusion, vitamin D supplementation's role in treating COVID-19 patients is an area of active research and has generated considerable interest in the scientific community. The results of the available studies suggest that vitamin D supplementation may have potential benefits in reducing the risk of severe COVID-19 and improving clinical outcomes.
Conflict of interest The authors declared absence of conflict of interest. [Citation Salman, M., Zaman, S., Aymun, U., Khawar, S., Khan, I., Karim, A.. ( 2023
References
Abioye, Bromage, Fawzi, Effect of micronutrient supplements on influenza and other respiratory tract infections among adults: a systematic review and meta-analysis, BMJ global health
Annweiler, Corvaisier, Gautier, Dubée, Legrand et al., Vitamin D supplementation associated to better survival in hospitalized frail elderly COVID-19 patients: The GERIA-COVID quasi-experimental study, Nutrients
Argano, Mallaci Bocchio, Natoli, Scibetta, Lo Monaco et al., Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis, Pharmaceuticals
Azkur, Akdis, Azkur, Sokolowska, Van De Veen et al., Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19, Allergy
Castillo, Costa, Barrios, Díaz, Miranda et al., Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study, The Journal of steroid biochemistry and molecular biology
Corrao, Gervasi, Di Bernardo, Argano, Immune Response Failure in Paucisymptomatic Long-Standing SARS-CoV-2 Spreaders, Clinics and Practice
Corrao, Gervasi, Di Bernardo, Natoli, Raspanti et al., Immunological Characteristics of Non-Intensive Care Hospitalized COVID-19 Patients: A Preliminary Report, Journal of Clinical Medicine
Giordano, Goracci, Fagiolini, Depression and vitamin D deficiency: Causality, assessment, and clinical practice implications, Neuropsychiatry
Grant, Lahore, Mcdonnell, Baggerly, French et al., Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths, Nutrients
Jolliffe, Camargo, Sluyter, Aglipay, Aloia et al., Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials, The lancet Diabetes & endocrinology
Kim, Meza, Clarke, Kim, Hickner, Vitamin D and endothelial function, Nutrients
Kumar, Dhanjal, Kaul, Wadhwa, Sundar, Withanone and caffeic acid phenethyl ester are predicted to interact with main protease (Mpro) of SARS-CoV-2 and inhibit its activity, Journal of Biomolecular Structure and Dynamics
Murai, Fernandes, Sales, Pinto, Goessler et al., None
Salman, Zaman, Aymun, Khawar, Khan et al., Role of vitamin-d supplementation in covid-19 patients, Biol. Clin. Sci. Res. J
Salman, Zaman, Aymun, Khawar, Khan et al., Role of vitamin-d supplementation in covid-19 patients, Biol. Clin. Sci. Res. J, doi:10.54112/bcsrj.v2023i1.322References
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Late treatment
is less effective
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