Vitamin D, First clinical trial

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)

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)

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

Ventilate

Don't abdicate

Dilute that virus

So you stay great

Ventilate

Don't complicate,

Complain or whine

You'll acclimate

Contemplate

When you congregate

Does the air here circulate

Instigate, Nominate

Educate, Motivate

I hope this message will resonate

That when we populate

Instead of isolate

Ventilate

Don't abdicate

Dilute that virus

So you stay great