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0 0.5 1 1.5 2+ Mortality -42% Improvement Relative Risk Case -146% Vitamin D for COVID-19  Ullah et al.  Prophylaxis Is prophylaxis with vitamin D beneficial for COVID-19? Retrospective 14,849 patients in the United Kingdom More cases with vitamin D (p<0.000001) Ullah et al., Pancreatology, March 2021 Favors vitamin D Favors control

COVID-19 in patients with hepatobiliary and pancreatic diseases in East London: a single-centre cohort study

Ullah et al., Pancreatology, doi:10.1016/j.pan.2020.10.005
Mar 2021  
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Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
*, now known with p < 0.00000000001 from 120 studies, recognized in 8 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Retrospective 15,440 patients with hepatobiliary and pancreatic diseases in the United Kingdom, 226 with confirmed COVID-19, showing higher risk with vitamin D supplementation. Results are likely confounded by impaired vitamin D processing and propensity to prescribe supplementation based on specifics of each patient's disease and vitamin D levels. Adjustments used broad age ranges, likely adding to residual confounding.
This is the 24th of 120 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 248 sextillion).
29 studies are RCTs, which show efficacy with p=0.0000024.
This study is excluded in the after exclusion results of meta analysis: significant unadjusted confounding possible.
risk of death, 42.1% higher, RR 1.42, p = 0.34, treatment 21 of 64 (32.8%), control 26 of 135 (19.3%), adjusted per study, odds ratio converted to relative risk.
risk of case, 146.0% higher, RR 2.46, p < 0.001, treatment 69 of 2,168 (3.2%), control 139 of 12,681 (1.1%), adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ullah et al., 4 Mar 2021, retrospective, United Kingdom, peer-reviewed, 3 authors, dosage not specified.
This PaperVitamin DAll
COVID-19 in patients with hepatobiliary and pancreatic diseases: A single-centre cross-sectional study in East London
Abu Z M Dayem Ullah, PhD student Lavanya Sivapalan, Hemant M Kocher, Claude Chelala
Objective To explore risk factors associated with COVID-19 susceptibility and survival in patients with pre-existing hepato-pancreato-biliary (HPB) conditions. Design Cross-sectional study. Setting East London Pancreatic Cancer Epidemiology (EL-PaC-Epidem) study at Barts Health NHS Trust, UK. Linked electronic health records were interrogated on a cohort of participants (age ≥ 18 years), reported with HPB conditions between 1 April 2008 and 6 March 2020. Participants EL-PaC-Epidem study participants, alive on 12 February 2020, and living in East London within the previous six months (n=15 440). The cohort represents a multi-ethnic population with 51.7% belonging to the non-White background. Main outcome measure COVID-19 incidence and mortality. Results Some 226 (1.5%) participants had confirmed COVID-19 diagnosis between 12 February and 12 June 2020, with an increased odds for men (OR 1.56; 95% CI 1.2 to 2.04) and Black ethnicity (2.04; 1.39 to 2.95) as well as patients with moderate to severe liver disease (2.2; 1.35 to 3.59). Each additional comorbidity increased the odds of infection by 62%. Substance mis-users were at more risk of infection, so were patients on Vitamin D treatment. The higher odds ratios in patients with chronic pancreatic or mild liver conditions, age>70, and history of smoking or obesity were due to co-existing comorbidities. Increased odds of death were observed for men (3.54; 1.68 to 7.85) and Black ethnicity (3.77; 1.38 to 10.7). Patients having respiratory complications from COVID-19 without a history of chronic respiratory disease also had higher odds of death (5.77; 1.75 to 19). Conclusions In this large population-based study of HPB patients, men, Black ethnicity, pre-existing moderate to severe liver conditions, six common medical multimorbidities, substance mis-use, and a history of Vitamin D treatment independently posed higher odds of acquiring COVID-19 compared to their respective counterparts. The odds of death were significantly high for men and Black people.
FOOTNOTES Contributors: ADU designed the study, and was responsible for undertaking and completing data collection, processing and analysis. HMK and CC oversaw the conduct and management of the study. All the authors contributed to the selection of study variables and interpretation post analysis. ADU wrote the first drafts of the report and all the authors made critical revisions. Data sharing: All statistical data relevant to the study are included in the article or uploaded as supplementary information. Only the corresponding author had full access to all the participants' data in the study. The authors confirm that researchers seeking the completely anonymised final analysis dataset for this work can submit a data request to the corresponding author. Transparency statement: The corresponding author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.
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