NMU – 179 Vitamin D Supplementation Shown to Improve Outcomes for Hospitalized Covid-19 Patients
Lifestyle Medicine Update No 179 (October 28, 2020)
with Dr. James Meschino
Topic: Vitamin D Supplementation Shown to Improve Outcomes for Hospitalized Covid-19 Patients
Source: J Steroid Biochem Mol Biol (October 2020)
In previous Lifestyle Medicine Updates, I reviewed the evidence showing that ideal blood levels of vitamin D were able to help prevent acute respiratory distress syndrome and that studies from various countries showed that this may also be true for Covid-19, as published studies suggest that individuals with lower vitamin D blood levels are susceptible to having more severe Covid-19 infections and greater risk of death. Studies like these prompted a Spanish hospital study to be undertaken whereby 76 consecutive patients with laboratory-confirmed Covid-10 cases, who were admitted to the hospital, were provided with standard medical treatment for Covid-19, but 50 of them were given vitamin D supplementation and 26 were not given vitamin D. The study was done using a computer-generated randomized approach, as to who received vitamin D and who did not, to eliminate the risk of doctor bias. The results showed that of the 26 patients who did not receive vitamin D supplementation, fifty percent of them (13) had their infection progress to the point where they required admission to the intensive care unit and two of them ultimately died. Of the 50 patients treated with vitamin D, only one required admission to the intensive care unit and none of them died.
As the researchers explain, patients with inadequate vitamin D status are at higher risk for more severe pulmonary infections such as acute respiratory distress syndrome. Vitamin D is required by immune cells to synthesize agents that literally destroy offending viruses on contact. More specifically immune cells require vitamin D to synthesize cathelicidin peptide, defensins, and the TLR co-receptor CD14, all of which help immune cells kill viruses on contact. Admittedly, this is a small study involving only 76 Covid-19 patients, but the positive results of the study have prompted a larger, multi-center trial, involving 15 hospitals across Spain, to be undertaken immediately. The new study will treat Covid-19 patients with either vitamin D or no vitamin D, concurrently with other standard treatments for Covid-19 that are approved in that country – which by the way include the use of hydroxychloroquine and azithromycin, and in patients with pneumonia, the addition of a broad-spectrum antibiotic. For patients on ventilators, the steroid drug dexamethasone is also used, as it has been shown to reduce mortality in hospitalized patients with Covid-19, who are on respiratory assistance. Keep in mind that in the current study, these drugs were being used as indicated on all 76 Covid-19 patients, but the addition of vitamin D supplementation significantly improved outcomes for the patients receiving vitamin D compared to the patients who did not receive the vitamin D.
The evidence continues to point to the importance of maintaining a blood vitamin D level of between 85-125 nmol/L (34 ng/ml – 50 ng/ml), which enables immune cells to mount a more effective attack against invading viruses and other pathogens.
I have included the reference for this study in the text below
Castillo ME et al. Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot study. J Biochem Mol Biol. 2020; 203:105751 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456194/
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