Retrospective 1,478 hospitalized Hispanic patients in the USA with 705 receiving vitamin D treatment, showing lower mortality with treatment in unadjusted results. Very minimal information is currently available.
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.
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.
, which show efficacy with
p=0.0000032.
Standard of Care (SOC) for COVID-19 in the study country,
the USA, is
very poor with
very low average efficacy for approved treatments
1.
Only expensive, high-profit treatments were approved. Low-cost treatments were excluded, reducing the probability of treatment—especially early—due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
This study is excluded in the after exclusion results of meta
analysis:
minimal details provided.
|
risk of death, 38.0% lower, RR 0.62, p < 0.001, treatment 705, control 773.
|
|
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
|
Shahid et al., 17 Jun 2022, retrospective, USA, peer-reviewed, 2 authors, dosage not specified.
Abstract: Abstracts from the 2022 Annual Meeting of the Society of
General Internal Medicine
J Gen Intern Med 37(Suppl 2):S129–S664
DOI: 10.1007/s11606-022-07653-8
© The Author(s), under exclusive licence to Society of General Internal
Medicine 2022
THE EFFECTS OF VITAMIN D THERAPY ON OUTCOMES FOR
HISPANIC PATIENTS HOSPITALIZED FOR COVID-19
Saqib Shahid1; Fatma Dihowm2
1
Department of Internal Medicine, Texas Tech University Health Sciences
Center El Paso, El Paso, TX
2
Internal Medicine, Texas Tech University Health Science Center, El paso,
TX. (Control ID #3709726)
BACKGROUND: The SARS-CoV-2 novel coronavirus that causes COVID19 has been shown to more severely affect individuals with underlying
conditions, such as metabolic syndrome or diabetes. This is a reason why
SARS-CoV-2 more severely affects populations at risk for these conditions,
notably the Hispanic population. Vitamin D has been shown to be a positive
immunomodulatory actor, shown to upregulate production of CAMP
(cathelicidin antimicrobial peptide) and its effect on mitigating the severity of
respiratory illnesses has been widely studied. Additionally, given vitamin D’s
role in the functional regulation of pancreatic beta cells, this study aims to
determine whether vitamin D plays a significant role in providing better
outcomes for Hispanic patients with diabetes. Data will be gathered for patients
treated at University Medical Center in El Paso, where the majority of the
population treated is Hispanic, allowing us the opportunity to observe phenomena unique to this population.
S194
METHODS: We collected data from the charts of 1,478 Hispanic patients
who were hospitalized for COVID-19 at University Medical Center El Paso.
Comparisons were made between patients who received VItamin D therapy
(705) and those who did not (773). The main outcome that was assessed was
mortality, as well as secondary outcomes such as length of hospital stay, need
for supplemental oxygen upon discharge, and ICU admission. Further
comparisons were made between patients who suffer from diabetes and those
who do not.
RESULTS: Our preliminary results by way of a univariate analysis show that
patients who were given Vitamin D therapy during their hospitalization had
significantly lower rates of mortality (p<0.001). Patients in the group that
received Vitamin D therapy were 38% less likely to die during their hospital
stay (p<0.001). We also discovered that patients admitted to UMC El Paso
were significantly more likely to be given Vitamin D therapy if they presented
with respiratory and GI symptoms (p<0.001). A multivariate analysis on the
relationship between previous history of diabetes and the efficacy of Vitamin D
therapy is pending.
CONCLUSIONS: Our results show that Vitamin D therapy as a part of the
treatment protocol for COVID-19 can significantly reduce mortality during
hospitalization. As a result of the unique composition of our patient population,
these findings can help build standards of practice that are applicable to the
specific needs of Hispanic patients throughout the course of the pandemic.
Because patients in the Hispanic population are more susceptible to severe
symptoms due to their predisposition to comorbid conditions like diabetes,
using protocols informed by evidence has the potential to prevent mortality on
a large scale.
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