RETRACTED ARTICLE: Impact of daily high dose oral vitamin D therapy on the inflammatory markers in patients with COVID 19 disease

Abstract

COVID 19 is known to cause immune dysregulation and vitamin D is a known immunomodulator. This study aims to objectively investigate the impact of Pulse D therapy in reducing the inflammatory markers of COVID-19. Consented COVID-19 patients with hypovitaminosis D were evaluated for inflammatory markers (N/L ratio, CRP, LDH, IL6, Ferritin) along with vitamin D on 0th day and 9th/11th day as per their respective BMI category. Subjects were randomised into VD and NVD groups. VD group received Pulse D therapy (targeted daily supplementation of 60,000 IUs of vitamin D for 8 or 10 days depending upon their BMI) in addition to the standard treatment. NVD group received standard treatment alone. Differences in the variables between the two groups were analysed for statistical significance. Eighty seven out of one hundred and thirty subjects have completed the study (VD:44, NVD:43). Vitamin D level has increased from 16 ± 6 ng/ml to 89 ± 32 ng/ml after Pulse D therapy in VD group and highly significant (p < 0.01) reduction of all the measured inflammatory markers was noted. Reduction of markers in NVD group was insignificant (p > 0.05). The difference in the reduction of markers between the groups (NVD vs VD) was highly significant (p < 0.01). Therapeutic improvement in vitamin D to 80–100 ng/ml has significantly reduced the inflammatory markers associated with COVID-19 without any side effects. Hence, adjunctive Pulse D therapy can be added safely to the existing treatment protocols of COVID-19 for improved outcomes.

Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis

“…After a scrupulous literature search and a meticulous study selection process, we included 13 studies in the present meta-analysis [7][8][9][10][11][12][13][14][15][22][23][24][25], pooling data retrieved from 2933 patients with COVID-19 (Fig. 1).…”

“…1). Of the 13 studies, 10 were observational studies [7-10, 12-14, 22-24], while 3 were RCTs [11,15,25]. Relevant studies where clinical outcomes were not reported in terms of ICU admission or mortality were excluded [26][27][28].…”

“…Five studies catered to the use of vitamin D before the diagnosis of COVID-19 [9,12,14,23,24], while seven studies had reported the use of vitamin D after the diagnosis of COVID-19 [7,10,11,13,15,22,25]. Annweiler et al [8] had considered the use of oral cholecalciferol in the week following the suspicion or diagnosis of COVID-19 or during the previous month.…”

Soluble HLA-G is upregulated in serum of patients with severe COVID-19

“…In the case of COVID-19, vitamin D can be considered as a protective factor due to its role in regulating the production of pro-inflammatory cytokines from pulmonary epithelial cells and macrophages, as well as in suppressing the cytokine storm, which is associated with immunopathogenesis of SARS-Cov-2 infection [31] . These beneficial effects in improving COVID-19 outcomes have been experimentally demonstrated, and patients who received adjunctive Pulse D therapy (vitamin D) showed a significant reduction in inflammatory markers associated with the clinical course of disease [32] .…”

A Prospective Cohort Study of Bioavailable 25-Hydroxyvitamin D Levels as a Marker of Vitamin D Status in Nontuberculous Mycobacterial Pulmonary Disease

“…Although a multidrug regimen with prolonged duration is recommended for the treatment of NTM-PD, the treatment outcomes are still suboptimal [4]. Moreover, malnutrition, which is frequently seen in patients with NTM-PD [5][6][7][8], has been shown to be a poor prognostic factor by previous studies [9,10].…”