Effect of a Single High Dose of Vitamin D₃ on Hospital Length of Stay in Patients With Moderate to Severe COVID-19

JAMA, Journal Year: 2021, Volume and Issue: 325(11), P. 1053 - 1053

Published: Feb. 20, 2021

The efficacy of vitamin D3 supplementation in coronavirus disease 2019 (COVID-19) remains unclear.To investigate the effect a single high dose on hospital length stay patients with COVID-19.This was multicenter, double-blind, randomized, placebo-controlled trial conducted 2 sites Sao Paulo, Brazil. study included 240 hospitalized COVID-19 who were moderately to severely ill at time enrollment from June 2, 2020, August 27, 2020. final follow-up October 7, 2020.Patients randomly assigned receive oral 200 000 IU (n = 120) or placebo 120).The primary outcome stay, defined as date randomization discharge. Prespecified secondary outcomes mortality during hospitalization; number admitted intensive care unit; required mechanical ventilation and duration ventilation; serum levels 25-hydroxyvitamin D, total calcium, creatinine, C-reactive protein.Of randomized patients, 237 analysis (mean [SD] age, 56.2 [14.4] years; 104 [43.9%] women; mean baseline D level, 20.9 [9.2] ng/mL). Median (interquartile range) not significantly different between (7.0 [4.0-10.0] days) groups [5.0-13.0] (log-rank P .59; unadjusted hazard ratio for discharge, 1.07 [95% CI, 0.82-1.39]; .62). difference group significant in-hospital (7.6% vs 5.1%; difference, 2.5% -4.1% 9.2%]; .43), admission unit (16.0% 21.2%; -5.2% -15.1% 4.7%]; .30), need 14.4%; -6.8% 1.2%]; .09). Mean increased after (44.4 ng/mL 19.8 ng/mL; 24.1 19.5-28.7]; < .001). There no adverse events, but an episode vomiting associated intervention.Among COVID-19, D3, compared placebo, did reduce stay. findings do support use treatment moderate severe COVID-19.ClinicalTrials.gov Identifier: NCT04449718.

Language: Английский

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Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis

Critical Reviews in Food Science and Nutrition, Journal Year: 2020, Volume and Issue: 62(5), P. 1308 - 1316

Published: Nov. 4, 2020

There is still limited evidence regarding the influence of vitamin D in people with COVID-19. In this systematic review and meta-analysis, we analyze association between deficiency COVID-19 severity, via an analysis prevalence insufficiency disease. Five online databases-Embase, PubMed, Scopus, Web Science, ScienceDirect pre-print Medrevix were searched. The inclusion criteria observational studies measuring serum adult elderly subjects main outcome was severe cases We carried out a meta-analysis random effect measures. identified 1542 articles selected 27. Vitamin not associated higher chance infection by (OR = 1.35; 95% CI 0.80-1.88), but that present 64% 1.64; 1.30-2.09) more compared mild cases. A concentration increased hospitalization 1.81, 1.41-2.21) mortality from 1.82, 1.06-2.58). observed positive severity

Language: Английский

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Effect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Care on Symptom Length and Reduction Among Ambulatory Patients With SARS-CoV-2 Infection

JAMA Network Open, Journal Year: 2021, Volume and Issue: 4(2), P. e210369 - e210369

Published: Feb. 12, 2021

Importance

There is limited evidence regarding early treatment of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to mitigate symptom progression.

Objective

To examine whether high-dose zinc and/or ascorbic acid reduce the severity or duration symptoms compared with usual care among ambulatory patients SARS-CoV-2 infection.

Design, Setting, and Participants

This multicenter, single health system randomized clinical factorial open-label trial enrolled 214 adult a diagnosis confirmed polymerase chain reaction assay who received outpatient in sites Ohio Florida. The was conducted from April 27, 2020, October 14, 2020.

Intervention

Patients were 1:1:1:1 allocation ratio receive either 10 days gluconate (50 mg), (8000 both agents, standard care.

Outcomes

primary end point number required reach 50% reduction symptoms, including fever, cough, shortness breath, fatigue (rated on 4-point scale for each symptom). Secondary points included total score 0, cumulative at day 5, hospitalizations, deaths, adjunctive prescribed medications, adverse effects study supplements.

Results

A randomized, mean (SD) age 45.2 (14.6) years 132 (61.7%) women. stopped low conditional power benefit no significant difference 4 groups point. without supplementation achieved 6.7 (4.4) 5.5 (3.7) group, 5.9 (4.9) (3.4) group receiving (overallP = .45). secondary outcomes groups.

Conclusions Relevance

In this diagnosed infection, gluconate, acid, combination supplements did not significantly decrease

Trial Registration

ClinicalTrials.gov Identifier:NCT04342728

Language: Английский

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Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study)

Postgraduate Medical Journal, Journal Year: 2020, Volume and Issue: 98(1156), P. 87 - 90

Published: Nov. 12, 2020

Abstract Background Vitamin D has an immunomodulatory role but the effect of therapeutic vitamin supplementation in SARS-CoV-2 infection is not known. Aim Effect high dose, oral cholecalciferol on viral clearance. Design Randomised, placebo-controlled. Participants Asymptomatic or mildly symptomatic RNA positive deficient (25(OH)D&lt;20 ng/ml) individuals. Intervention were randomised to receive daily 60 000 IU (oral nano-liquid droplets) for 7 days with target 25(OH)D&gt;50 ng/ml (intervention group) placebo (control group). Patients requiring invasive ventilation significant comorbidities excluded. 25(OH)D levels assessed at day 7, and was continued those &lt;50 intervention arm. inflammatory markers fibrinogen, D-dimer, procalcitonin (CRP), ferritin measured periodically. Outcome measure Proportion patients negative before day-21 change markers. Results Forty individuals (n=16) control (n=24) group. Baseline serum 8.6 (7.1 13.1) 9.54 (8.1 12.5) (p=0.730), group, respectively. 10 out 16 could achieve by day-7 another two day-14 [day-14 51.7 (48.9 59.5) 15.2 (12.7 19.5) (p&lt;0.001) respectively]. (62.5%) participants group 5 (20.8%) arm (p&lt;0.018) became negative. Fibrinogen significantly decreased (intergroup difference 0.70 ng/ml; P=0.007) unlike other biomarkers. Conclusion Greater proportion D-deficient turned a decrease fibrinogen high-dose supplementation. Trial register number NCT04459247.

Language: Английский

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Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity

Nutrients, Journal Year: 2020, Volume and Issue: 12(11), P. 3361 - 3361

Published: Oct. 31, 2020

Vitamin D deficiency co-exists in patients with COVID-19. At this time, dark skin color, increased age, the presence of pre-existing illnesses and vitamin are features severe COVID disease. Of these, only is modifiable. Through its interactions a multitude cells, may have several ways to reduce risk acute respiratory tract infections COVID-19: reducing survival replication viruses, inflammatory cytokine production, increasing angiotensin-converting enzyme 2 concentrations, maintaining endothelial integrity. Fourteen observational studies offer evidence that serum 25-hydroxyvitamin concentrations inversely correlated incidence or severity The date generally satisfies Hill’s criteria for causality biological system, namely, strength association, consistency, temporality, gradient, plausibility (e.g., mechanisms), coherence, although experimental verification lacking. Thus, seems strong enough people physicians can use recommend supplements prevent treat COVID-19 light their safety wide therapeutic window. In view public health policy, however, results large-scale randomized controlled trials required currently progress.

Language: Английский

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Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: a review of current evidence

Expert Review of Clinical Pharmacology, Journal Year: 2021, Volume and Issue: 14(5), P. 601 - 621

Published: March 12, 2021

Introduction The COVID-19 pandemic has created a public health crisis, infected millions of people, and caused significant number deaths. SARS-CoV-2 transmits from person to through several routes, mainly via respiratory droplets, which makes it difficult contain its spread into the community. Here, we provide an overview epidemiology, pathogenesis, clinical presentation, diagnosis, treatment COVID-19.

Language: Английский

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Vitamin D and cardiovascular health

Clinical Nutrition, Journal Year: 2020, Volume and Issue: 40(5), P. 2946 - 2957

Published: Dec. 29, 2020

The principal source of vitamin D in humans is its biosynthesis the skin through a chemical reaction dependent on sun exposure. In lesser amounts, can be obtained from diet, mostly fatty fish, fish liver oil and mushrooms. Individuals with deficiency, defined as serum level 25 hydroxyvitamin < 20 ng/dl, should supplemented. Vitamin deficiency prevalent global problem caused mainly by low exposure to sunlight. main role 1,25 dihydroxyvitamin maintenance calcium phosphorus homeostasis. However, receptors are found most human cells tissues, indicating many extra-skeletal effects vitamin, particularly immune cardiovascular (CV) systems. regulates blood pressure acting endothelial smooth muscle cells. Its has been associated various CV risk factors appears linked higher mortality incidence disease (CVD). Several mechanisms have proposed relating such renin-angiotensin-aldosterone system activation, abnormal nitric oxide regulation, oxidative stress or altered inflammatory pathways. latest randomized controlled trials no benefits supplementation for CVD confirmed. Although more work needed establish protective this setting, according current evidences supplements not recommended prevention.

Language: Английский

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Vitamin D Supplementation Associated to Better Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Quasi-Experimental Study

Nutrients, Journal Year: 2020, Volume and Issue: 12(11), P. 3377 - 3377

Published: Nov. 2, 2020

Background. The objective of this quasi-experimental study was to determine whether bolus vitamin D supplementation taken either regularly over the preceding year or after diagnosis COVID-19 effective in improving survival among hospitalized frail elderly patients. Methods. Seventy-seven patients consecutively for a geriatric unit were included. Intervention groups participants supplemented with (Group 1), and those 2). comparator group involved having received no supplements 3). Outcomes 14-day mortality highest (worst) score on ordinal scale clinical improvement (OSCI) measured during acute phase. Potential confounders age, gender, functional abilities, undernutrition, cancer, hypertension, cardiomyopathy, glycated hemoglobin, number health issues at admission, hospital use antibiotics, corticosteroids, pharmacological treatments respiratory disorders. Results. three (n = 77; mean ± SD, 88 5 years; 49% women) similar baseline (except woman proportion, p 0.02), as used COVID-19. In Group 1 29), 93.1% survived day 14, compared 81.2% survivors 2 16) (p 0.33) 68.7% 3 32) 0.02). While considering reference (hazard ratio (HR) fully-adjusted HR 0.07 0.017) 0.37 0.28) 2. had longer time than (log-rank 0.015), although there difference between Groups 0.32). 1, but not 0.40), associated lower risk OSCI ≥5 (odds 0.08, 0.03). Conclusions. Regular less severe better elderly.

Language: Английский

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Vitamin D and survival in COVID-19 patients: A quasi-experimental study

The Journal of Steroid Biochemistry and Molecular Biology, Journal Year: 2020, Volume and Issue: 204, P. 105771 - 105771

Published: Oct. 13, 2020

Language: Английский

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The link between COVID-19 and VItamin D (VIVID): A systematic review and meta-analysis

Metabolism, Journal Year: 2021, Volume and Issue: 119, P. 154753 - 154753

Published: March 24, 2021

Disease severity and mortality rates due to COVID-19 infection are greater in the elderly chronically ill patients, populations at high risk for vitamin D deficiency. Vitamin plays an important role immune function inflammation. This systematic review meta-analysis assesses impact of status supplementation on related health outcomes.

Language: Английский

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