Vitamin D Supplementation and Clinical Outcomes in Severe COVID-19 Patients—Randomized Controlled Trial

Abstract

COVID-19 symptoms vary from asymptomatic cases to moderate and severe illness with patients needing hospitalization and intensive care treatment. Vitamin D is associated with severity of viral infections and has an immune-modulatory effect in immune response. Observational studies showed a negative association of low vitamin D levels and COVID-19 severity and mortality outcomes. In this study, we aimed to determine whether daily supplementation of vitamin D during intensive care unit (ICU) stay in COVID-19 patients with severe illness affects clinically relevant outcomes. Patients with COVID-19 disease in need of respiratory support admitted to the ICU were eligible for inclusion. Patients with low vitamin D levels were randomized into one of two groups: the intervention group received daily supplementation of vitamin D and the control group did not receive vitamin D supplementation. In total, 155 patients were randomized: 78 into the intervention group and 77 into the control group. There was no statistically significant difference in number of days spent on respiratory support, although the trial was underpowered for the main outcome. There was no difference in any of the secondary outcomes analyzed between two groups. Our study suggests no benefit in vitamin D supplementation to patients with severe COVID-19 disease admitted to the ICU and in need of respiratory support in any of the analyzed outcomes

Effectiveness of Vitamin D and Alpha-Lipoic Acid in COVID-19 Infection: A Literature Review

“…However, Domazet Bugarin et al. acknowledged that one of the main limitations of that study was the small sample size [ 10 ]. Initially, they wanted to recruit at least 274 patients to be able to detect a two-day difference in the primary outcome.…”

“…Initially, they wanted to recruit at least 274 patients to be able to detect a two-day difference in the primary outcome. Therefore, they suggest the available results would serve for larger and more powerful studies in the future [ 10 ]. The other study by Brunvoll et al also reported that there was no difference when using 400 IUs of VD daily for six months [ 11 ].…”

Vitamin D and COVID-19: An Update on Evidence and Potential Therapeutic Implications

“…), that true deficiency is likely to worsen infectious outcomes, including those from COVID, and that vitamin D is essential for a variety of normal immunological functions. Why, therefore, save maybe in individuals with the absolute lowest levels, do all the randomized studies conducted yet fall short of the lofty expectations that vitamin D treatment will prevent or alleviate COVID-19 [ 30 ]? According to what I understand, a deficiency state happens when a substance is deficient, and this deficiency results in a pathological condition that can be treated or avoided by replacing or supplementing the missing substance.…”

“…There is no deficient state when there is a low calcium level, low albumin level, and systemic inflammation. Patients with low vitamin D levels should not be deemed to have a deficiency if supplementation is offered to them and results are not improved [ 30 ]. In our eagerness to show how important nutrition is, we frequently overlook this kind of connection between nutrients and the severity of a disease.…”

“…Second, when scientists and other experts fail to keep an eye on how research findings are communicated to science consumers, the credibility of science continues to suffer. The public's trust in science is compromised when benefits are extolled or even theorized before being disproven [ 30 ].…”