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All Studies   Meta Analysis    Recent:   

Vitamin D3 supplementation in COVID-19 patients with cardiovascular disease and gut dysbiosis

Sanz et al., Hipertensión y Riesgo Vascular, doi:10.1016/j.hipert.2024.04.002
Jun 2024  
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Mortality 80% Improvement Relative Risk Ventilation 83% ICU admission 60% ICU time 62% no CI Vitamin D  Sanz et al.  LATE TREATMENT  DB RCT Is late treatment with vitamin D beneficial for COVID-19? Double-blind RCT 22 patients in Argentina (August 2021 - June 2022) Lower mortality (p=0.48) and ventilation (p=0.063), not sig. c19early.org Sanz et al., Hipertensión y Riesgo Vas.., Jun 2024 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. * >10% efficacy, ≥3 studies.
4,400+ studies for 81 treatments. c19early.org
Small RCT 22 hospitalized COVID-19 patients with cardiovascular disease in Argentina showing lower mortality, ventilation, and ICU admission with vitamin D treatment, without statistical significance. Treatment was associated with lower levels of inflammatory markers IL-6, IL-8 and TNF-α, higher levels of anti-inflammatory IL-10, and improvements in gut microbiome markers. 10,000 IU/day vitamin D3 for 10 days.
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: 69% [47‑82%] lower risk vs. 39% [27‑49%] 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 30th COVID-19 RCT for vitamin D, which collectively show efficacy with p=0.0000032.
This is the 122nd COVID-19 controlled study for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 587 sextillion).
risk of death, 80.0% lower, RR 0.20, p = 0.48, treatment 0 of 11 (0.0%), control 2 of 11 (18.2%), NNT 5.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of mechanical ventilation, 83.3% lower, RR 0.17, p = 0.06, treatment 1 of 11 (9.1%), control 6 of 11 (54.5%), NNT 2.2.
risk of ICU admission, 60.0% lower, RR 0.40, p = 0.36, treatment 2 of 11 (18.2%), control 5 of 11 (45.5%), NNT 3.7.
ICU time, 62.5% lower, relative time 0.38, treatment 11, control 11.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sanz et al., 12 Jun 2024, Double Blind Randomized Controlled Trial, placebo-controlled, Argentina, peer-reviewed, mean age 59.0, 7 authors, study period August 2021 - June 2022, dosage 10,000IU days 1-10. Contact: wmanucha@yahoo.com.ar, wmanucha@fcm.uncu.edu.ar.
This PaperVitamin DAll
Vitamin D3 supplementation in COVID-19 patients with cardiovascular disease and gut dysbiosis
R L Sanz, F García, A Gutierrez, S García Menendez, F Inserra, L Ferder, W Manucha
Hipertensión y Riesgo Vascular, doi:10.1016/j.hipert.2024.04.002
Background: The COVID-19 pandemic has highlighted the vulnerability of particular patient groups to SARS-CoV-2 infection, including those with cardiovascular diseases, hypertension, and intestinal dysbiosis. COVID-19 affects the gut, suggesting diet and vitamin D3 supplementation may affect disease progression. Aims: To evaluate levels of Ang II and Ang-(1---7), cytokine profile, and gut microbiota status in patients hospitalized for mild COVID-19 with a history of cardiovascular disease and treated with daily doses of vitamin D3. Methods: We recruited 50 adult patients. We screened 50 adult patients and accessed pathophysiology study 22, randomized to daily oral doses of 10,000 IU vitamin D3 (n = 11) or placebo (n = 11). Plasma levels of Ang II and Ang-(1---7) were determined by radioimmunoassay, TMA and TMAO were measured by liquid chromatography and interleukins (ILs) 6, 8, 10 and TNF-␣ by ELISA. Results: The Ang-(1---7)/Ang II ratio, as an indirect measure of ACE2 enzymatic activity, increased in the vitamin D3 group (24 ± 5 pg/mL vs. 4.66 ± 2 pg/mL, p < 0.01). Also, in the vitamin D3-treated, there was a significant decline in inflammatory ILs and an increase in protective markers, such as a substantial reduction in TMAO (5 ± 2 moles/dL vs. 60 ± 10 moles/dL, p < 0.01). In addition, treated patients experienced less severity of infection, required less Abbreviations: ACE2, angiotensin-converting enzyme 2; Ang II, angiotensin II; COVID-19, coronavirus disease 2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; Ang-(1---7), angiotensin 1---7; Vitamin D3, cholecalciferol; TMA, trimethylamine; TMAO, trimethylamine-N-oxide; IL-6, interleukin 6; IL-8, interleukin 8; IL-10, interleukin 10; TNF-␣, tumor necrosis factor-alpha; RT-PCR, reverse transcription polymerase chain reaction; 25-OH VitD, 25-hydroxyvitamin D; d9-TMA, deuterated trimethylamine; d9-TMAO,
Authors' contributions Raúl Lelio Sanz (data collect analysis and interpretation of the data), Federico García (data collect), Alejandro Gutierrez (data collect), Sebastián García Menendez (data collect), Felipe Inserra (data collect analysis and interpretation of the data, conception and design of the manuscript, drafting, review, approval of the submitted manuscript), León Ferder (conception and design of the manuscript), Walter Manucha (analysis and interpretation of the data, conception and design of the manuscript, drafting, review, approval of the submitted manuscript). ARTICLE IN PRESS Ethical responsibilities Protection of people and animals. For this work, the authors considered the basic principles of bioethics. Before the protocolization, each patient signed the informed consent. The Provincial Council for Research Ethical Evaluation and the Provincial Health Research Registry approved the protocol. Confidentiality of the data The authors declare that patient data does not appear in this article. Right to privacy and informed consent. The authors declare that patient data does not appear in this article. Before the protocolization, each patient signed the informed consent. Conflict of interests None of the authors declare a conflict of interest with the manuscript's content.
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system components and arachidonic acid metabolites as ' 'biomarkers of COVID-19', 'volume': '11', 'author': 'Ghimire', 'year': '2023', 'journal-title': 'Biomedicines'}, { 'key': '10.1016/j.hipert.2024.04.002_bib0300', 'doi-asserted-by': 'crossref', 'first-page': '1360', 'DOI': '10.3390/nu14071360', 'article-title': 'Effects of vitamin D supplementation on 24-hour blood pressure in ' 'patients with low 25-hydroxyvitamin D levels: a randomized controlled ' 'trial', 'volume': '14', 'author': 'Theiler-Schwetz', 'year': '2022', 'journal-title': 'Nutrients'}, { 'key': '10.1016/j.hipert.2024.04.002_bib0305', 'doi-asserted-by': 'crossref', 'first-page': '196', 'DOI': '10.1016/j.ijid.2020.10.059', 'article-title': 'Could SARS-CoV-2-induced lung injury be attenuated by vitamin D?', 'volume': '102', 'author': 'Xiao', 'year': '2021', 'journal-title': 'Int J Infect Dis'}, { 'key': '10.1016/j.hipert.2024.04.002_bib0310', 'doi-asserted-by': 'crossref', 'first-page': '293', 'DOI': 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Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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