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The Effects of 10,000 IU Vitamin D Supplementation on Improvement of Clinical Outcomes, Inflammatory and Coagulation Markers in Moderate COVID-19 Patients: A Randomized-Controlled Trial

Taslim et al., Nutr. clín. diet. hosp., doi:10.12873/432taslim, NCT05126602
May 2023  
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Oxygen therapy 71% Improvement Relative Risk Oxygen therapy, mask 67% Oxygen therapy, cannula 73% Recovery, fever 60% Hospitalization time 21% Time to viral- 38% primary Vitamin D  Taslim et al.  LATE TREATMENT  RCT Is late treatment with vitamin D beneficial for COVID-19? RCT 60 patients in Indonesia (April - September 2021) Lower need for oxygen therapy (p=0.01) and shorter hospitalization (p=0.00019) Taslim et al., Nutr. clín. diet. hosp., May 2023 Favorshigh dose Favorslow dose 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.
4,300+ studies for 77 treatments.
RCT 72 moderate COVID-19 patients with vitamin D deficiency or insufficiency in Indonesia, showing faster viral clearance and improved recovery with 10,000IU vitamin D vs. 1,000IU vitamin D. Higher vitamin D levels were associated with shorter length of stay (p = 0.009).
10,000IU vs. 1,000IU cholecalciferol daily for 2 weeks.
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.
risk of oxygen therapy, 71.4% lower, RR 0.29, p = 0.01, treatment 4 of 30 (13.3%), control 14 of 30 (46.7%), NNT 3.0.
risk of oxygen therapy, 66.7% lower, RR 0.33, p = 0.61, treatment 1 of 30 (3.3%), control 3 of 30 (10.0%), NNT 15, mask.
risk of oxygen therapy, 72.7% lower, RR 0.27, p = 0.03, treatment 3 of 30 (10.0%), control 11 of 30 (36.7%), NNT 3.8, nasal cannula.
risk of no recovery, 60.0% lower, RR 0.40, p = 0.42, treatment 2 of 30 (6.7%), control 5 of 30 (16.7%), NNT 10.0, fever.
hospitalization time, 21.0% lower, relative time 0.79, p < 0.001, treatment mean 11.63 (±2.5) n=30, control mean 14.73 (±3.45) n=30.
time to viral-, 37.6% lower, relative time 0.62, p < 0.001, treatment mean 6.53 (±1.17) n=30, control mean 10.47 (±2.56) n=30, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Taslim et al., 1 May 2023, Single Blind Randomized Controlled Trial, Indonesia, peer-reviewed, 10 authors, study period 1 April, 2021 - 30 September, 2021, trial NCT05126602 (history). Contact:
This PaperVitamin DAll
The Effects of 10,000 IU Vitamin D Supplementation on Improvement of Clinical Outcomes, Inflammatory and Coagulation Markers in Moderate COVID-19 Patients: A Randomized-Controlled Trial
Nurpudji Astuti Taslim, Zahratul Fajri, Sisca Agustia Olii, Mardiana Madjid, Yasmin Syauki, Irawaty Djaharuddin, Agussalim Bukhari, Suryani As'ad, Haerani Rasyid, Nurpudji Astuti Taslim
Background & aims: Vitamin D supplementation as an immunomodulator has been identified as a potential strategy to prevent and treat Coronavirus disease 2019 (COVID-19). We aimed to analyze the effect of 10,000 IU vitamin D3 supplementation on 25(OH)D levels on primary clinical outcomes (conversion length), inflammatory markers (Total Lymphocyte Count (TLC), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR)) and coagulation marker (D-Dimer
CONCLUSION The effects of 10,000 IU Vitamin D3 supplementation in moderate COVID-19 patients whom have low vitamin D status showed improvements in LOC, LOS, clinical manifestations, functional capacity, and positive correlation on inflammatory and coagulation markers, such as PLR.
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Late treatment
is less effective
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