Activated Vitamin D trial
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The effect of 1-hydroxy-vitamin D treatment in hospitalized patients with COVID-19: A retrospective study
Vitamin D deficiency is associated with elevated risk, severity, and mortality
Asthma, tuberculosis, chronic pulmonary obstructive disease (COPD), and viral respiratory infections
Consistent paper 1.
Vitamin D and its therapeutic relevance in pulmonary diseases
Vitamin D essential for several cellular processes, wound healing, immunity inflammation
Studies have displayed strong inter-relations with vit D deficiency and progression of lung disorders
Its ease of supplementation and development of personalized medicine,
could lead us to an effective adjunct and cost-effective method of therapeutic modality for highly fatal pulmonary diseases.
Consistent paper 2.
Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths
To reduce the risk of infection,
it is recommended that people at risk of influenza and/or COVID-19,
consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations,
followed by 5000 IU/d.
The goal should be to raise 25(OH)D concentrations above 40–60 ng/mL (100–150 nmol/L).
For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful.
Vitamin D deficiency is relatively common
Especially among the elderly, the obese, and patients with comorbidities including hypertension, diabetes, COPD, and CKD
Vitamin D induces
Production of antiviral peptides (defensins),
especially in the respiratory epithelium
Vitamin D upregulates anti-inflammatory cytokines such as interleukin-10 (IL-10),
and downregulates pro-inflammatory cytokines including IL-1, IL-6, and tumor necrosis factor alfa
Vitamin D effects angiotensin-converting enzyme axis,
which has a protective effect against ARDS
Efficacy of activated vitamin D supplementation in coronavirus disease 2019 (COVID-19)
1-hydroxy-vitamin D was prescribed on day 1 or 2 (median duration 8 days)
To evaluate the effect of 1-hydroxy-vitamin D,
on the prevention of severe disease and mortality,
in patients hospitalized for COVID-19.
Retrospective study, April 2021 and October 2021
Primarily Delta variant
Hospitalised 312 patients with COVID-19
Between July 2022 and September 2022
Primarily Omicron variant
Serum 25-hydroxyvitamin D (25(OH)D) levels measured at admission
1-hydroxy-vitamin D was prescribed
Primary composite endpoints
Need for additional respiratory support
Need for high-flow oxygen therapy or invasive mechanical ventilation
In-hospital mortality rate.
Experimental group
(n = 122)
Given 1-hydroxy-vitamin D
Median age, 66
Baseline vitamin D deficient, 77%
Control group ( n = 190)
Median age, 58
Age difference (p = )
Baseline vitamin D deficient, 65%
Baseline D deficiency
(p = )
(defined as serum 25(OH)D level less than 20 ng/mL)
Proportion of those requiring more respiratory support and in-hospital mortality
Vit D group, 6%
Control group,14%
(p = )
After propensity score matching
(to reduce bias caused by confounding variables)
(P = log-rank test)
Proportion of patients who received high flow oxygen
Vit D group 4%
Control group, 11% (P = )
In-hospital mortality
Vit D group, 3%
Control group, 5% (P = 0.3).
Need for additional respiratory support
Vit D group, 6%
Control group, 14% (P = )
Conclusions
1-hydroxy-vitamin treatment may improve outcomes in hospitalized patients with COVID- 19,
reducing composite outcomes including the need for additional respiratory support and in-hospital mortality.