Review the Research<\/p>\n
Get summaries of key research on vitamin D and COVID-19<\/h5><\/div><\/div><\/div><\/div><\/div>\nEffectiveness of In-Hospital Cholecalciferol Use on Clinical Outcomes in Comorbid COVID-19 Patients: A Hypothesis-Generating Study<\/span><\/span><\/span><\/span><\/span><\/h1><\/div>Take Home Message<\/span><\/h2><\/div>Results from this retrospective analysis demonstrate that two consecutive doses of<\/span><\/span> 200,000 IU cholecalciferol (total of 400,000 IU) can significantly improve the outcome in<\/span><\/span> patients affected by COVID-19 that are also burdened with three or more comorbid diseases.<\/span><\/span><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>Who<\/span><\/h2><\/div>Ninety-one p<\/span>atients<\/span> (50 males and 41 females aged 40\u201398 years<\/span>; mean age 74 years<\/span>) consecutively admitted from the emergency department in the internal<\/span> medicine ward specifically dedicated to the management of COVID-19 patients in the<\/span> University Hospital of Padova, Italy, from 15th March to 20th April 2020 were included. All participants included in this study had:<\/span>\u00a0<\/span><\/p>\n\n- a confirmed<\/span> diagnosis of <\/span>COVID-19<\/span> infection according to the WHO, by a positive result of real-time<\/span> reverse transcriptase PCR (RT-PCR) assay;\u00a0<\/span>\u00a0<\/span><\/li>\n
- a<\/span>ge<\/span> of<\/span> 40<\/span> or more years;\u00a0<\/span>\u00a0<\/span><\/li>\n
- the presence on admission of fever (body temperature of 37.5 <\/span>\u00b0<\/span>C),<\/span> interstitial lung pattern or consolidation on chest X-ray and dyspnea;\u00a0<\/span>\u00a0<\/span><\/li>\n
- testing of serum<\/span> 25(OH) vitamin D levels within 24 h of admission; <\/span>and<\/span>\u00a0<\/span><\/li>\n
- fully available data on the specific<\/span> treatment applied, including in-hospital cholecalciferol administration.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Length of Study
\n<\/span><\/p><\/h2><\/div>Patients were followed <\/span>for the duration of their in-hospital stay<\/span> or <\/span>until <\/span>death.<\/span>\u00a0<\/span><\/p>\n\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/b>Results<\/span><\/h2><\/div><\/div><\/div>\n- Over the follow-up period 27 (29.7%) patients were transferred to the ICU<\/span> and 22 (24.2%) died (16 prior to ICU and six in ICU). Overall, 43 (47.3%) patients <\/span> experienced the<\/span> combined endpoint of transfer to ICU and\/or death.\u00a0<\/span>\u00a0<\/span><\/li>\n
- Additional <\/span>analyses revealed that the<\/span> presence of multiple medical conditions (<\/span>i.e<\/span><\/i>., the <\/span>comorbidity burden<\/span>)<\/span> significantly modified the effect of vitamin D treatment on the study outcome<\/span>. T<\/span>he positive effect<\/span> of high-dose cholecalciferol<\/span> supplementation on reducing ICU admission or death<\/span> was significantly amplified with increasing<\/span> comorbidity burden.<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div>
![](\"http:\/\/vitamindandme.org\/wp-content\/uploads\/2021\/05\/4Giannini_FINAL_iStock-1255835319-1.jpg\")
<\/span><\/div><\/div><\/div><\/div><\/div>Things to Keep in Mind<\/span><\/h2><\/div>\n- Observational<\/span> studies involving databases that are retrospectively examined may be characterized by a<\/span> lack of reliability of results and incompleteness of data<\/span>.<\/span>\u00a0<\/span><\/li>\n
- This study included patients from a single center in Northern Italy and<\/span> may not be generalizable to all COVID-19 patient populations.<\/span>\u00a0<\/span><\/li>\n
- The study included a very limited number of patients (n=91)<\/span> an<\/span>d<\/span> n<\/span>o formal sample size calculation was performed<\/span>.<\/span>\u00a0<\/span><\/li>\n
- Because a <\/span>post-dose <\/span>measurement<\/span> of serum 25(OH)D was not <\/span>performed<\/span>, the effectiveness of supplementation to increase vitamin D levels could not be assessed<\/span>.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>Results from this retrospective analysis demonstrate that two consecutive doses of <\/span>200,000 IU cholecalciferol (total of 400,000 IU) can significantly improve the outcome in<\/span> patients affected by COVID-19 that are also burdened with three or more comorbid diseases.<\/span> These findings are hypothesis generating and as such should be treated with caution.<\/span>\u00a0<\/span><\/p>\n\u00a0<\/span><\/span><\/p>\n<\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>Retrospective analysis<\/span>\u00a0<\/span><\/p>\n\n- Based on <\/span>the <\/span>individual clinical<\/span> judgement of the referring physician, patients were administered 400,000 IU vitamin D<\/span> supplementation as bolus oral cholecalciferol (two vials of 100,000 IU) daily for two consecutive days (the second and third day of the in<\/span> hospital<\/span> stay). Following this treatment decision, patients were divided into two groups<\/span> depending on whether they received cholecalciferol (n = 36; <\/span>47<\/span>%<\/span> female<\/span>) or not (n = 55; <\/span>44<\/span>%<\/span> female<\/span>).<\/span>\u00a0<\/span><\/li>\n
- The decision to administer vitamin D was largely based on:<\/span>\u00a0<\/span>\n
\n- low (<50 nmol\/L) 25(OH) vitamin D<\/span>,<\/span>\u00a0<\/span><\/li>\n
- current cigarette smoking,\u00a0<\/span>\u00a0<\/span><\/li>\n
- elevated D-dimer levels<\/span>, <\/span>and\u00a0<\/span>\u00a0<\/span><\/li>\n
- the presence of comorbid diseases<\/span>, the most frequent of which were cardiovascular disease (79%) and diabetes (33%)<\/span>.<\/span><\/li>\n<\/ul>\n<\/li>\n
- C<\/span>omputerized medical records were reviewed and demographic, clinical, radiological<\/span> and laboratory data were collected at admission. These included the following: age,<\/span>
Effectiveness of In-Hospital Cholecalciferol Use on Clinical Outcomes in Comorbid COVID-19 Patients: A Hypothesis-Generating Study<\/span><\/span><\/span><\/span><\/span><\/h1><\/div>Take Home Message<\/span><\/h2><\/div>Results from this retrospective analysis demonstrate that two consecutive doses of<\/span><\/span> 200,000 IU cholecalciferol (total of 400,000 IU) can significantly improve the outcome in<\/span><\/span> patients affected by COVID-19 that are also burdened with three or more comorbid diseases.<\/span><\/span><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>Who<\/span><\/h2><\/div>Ninety-one p<\/span>atients<\/span> (50 males and 41 females aged 40\u201398 years<\/span>; mean age 74 years<\/span>) consecutively admitted from the emergency department in the internal<\/span> medicine ward specifically dedicated to the management of COVID-19 patients in the<\/span> University Hospital of Padova, Italy, from 15th March to 20th April 2020 were included. All participants included in this study had:<\/span>\u00a0<\/span><\/p>\n\n- a confirmed<\/span> diagnosis of <\/span>COVID-19<\/span> infection according to the WHO, by a positive result of real-time<\/span> reverse transcriptase PCR (RT-PCR) assay;\u00a0<\/span>\u00a0<\/span><\/li>\n
- a<\/span>ge<\/span> of<\/span> 40<\/span> or more years;\u00a0<\/span>\u00a0<\/span><\/li>\n
- the presence on admission of fever (body temperature of 37.5 <\/span>\u00b0<\/span>C),<\/span> interstitial lung pattern or consolidation on chest X-ray and dyspnea;\u00a0<\/span>\u00a0<\/span><\/li>\n
- testing of serum<\/span> 25(OH) vitamin D levels within 24 h of admission; <\/span>and<\/span>\u00a0<\/span><\/li>\n
- fully available data on the specific<\/span> treatment applied, including in-hospital cholecalciferol administration.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Length of Study
\n<\/span><\/p><\/h2><\/div>Patients were followed <\/span>for the duration of their in-hospital stay<\/span> or <\/span>until <\/span>death.<\/span>\u00a0<\/span><\/p>\n\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/b>Results<\/span><\/h2><\/div><\/div><\/div>\n- Over the follow-up period 27 (29.7%) patients were transferred to the ICU<\/span> and 22 (24.2%) died (16 prior to ICU and six in ICU). Overall, 43 (47.3%) patients <\/span> experienced the<\/span> combined endpoint of transfer to ICU and\/or death.\u00a0<\/span>\u00a0<\/span><\/li>\n
- Additional <\/span>analyses revealed that the<\/span> presence of multiple medical conditions (<\/span>i.e<\/span><\/i>., the <\/span>comorbidity burden<\/span>)<\/span> significantly modified the effect of vitamin D treatment on the study outcome<\/span>. T<\/span>he positive effect<\/span> of high-dose cholecalciferol<\/span> supplementation on reducing ICU admission or death<\/span> was significantly amplified with increasing<\/span> comorbidity burden.<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/span><\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- Observational<\/span> studies involving databases that are retrospectively examined may be characterized by a<\/span> lack of reliability of results and incompleteness of data<\/span>.<\/span>\u00a0<\/span><\/li>\n
- This study included patients from a single center in Northern Italy and<\/span> may not be generalizable to all COVID-19 patient populations.<\/span>\u00a0<\/span><\/li>\n
- The study included a very limited number of patients (n=91)<\/span> an<\/span>d<\/span> n<\/span>o formal sample size calculation was performed<\/span>.<\/span>\u00a0<\/span><\/li>\n
- Because a <\/span>post-dose <\/span>measurement<\/span> of serum 25(OH)D was not <\/span>performed<\/span>, the effectiveness of supplementation to increase vitamin D levels could not be assessed<\/span>.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>Results from this retrospective analysis demonstrate that two consecutive doses of <\/span>200,000 IU cholecalciferol (total of 400,000 IU) can significantly improve the outcome in<\/span> patients affected by COVID-19 that are also burdened with three or more comorbid diseases.<\/span> These findings are hypothesis generating and as such should be treated with caution.<\/span>\u00a0<\/span><\/p>\n\u00a0<\/span><\/span><\/p>\n<\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>Retrospective analysis<\/span>\u00a0<\/span><\/p>\n\n- Based on <\/span>the <\/span>individual clinical<\/span> judgement of the referring physician, patients were administered 400,000 IU vitamin D<\/span> supplementation as bolus oral cholecalciferol (two vials of 100,000 IU) daily for two consecutive days (the second and third day of the in<\/span> hospital<\/span> stay). Following this treatment decision, patients were divided into two groups<\/span> depending on whether they received cholecalciferol (n = 36; <\/span>47<\/span>%<\/span> female<\/span>) or not (n = 55; <\/span>44<\/span>%<\/span> female<\/span>).<\/span>\u00a0<\/span><\/li>\n
- The decision to administer vitamin D was largely based on:<\/span>\u00a0<\/span>\n
\n- low (<50 nmol\/L) 25(OH) vitamin D<\/span>,<\/span>\u00a0<\/span><\/li>\n
- current cigarette smoking,\u00a0<\/span>\u00a0<\/span><\/li>\n
- elevated D-dimer levels<\/span>, <\/span>and\u00a0<\/span>\u00a0<\/span><\/li>\n
- the presence of comorbid diseases<\/span>, the most frequent of which were cardiovascular disease (79%) and diabetes (33%)<\/span>.<\/span><\/li>\n<\/ul>\n<\/li>\n
- C<\/span>omputerized medical records were reviewed and demographic, clinical, radiological<\/span> and laboratory data were collected at admission. These included the following: age,<\/span>
Take Home Message<\/span><\/h2><\/div>Results from this retrospective analysis demonstrate that two consecutive doses of<\/span><\/span> 200,000 IU cholecalciferol (total of 400,000 IU) can significantly improve the outcome in<\/span><\/span> patients affected by COVID-19 that are also burdened with three or more comorbid diseases.<\/span><\/span><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>Who<\/span><\/h2><\/div>Ninety-one p<\/span>atients<\/span> (50 males and 41 females aged 40\u201398 years<\/span>; mean age 74 years<\/span>) consecutively admitted from the emergency department in the internal<\/span> medicine ward specifically dedicated to the management of COVID-19 patients in the<\/span> University Hospital of Padova, Italy, from 15th March to 20th April 2020 were included. All participants included in this study had:<\/span>\u00a0<\/span><\/p>\n\n- a confirmed<\/span> diagnosis of <\/span>COVID-19<\/span> infection according to the WHO, by a positive result of real-time<\/span> reverse transcriptase PCR (RT-PCR) assay;\u00a0<\/span>\u00a0<\/span><\/li>\n
- a<\/span>ge<\/span> of<\/span> 40<\/span> or more years;\u00a0<\/span>\u00a0<\/span><\/li>\n
- the presence on admission of fever (body temperature of 37.5 <\/span>\u00b0<\/span>C),<\/span> interstitial lung pattern or consolidation on chest X-ray and dyspnea;\u00a0<\/span>\u00a0<\/span><\/li>\n
- testing of serum<\/span> 25(OH) vitamin D levels within 24 h of admission; <\/span>and<\/span>\u00a0<\/span><\/li>\n
- fully available data on the specific<\/span> treatment applied, including in-hospital cholecalciferol administration.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Length of Study
\n<\/span><\/p><\/h2><\/div>Patients were followed <\/span>for the duration of their in-hospital stay<\/span> or <\/span>until <\/span>death.<\/span>\u00a0<\/span><\/p>\n\u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/b>Results<\/span><\/h2><\/div><\/div><\/div>\n- Over the follow-up period 27 (29.7%) patients were transferred to the ICU<\/span> and 22 (24.2%) died (16 prior to ICU and six in ICU). Overall, 43 (47.3%) patients <\/span> experienced the<\/span> combined endpoint of transfer to ICU and\/or death.\u00a0<\/span>\u00a0<\/span><\/li>\n
- Additional <\/span>analyses revealed that the<\/span> presence of multiple medical conditions (<\/span>i.e<\/span><\/i>., the <\/span>comorbidity burden<\/span>)<\/span> significantly modified the effect of vitamin D treatment on the study outcome<\/span>. T<\/span>he positive effect<\/span> of high-dose cholecalciferol<\/span> supplementation on reducing ICU admission or death<\/span> was significantly amplified with increasing<\/span> comorbidity burden.<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/span><\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- Observational<\/span> studies involving databases that are retrospectively examined may be characterized by a<\/span> lack of reliability of results and incompleteness of data<\/span>.<\/span>\u00a0<\/span><\/li>\n
- This study included patients from a single center in Northern Italy and<\/span> may not be generalizable to all COVID-19 patient populations.<\/span>\u00a0<\/span><\/li>\n
- The study included a very limited number of patients (n=91)<\/span> an<\/span>d<\/span> n<\/span>o formal sample size calculation was performed<\/span>.<\/span>\u00a0<\/span><\/li>\n
- Because a <\/span>post-dose <\/span>measurement<\/span> of serum 25(OH)D was not <\/span>performed<\/span>, the effectiveness of supplementation to increase vitamin D levels could not be assessed<\/span>.<\/span>\u00a0<\/span><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>Results from this retrospective analysis demonstrate that two consecutive doses of <\/span>200,000 IU cholecalciferol (total of 400,000 IU) can significantly improve the outcome in<\/span> patients affected by COVID-19 that are also burdened with three or more comorbid diseases.<\/span> These findings are hypothesis generating and as such should be treated with caution.<\/span>\u00a0<\/span><\/p>\n\u00a0<\/span><\/span><\/p>\n<\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>Retrospective analysis<\/span>\u00a0<\/span><\/p>\n\n- Based on <\/span>the <\/span>individual clinical<\/span> judgement of the referring physician, patients were administered 400,000 IU vitamin D<\/span> supplementation as bolus oral cholecalciferol (two vials of 100,000 IU) daily for two consecutive days (the second and third day of the in<\/span> hospital<\/span> stay). Following this treatment decision, patients were divided into two groups<\/span> depending on whether they received cholecalciferol (n = 36; <\/span>47<\/span>%<\/span> female<\/span>) or not (n = 55; <\/span>44<\/span>%<\/span> female<\/span>).<\/span>\u00a0<\/span><\/li>\n
- The decision to administer vitamin D was largely based on:<\/span>\u00a0<\/span>\n
\n- low (<50 nmol\/L) 25(OH) vitamin D<\/span>,<\/span>\u00a0<\/span><\/li>\n
- current cigarette smoking,\u00a0<\/span>\u00a0<\/span><\/li>\n
- elevated D-dimer levels<\/span>, <\/span>and\u00a0<\/span>\u00a0<\/span><\/li>\n
- the presence of comorbid diseases<\/span>, the most frequent of which were cardiovascular disease (79%) and diabetes (33%)<\/span>.<\/span><\/li>\n<\/ul>\n<\/li>\n
- C<\/span>omputerized medical records were reviewed and demographic, clinical, radiological<\/span> and laboratory data were collected at admission. These included the following: age,<\/span>
Results from this retrospective analysis demonstrate that two consecutive doses of<\/span><\/span> 200,000 IU cholecalciferol (total of 400,000 IU) can significantly improve the outcome in<\/span><\/span> patients affected by COVID-19 that are also burdened with three or more comorbid diseases.<\/span><\/span><\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div> Ninety-one p<\/span>atients<\/span> (50 males and 41 females aged 40\u201398 years<\/span>; mean age 74 years<\/span>) consecutively admitted from the emergency department in the internal<\/span> medicine ward specifically dedicated to the management of COVID-19 patients in the<\/span> University Hospital of Padova, Italy, from 15th March to 20th April 2020 were included. All participants included in this study had:<\/span>\u00a0<\/span><\/p>\n Length of Study Patients were followed <\/span>for the duration of their in-hospital stay<\/span> or <\/span>until <\/span>death.<\/span>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div> Results from this retrospective analysis demonstrate that two consecutive doses of <\/span>200,000 IU cholecalciferol (total of 400,000 IU) can significantly improve the outcome in<\/span> patients affected by COVID-19 that are also burdened with three or more comorbid diseases.<\/span> These findings are hypothesis generating and as such should be treated with caution.<\/span>\u00a0<\/span><\/p>\n \u00a0<\/span><\/span><\/p>\n<\/div><\/div><\/div> Retrospective analysis<\/span>\u00a0<\/span><\/p>\nWho<\/span><\/h2><\/div>
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\n<\/span><\/p><\/h2><\/div><\/b>Results<\/span><\/h2><\/div><\/div><\/div>
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<\/span><\/div><\/div><\/div><\/div><\/div>Things to Keep in Mind<\/span><\/h2><\/div>
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Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>
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“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>
Study Design<\/span><\/h2><\/div>
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