Impact of Vitamin D Therapy on the Progress COVID-19: Six Weeks Follow-Up Study of Vitamin D Deficient Elderly Diabetes Patients

Abstract

Background Coronavirus disease-19 (COVID-19) is an ongoing pandemic causing considerable fatalities worldwide. Vitamin D modulates the immune response through effects on various cells, such as: macrophages, B and T lymphocytes, neutrophils, and dendritic cells. Aim To explore whether supplementation of vitamin D, in the form of a single intramuscular cholecalciferol injection, to patients with diabetes, COVID-19, and low vitamin D levels could improve the prognosis of those patients. Methods This was a placebo-controlled randomized prospective study. The study has two arms as follows: the intervention arm (40 vitamin D deficient diabetes elderly patients that acquired SARS-CoV-2), compared to the control arm (16 elderly diabetes patients, with deficient vitamin D with SARS-CoV-2). Patients in the intervention arm were given vitamin D as a single intramuscular injection (200,000 IU); patients in the control arm were given placebo. The primary outcome was mortality within 6 weeks of the diagnosis of COVID-19. Clinical, laboratory, treatment, and outcome data were recorded after 6 weeks of follow-up. Results No significant difference in 6 weeks mortality was observed between patients who received vitamin D and patients who received placebo (17.5% vs 18.8%, p = 0.838). Age, presence of hypertension, and chronic obstructive pulmonary disease were independent predictors of mortality at 6 weeks. Conclusion Vitamin D supplementation did not reduce the severity or mortality of COVID-19 at 6 weeks. Further large scale studies are required to explore the effect of vitamin D therapy on survival in patients with diabetes mellitus who acquire COVID-19.

Therapeutic Vitamin D Supplementation Following COVID-19 Diagnosis: Where Do We Stand?—A Systematic Review

“…The literature search yielded a total of 1376 articles (832 on PubMed and 544 on Scopus), among which 189 were selected to be evaluated as full texts. Finally, a total of 11 [ 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ] articles fully met our inclusion criteria and were included in this systematic review ( Figure 1 ).…”

“…The studies were published from October 2020 to September 2021 and were conducted in four different continents. Three studies took place in Spain [ 31 , 33 , 34 ] and one in each of the following countries: France [ 28 ], USA [ 32 ], Brazil [ 35 ] Turkey [ 30 ], Singapore [ 36 ], Saudi Arabia [ 29 ], India [ 25 ] and Egypt [ 37 ]. The majority [ 25 , 28 , 30 , 31 , 33 , 36 , 37 ] were single-center, while in four studies patients from two [ 35 ], three [ 29 , 32 ] or five [ 34 ] centers were recruited.…”

The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2

“…Considerable discordance exists regarding the effectiveness of Vit D in the treatment of COVID-19, with some reports suggesting a beneficial effect [ 15 , 16 , 17 , 28 , 29 , 31 , 41 , 45 , 53 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 ] and others no change [ 26 , 27 , 30 , 32 , 33 , 34 , 35 , 36 , 37 , 44 , 107 , 108 , 109 ]. The reasons for these disparate findings are likely complex and multifactorial, with varying doses, duration, and timing of Vit D administration along with patient populations and sample sizes all playing roles [ 110 ].…”

“…Most of the studies on this topic have been observational in design and did not account for heterogeneous comorbid conditions or the effect of CRT use. Moreover, the few randomized clinical trials published to date have been small and insufficiently powered to assure the balance of CRT use between study arms [ 35 , 36 , 84 , 86 , 96 ].…”

“…Vitamin D (Vit D) is an oxysterol hormone with important immunomodulatory and antiviral properties [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. Even though this vitamin is often recommended as a nutritional supplement in treatment guidelines and prescribed for the management of coronavirus disease 2019 (COVID-19) [ 9 , 10 , 11 , 12 ], several studies have yielded divergent or inconclusive results [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ].…”