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Effect of a Single High Dose of Vitamin D3 on Hospital Length of Stay in Patients With Moderate to Severe COVID-19: A Randomized Clinical Trial

Take Home Message

A high, single oral dose of 200,000 IU vitamin D3, compared to placebo, did not significantly reduce hospital length of stay in moderately to severely ill hospitalized patients diagnosed with COVID-19 in Brazil during the study period of June-August 2020.

Who

Two hundred-forty hospitalized patients with moderate to severe COVID-19 diagnosed by PCR testing or serology assay were included in the trial. 

 

Length of Study

Patients were enrolled from June 2, 2020 to August 27, 2020 with the final follow-up completed on October, 7 2020.

Results

  • High dose vitamin D3 did not significantly reduce hospital length of stay (median 7.0 vs. 7.0 days). 
  • Vitamin D3 also did not reduce in-hospital mortality, admission to the intensive care unit or the need for or duration of mechanical ventilation. 

Things to Keep in Mind

  • Mean serum vitamin D levels (vitamin D3 group = 52.9 nmol/L; placebo = 51.4 nmol/L; sufficiency >50 nmol/L) indicate that the study population was less vitamin D deficient than other study groups, perhaps owing to geographical location. 
  • Patients were given the vitamin D3 dose a long time after symptom onset (mean = 10.3 days). Preventative or early vitamin D3 supplementation may be more effective. 
  • Small but meaningful differences between the groups may have been missed due to the relatively low number of patients enrolled in the study. 
  • Numerous pre-existing conditions with corresponding medications may have affected the results. 

Author’s Conclusions

Among hospitalized patients with COVID-19 in Brazil, a single high dose of vitamin D3, compared with placebo, did not significantly reduce length of stay.

Study Design

  • This study was a multicenter, double-blind, parallel-group, randomized placebo-controlled trial. 
  • The intervention group, consisting of 119 patients (41.2% female with a mean age of 56.5 years and a mean BMI of 31.9), received a single oral dose of 200,000 IU vitamin D3 dissolved in 10 ml peanut oil. Oxygen therapy was required by 72.3%  of the intervention group. 
  • The placebo group, consisting of 118 patients (46.6% female with a mean age of 56.0 years and a mean BMI of 31.4), received a single oral dose of 10 ml peanut oil only. Oxygen therapy was required by 80.5%  of the placebo group. 
  • There were no differences between the groups at baseline for ethnicity or COVID symptoms. 

Reference

Murai, I. H., Fernandes, A. L., Sales, L. P., Pinto, A. J., Goessler, K. F., Duran, C. S. C., Silva, C. B. R., Franco, A. S., Macedo, M. B., Dalmolin, H. H. H., Baggio, J., Balbi, G. G. M., Reis, B. Z., Antonangelo, L., Caparbo, V. F., Gualano, B. and Pereira, R. M. R. (2021) ‘Effect of a Single High Dose of Vitamin D3 on Hospital Length of Stay in Patients With Moderate to Severe COVID-19: A Randomized Clinical Trial’, JAMA. 

 

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clinicaltrials.gov

Research Summaries

Changes in 25‐hydroxyvitamin D levels post‐vitamin D supplementation in people of Black and Asian ethnicities and its implications during COVID‐19 pandemic: A systematic review

Changes in 25‐hydroxyvitamin D levels post‐vitamin D supplementation in people of Black and Asian ethnicities and its implications during COVID‐19

Vitamin D insufficiency in COVID-19 and influenza A, and critical illness survivors: a cross-sectional study

Take Home Message Vitamin D deficiency/insufficiency was present in majority of hospitalized patients with COVID-19 or influenza A and correlated with severity and persisted in critical illness survivors at concentrations expected

2022-05-10T12:29:26-05:00