Effect of Cholecalciferol Supplementation on the Clinical Features and Inflammatory Markers in Hospitalized COVID-19 Patients: A Randomized, Open-Label, Single-Center Study

Abstract

Recent studies showed that a low 25-hydroxyvitamin D (25(OH)D) level was associated with a higher risk of morbidity and severe course of COVID-19. Our study aimed to evaluate the effects of cholecalciferol supplementation on the clinical features and inflammatory markers in patients with COVID-19. A serum 25(OH)D level was determined in 311 COVID-19 patients. Among them, 129 patients were then randomized into two groups with similar concomitant medication. Group I (n = 56) received a bolus of cholecalciferol at a dose of 50,000 IU on the first and the eighth days of hospitalization. Patients from Group II (n = 54) did not receive the supplementation. We found significant differences between groups with the preferential increase in serum 25(OH)D level and Δ 25(OH)D in Group I on the ninth day of hospitalization (p < 0.001). The serum 25(OH)D level on the ninth day was negatively associated with the number of bed days (r = −0.23, p = 0.006); we did not observe other clinical benefits in patients receiving an oral bolus of cholecalciferol. Moreover, in Group I, neutrophil and lymphocyte counts were significantly higher (p = 0.04; p = 0.02), while the C-reactive protein level was significantly lower on the ninth day of hospitalization (p = 0.02). Patients with supplementation of 100,000 IU of cholecalciferol, compared to those without supplementation, showed a decrease in the frequencies of CD38++CD27 transitional and CD27−CD38+ mature naive B cells (p = 0.006 and p = 0.02) and an increase in the level of CD27−CD38− DN B cells (p = 0.02). Thus, the rise in serum 25(OH)D level caused by vitamin D supplementation in vitamin D insufficient and deficient patients may positively affect immune status and hence the course of COVID-19.

Hospital and laboratory outcomes of patients with COVID-19 who received vitamin D supplementation: a systematic review and meta-analysis of randomized controlled trials

“…Five trials reported this outcome in 671 patients (Entrenas Castillo et al 2020 ; Maghbooli et al 2021 ; Murai et al 2021b ; Mariani et al 2022 ; Karonova et al 2022 ). The pooled data showed a significant lower incidence of patients who required ICU admission in vitamin D group compared with placebo group (RR = 0.59, 95% CI [0.41, 0.84], P = 0.003) and the pooled analysis was heterogeneous ( P = 0.02, I 2 = 66%) (Fig.…”

“…The title and abstract screening excluded 641 articles. Thirty-two articles underwent full-text screening, and nine RCTs matched our criteria and entered all steps of meta-analysis to get the evidence (Cannata-Andía et al 2022 ; Entrenas Castillo et al 2020 ; Fernandes et al 2022 ; Maghbooli et al 2021 ; Murai et al 2021b ; Rastogi et al 2022 ; Mariani et al 2022 ; Karonova et al 2022 ; Soliman et al 2021 ). See the PRISMA chart in Fig.…”

Visual analysis of the research trend and status on the association between vitamin D and immunity: From 2012 to 2021

“…The debate on the relevance of the two continues, while research on vitamin D in disease treatment and prevention has been conducted. However, different RCTs came to different conclusions either (64,65). To date, three bibliometric studies on vitamin D and COVID-19 are available.…”

Nutraceuticals for Complementary Treatment of Multisystem Inflammatory Syndrome in Children: A Perspective from Their Use in COVID-19

“…The possible role of vitamin D in SARS-CoV-2 infection in children could be explained initially by its antiviral activities and its use in adults with COVID-19 [ 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 ]. It has been postulated that vitamin D intake reduces inflammatory state and plays an essential role in endothelial function, mediated by vitamin D receptors (VDRs).…”

“…The signaling of vitamin D and VDR together has an anti-inflammatory effect [ 202 ]. Some studies have reported that vitamin D treatment could be helpful for COVID-19 prevention [ 140 , 146 ] or treatment because vitamin D plays an essential role as a modulator of immunocompetence [ 203 , 204 , 205 ], regulates B and T cells [ 141 , 143 ], reduces CRP levels [ 141 ], mortality [ 135 , 136 , 139 ], the time of hospital stay [ 142 , 143 ] and the need of oxygen support [ 142 , 148 ]. However, there is no consensus about doses and therapeutic schemes because of high variability among clinical trials.…”