scholarly journals Vitamin D Supplementation to Prevent COVID-19 Infections and Deaths—Accumulating Evidence from Epidemiological and Intervention Studies Calls for Immediate Action

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 411 ◽  
Author(s):  
Hermann Brenner
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Large Scale ◽  
Intervention Studies ◽  
Health Care Systems ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
World Population ◽  
High Risk Populations

The COVID-19 pandemic poses an unprecedented threat to human health, health care systems, public life, and economy around the globe. The repertoire of effective therapies for severe courses of the disease has remained limited. A large proportion of the world population suffers from vitamin D insufficiency or deficiency, with prevalence being particularly high among the COVID-19 high-risk populations. Vitamin D supplementation has been suggested as a potential option to prevent COVID-19 infections, severe courses, and deaths from the disease, but is not widely practiced. This article provides an up-to-date summary of recent epidemiological and intervention studies on a possible role of vitamin D supplementation for preventing severe COVID-19 cases and deaths. Despite limitations and remaining uncertainties, accumulating evidence strongly supports widespread vitamin D supplementation, in particular of high-risk populations, as well as high-dose supplementation of those infected. Given the dynamics of the COVID-19 pandemic, the benefit–risk ratio of such supplementation calls for immediate action even before results of ongoing large-scale randomized trials become available.

scholarly journals COvid-19 and high-dose VITamin D supplementation TRIAL in high-risk older patients (COVIT-TRIAL): study protocol for a randomized controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Cédric Annweiler ◽  
◽  
Mélinda Beaudenon ◽  
Jennifer Gautier ◽  
Romain Simon ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trial ◽  
High Risk ◽  
Older Patients ◽  
Standard Dose ◽  
Controlled Trial ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Randomized Controlled ◽  
High Dose Vitamin

Abstract Background With the lack of effective therapy, chemoprevention, and vaccination against SARS-CoV-2, focusing on the immediate repurposing of existing drugs gives hope of curbing the COVID-19 pandemic. A recent unbiased genomics-guided tracing of the SARS-CoV-2 targets in human cells identified vitamin D among the three top-scoring molecules manifesting potential infection mitigation patterns. Growing pre-clinical and epidemiological observational data support this assumption. We hypothesized that vitamin D supplementation may improve the prognosis of COVID-19. The aim of this trial is to compare the effect of a single oral high dose of cholecalciferol versus a single oral standard dose on all-cause 14-day mortality rate in COVID-19 older adults at higher risk of worsening. Methods The COVIT-TRIAL study is an open-label, multicenter, randomized controlled superiority trial. Patients aged ≥ 65 years with COVID-19 (diagnosed within the preceding 3 days with RT-PCR and/or chest CT scan) and at least one worsening risk factor at the time of inclusion (i.e., age ≥ 75 years, or SpO2 ≤ 94% in room air, or PaO2/FiO2 ≤ 300 mmHg), having no contraindications to vitamin D supplementation, and having received no vitamin D supplementation > 800 IU/day during the preceding month are recruited. Participants are randomized either to high-dose cholecalciferol (two 200,000 IU drinking vials at once on the day of inclusion) or to standard-dose cholecalciferol (one 50,000 IU drinking vial on the day of inclusion). Two hundred sixty participants are recruited and followed up for 28 days. The primary outcome measure is all-cause mortality within 14 days of inclusion. Secondary outcomes are the score changes on the World Health Organization Ordinal Scale for Clinical Improvement (OSCI) scale for COVID-19, and the between-group comparison of safety. These outcomes are assessed at baseline, day 14, and day 28, together with the serum concentrations of 25(OH)D, creatinine, calcium, and albumin at baseline and day 7. Discussion COVIT-TRIAL is to our knowledge the first randomized controlled trial testing the effect of vitamin D supplementation on the prognosis of COVID-19 in high-risk older patients. High-dose vitamin D supplementation may be an effective, well-tolerated, and easily and immediately accessible treatment for COVID-19, the incidence of which increases dramatically and for which there are currently no scientifically validated treatments. Trial registration ClinicalTrials.govNCT04344041. Registered on 14 April 2020 Trial status Recruiting. Recruitment is expected to be completed in April 2021.

Seasonal variation of vitamin D levels in Swiss athletes

2016 ◽  
Vol 64 (1) ◽  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Sun Exposure ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Vitamin Supplementation ◽  
World Population ◽  
Outdoor Sports ◽  
Sunscreen Use ◽  
Vitamin D Levels

Introduction: Vitamin D deficiency is very prevalent in world population and growing evidence shows that also athletes are affected. Vitamin D deficiency causes beside bone disorders, musculoskeletal pain, muscle weakness and is associated with many other health disorders. For athletes in particular it may impair training and performance, prolong recovery and increase risk of injury. We therefore analyzed vitamin D levels in Swiss athletes focusing on prevalence according to age, gender, seasonal variations, indoor or outdoor sports, sunscreen use and vitamin D supplementation. Methods: This study was performed in a convenient sample of 655 Swiss Olympic athletes over one year. Blood samples were obtained and a questionnaire was filled in at Swiss Olympic Medical Centers or Bases during an annual routine exam. Data were then sent to the central laboratory of the Aarau hospital where they were processed and sent to us in an anonymized version. Vitamin D levels were categorized into deficiency (≤ 50 nmol/l), insufficiency (between 50 and 75 nmol/l) and adequate levels (> 75 nmol/l) of 25-hydroxyvitamin D. By means of the questionnaire, we assessed age, gender, type of sport, symptoms possibly related to vitamin D deficiency during the last year, frequency of sunscreen use and vitamin D-containing medications of the athletes. Results: 13.5% of the participants (total number = 651) presented a vitamin D deficiency, 37.8% a vitamin D insufficiency so that more than half of the athletes (51.2%) had inadequate vitamin D levels. Inadequate vitamin D levels were more prevalent in younger athletes, during seasons with lower sun exposure, in indoor sports during the sun deprived seasons, in athletes without vitamines supplementation and in athletes of lower Swiss Olympic classes compared to their counterparts. Conclusions: The results of the study show that the prevalence of inadequate vitamin D levels in Swiss athletes is substantial for younger athletes (< 18 years of age) and for indoor athletes during sun deprived periods of the year. However, a general vitamin supplementation containing vitamin D reduced the prevalence of vitamin D inadequacy which is especially relevant during sun deprived seasons.

scholarly journals Circulating Levels of Muscle-Related Metabolites Increase in Response to a Daily Moderately High Dose of a Vitamin D3 Supplement in Women with Vitamin D Insufficiency—Secondary Analysis of a Randomized Placebo-Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1310
Author(s):  
Lise Sofie Bislev ◽  
Ulrik Kræmer Sundekilde ◽  
Ece Kilic ◽  
Trine Kastrup Dalsgaard ◽  
Lars Rejnmark ◽  
...  
Keyword(s):  
Vitamin D ◽  
Muscle Strength ◽  
Physical Performance ◽  
Vitamin D3 ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Negative Effects

Recently, we demonstrated negative effects of vitamin D supplementation on muscle strength and physical performance in women with vitamin D insufficiency. The underlying mechanism behind these findings remains unknown. In a secondary analysis of the randomized placebo-controlled trial designed to investigate cardiovascular and musculoskeletal health, we employed NMR-based metabolomics to assess the effect of a daily supplement of vitamin D3 (70 µg) or an identically administered placebo, during wintertime. We assessed the serum metabolome of 76 postmenopausal, otherwise healthy, women with vitamin D (25(OH)D) insufficiency (25(OH)D < 50 nmol/L), with mean levels of 25(OH)D of 33 ± 9 nmol/L. Compared to the placebo, vitamin D3 treatment significantly increased the levels of 25(OH)D (−5 vs. 59 nmol/L, respectively, p < 0.00001) and 1,25(OH)2D (−10 vs. 59 pmol/L, respectively, p < 0.00001), whereas parathyroid hormone (PTH) levels were reduced (0.3 vs. −0.7 pmol/L, respectively, p < 0.00001). Analysis of the serum metabolome revealed a significant increase of carnitine, choline, and urea and a tendency to increase for trimethylamine-N-oxide (TMAO) and urinary excretion of creatinine, without any effect on renal function. The increase in carnitine, choline, creatinine, and urea negatively correlated with muscle health and physical performance. Combined with previous clinical findings reporting negative effects of vitamin D on muscle strength and physical performance, this secondary analysis suggests a direct detrimental effect on skeletal muscle of moderately high daily doses of vitamin D supplements.

scholarly journals SUN-083 Screening of Vitamin D and Calcium Concentrations in Neonates of Mothers at High Risk of Vitamin D Deficiency

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Sheikh Arif Maqbool Kozgar ◽  
Paul Chay ◽  
Craig Frank Munns
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Vitamin D Deficiency ◽  
Reference Range ◽  
Financial Burden ◽  
Venous Blood ◽  
Reference Interval ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Serum 25Ohd

Abstract Objective: The aim of this study was to determine, retrospectively, the serum 25OHD and calcium concentrations of screened neonates of mothers at high risk of 25OHD deficiency (maternal 25OHD &lt; 25 nmol/L or unknown vitamin D concentrations and risk factors for vitamin D deficiency) and critically analyse whether their measurements contributes to the management of these neonates. Methods: Serum 25OHD and calcium concentrations from 600 samples of umbilical cord blood or venous blood collected from neonates over a 12-month period were analysed. 25OHD concentrations were reported for all while both the corrected calcium concentrations and vitamin D concentrations were available for 569 samples. Results: There was little or no evidence of association between neonatal 25OHD concentrations and gender, gestational age or birth weight. There was a high prevalence of vitamin D insufficiency (27.6%, 30–50 nmol/L) and deficiency (21.3%, &lt; 30 nmol/L) in neonates from high-risk maternal groups. There was a statistically positive but weak correlation (ρ = 0.22, P &lt; 0.0001) between serum calcium and 25OHD concentrations. Only 7 neonates out of 569 (1.2%) had calcium levels in the hypocalcaemic range; however, a significant number (47.6%) were reported to be in the hypercalcaemic range. Nearly all of these were venous samples collected in first 24 hours after birth. We calculated the reference interval for corrected calcium from our data of venous samples in first 24 hours and the upper limit was significantly higher (2.38–3.04 mmol/L) than the standard reference range used. Conclusion: Vitamin D deficiency is prevalent in neonates of high-risk mothers but the risk of hypocalcaemia due to vitamin D deficiency at birth is low. Screening neonates entails blood testing which can cause distress to neonates and their parents, substantial impost on staff and financial burden on the health care system. 25OHD deficiency is corrected relatively easily in neonates with supplementation and vitamin D supplementation of neonates from birth without routine screening appears to offer better value of care. Also, the data from this study suggest that the paediatric reference range for corrected calcium concentrations in neonates is higher and the paediatric reference range should be reconsidered.

24 A Retrospective Review of Vitamin D Levels and Dosing in Burn Center Patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S21-S21
Author(s):  
Sara Calder ◽  
Asia N Quan ◽  
Suzanne C Osborn ◽  
Karen J Richey ◽  
Curt Bay ◽  
...  
Keyword(s):  
Vitamin D ◽  
Retrospective Chart Review ◽  
Vitamin D Insufficiency ◽  
Infectious Complications ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Weekly Dose ◽  
Burn Patients ◽  
Increased Risk ◽  
Vitamin D Levels

Abstract Introduction The potential consequences of vitamin D insufficiency/deficiency (I/D), include increases in ICU length of stay, organ dysfunction, infectious complications, and mortality. Burn patients, in particular, may be at increased risk of vitamin D I/D due to bleeding, systemic inflammatory response syndrome, increased utilization of vitamin D by injured tissues, compromised vascular integrity, fluid shifts, and leakage of vitamin D binding protein (VDBP) and albumin. The purpose of this study is to determine the incidence of vitamin D I/D and evaluate the institutional vitamin D dosing regimen. Methods A retrospective chart review was performed of all adult patients from January 1, 2018 through December 31, 2019 who received cholecalciferol and had at least one vitamin D hydroxy level during their hospitalization. Vitamin D level was drawn on admission, then weekly thereafter. Patients found to be I/D were initiated on high dose vitamin D supplementation and then adjusted based on the weekly levels. The therapeutic goal for vitamin D supplementation was set at 50 ng/ml. Results Three hundred and sixteen patients met criteria for review. Of those patients, 293 patients (93%) were vitamin D I/D. The magnitude of vitamin D deficiency was strongly positively correlated with %TBSA burn size (p&lt; 0.001). Mean time to reach therapeutic vitamin D levels following initiation of supplementation was 19 days with an average weekly dose of 142,877 international units cholecalciferol. Many patients were discharged prior to reaching therapeutic levels. Time to reach therapeutic levels was also positively correlated with increasing burn size (p&lt; 0.05). Conclusions Vitamin D I/D is present is over 90% of burn patients and the degree of I/D was profound. Additionally, vitamin D I/D was not easily corrected, taking almost 3 weeks to reach therapeutic levels using an aggressive supplementation regimen. Further studies documenting the clinical consequences of vitamin D I/D and development of evidence-based supplementation dosing regimens are warranted.

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