Dr. John Campbell | September 6, 2020
About 42% of the US population is vitamin D deficient
82% in black people
70% in Hispanics
Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results, (JAMA Open, 3rd September, Chicago)
https://jamanetwork.com/journals/jama…
Cohort study of 489 Patients who had a vitamin D level measured in the year before COVID-19 testing
Relative risk of testing positive for COVID-19 was 1.77 times
First clinical trial on vitamin D and COVID Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study (Spain, Journal of steroid biochemistry and molecular biology)
https://www.sciencedirect.com/science…
Objective
Vitamin D decreases Acute Respiratory Distress Syndrome
Effect of calcifediol treatment
Calcifediol can rapidly increase serum 25OHD concentration
25-hydroxyvitamin D
Intensive Care Unit Admission and Mortality
Spanish patients hospitalized for COVID-19.
Design
Parallel pilot, randomized, double-masked clinical trial
Setting
Reina Sofia University Hospital, Córdoba, Spain
Participants
76 consecutive patients hospitalized with COVID-19 infection
Clinical picture of acute respiratory infection
Confirmed by a radiographic pattern of viral pneumonia
Positive SARS-CoV-2 PCR
Procedures
All hospitalized patients received as best available therapy
Hydroxychloroquine and azithromycin
Allocated at a 2 calcifediol:1
Oral calcifediol (0.532 mg), or not
Oral calcifediol (0.266 mg) on day 3 and 7
Then weekly until discharge
End points, ICU admission and deaths.
Results
50 patients treated with calcifediol
One required admission to the ICU (2%),
Of 26 untreated patients, 13 required admission (50%)
p less than 0.001
Of the patients treated with calcifediol, none died, and all were discharged, without complications
Of the patients not treated, 2 died
Conclusion
Calcifediol seems to be able to reduce severity of the disease
Larger trials with groups properly matched will be required to show a definitive answer
Rationale, activation of the vitamin D receptor (VDR) signalling pathway
Reduced ARDS
Cytokine/chemokine storm
Regulating the renin angiotensin system
Modulating neutrophil activity
Maintaining the integrity of the pulmonary epithelial barrier
Stimulating epithelial repair
Tapering down the increased coagulability