The Effect of Vitamin D treatment on COVID 19- Patients, an Inverted Propensity Score Weighting (IPSW), and Inverted Probability of Treatment Weighting (IPTW) Analyzed Study
Keywords:Vitamin D and COVID-19, COVID-19 Recovery, Covid-19 Mortality, COVID-19 the need for home oxygen therapy
Vitamin D3 (1,25(OH)2 cholecalciferol) as a treatment for COVID 19 patients is being disputed, and a clear clinical benefit is not being confirmed.
A retrospective evaluation for COVID-19 patients who were treated with various cumulative doses of vitamin D. Data was extracted from the COVID-19 database, it included patients admitted to three hospitals in Amman, Jordan. Characteristics of patients were tabulated and compared for all-cohort, and propensity score index (PSI) adjustment, The comparison was based on two vitamin D strata ((≤ 149,000 i.u. and > 150,000 i.u.). Logistic regression analysis was utilized to predict recovery, the need for oxygen, and all-cause mortality for all-cohort, IPSW, and IPTW patients, based on vitamin D cumulative doses during their hospital stay.
1131 all-cohort and 768 PSI-adjusted patients were recruited. Except for antibiotics and antivirals, all other characteristics were balanced (P = NS). There were 1017 patients on vitamin D, 847 received cumulative ≤ 149,000 i.u., and 170 patients received cumulative dose ≥ 150,000 i.u. (Range 1000 – 385000). It was demonstrated that escalating cumulative doses of vitamin D did not contribute to the assessed outcomes; all-cohort patients (OR = 1.000, 95% C.I. 1.000 to 1.000), IPSW (OR = 1.000, 95% C.I. 1.000 to 1.000), and the IPTW (OR = 1.000, 95% C.I. 1.000 to 1.000).
In our patients’ cohorts, we could not demonstrate a beneficial effect for vitamin D therapy in COVID-19 patients for recovery, the need for home oxygen, and all-cause mortality, by hospital discharge.
- Alanagreh LA, Alzoughool F, Atoum M. The human coronavirus disease COVID-19: its origin, characteristics, and insights into potential drugs and its mechanisms. Pathogens. 2020 May;9(5):331.
- Nittari G, Pallotta G, Amenta F, Tayebati SK. Current pharmacological treatments for SARS-COV-2: A narrative review. European Journal of Pharmacology. 2020 Jun 27:173328.
- Marik PE, Kory P, Varon J, Iglesias J, Meduri GU. MATH+ protocol for the treatment of SARS-CoV-2 infection: the scientific rationale. Expert Review of Anti-infective Therapy. 2021 Feb 1;19(2):129-35.
- Thomas S, Patel D, Bittel B, Wolski K, Wang Q, Kumar A, Il’Giovine ZJ, Mehra R, McWilliams C, Nissen SE, Desai MY. Effect of high-dose zinc and ascorbic acid supplementation vs usual care on symptom length and reduction among ambulatory patients with SARS-CoV-2 infection: the COVID A to Z randomized clinical trial. JAMA network open. 2021 Feb 1;4(2):e210369-.
- Faqihi F, Alharthy A, Alodat M, Asad D, Aletreby W, Kutsogiannis DJ, Brindley PG, Karakitsos D. A pilot study of therapeutic plasma exchange for serious SARS CoV-2 disease (COVID-19): a structured summary of a randomized controlled trial study protocol. Trials. 2020 Dec;21:1-3.
- Balcells ME, Rojas L, Le Corre N, Martínez-Valdebenito C, Ceballos ME, Ferrés M, Chang M, Vizcaya C, Mondaca S, Huete Á, Castro R. Early versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial. PLoS medicine. 2021 Mar 3;18(3):e1003415.
- Sundaram ME, Coleman LA. Vitamin D and influenza. Advances in nutrition. 2012 Jul;3(4):517-25.
- Mitsuyoshi Urashima, Takaaki Segawa, Minoru Okazaki, Mana Kurihara, Yasuyuki Wada, Hiroyuki Ida, Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren, The American Journal of Clinical Nutrition, Volume 91, Issue 5, May 2010, Pages 1255–1260
- Science M, Maguire JL, Russell ML, Smieja M, Walter SD, Loeb M. Low serum 25-hydroxyvitamin D level and risk of upper respiratory tract infection in children and adolescents. Clinical infectious diseases. 2013 Aug 1;57(3):392-7.
- Dubnov-Raz G, Hemilä H, Cohen AH, Rinat B, Choleva L, Constantini NW. Vitamin D supplementation and upper respiratory tract infections in adolescent swimmers: a randomized controlled trial. Pediatric exercise science. 2015 Feb 1;27(1):113-9.
- Kaufman HW, Niles JK, Kroll MH, Bi C, Holick MF. SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PloS one. 2020 Sep 17;15(9):e0239252.
- Castillo ME, Costa LM, Barrios JM, Díaz JF, Miranda JL, Bouillon R, Gomez JM. 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 randomized clinical study. The Journal of steroid biochemistry and molecular biology. 2020 Oct 1;203:105751.
- Annweiler C, Hanotte B, de l’Eprevier CG, Sabatier JM, Lafaie L, Célarier T. Vitamin D and survival in COVID-19 patients: a quasi-experimental study. The Journal of steroid biochemistry and molecular biology. 2020 Nov 1;204:105771.
- Panfili FM, Roversi M, D’argenio P, Rossi P, Cappa M, Fintini D. Possible role of vitamin D in Covid-19 infection in pediatric population. Journal of endocrinological investigation. 2021 Jan;44(1):27-35.
- Wong HY, Lam HY, Fong AH, Leung ST, Chin TW, Lo CS, Lui MM, Lee JC, Chiu KW, Chung TW, Lee EY. Frequency and distribution of chest radiographic findings in patients positive for COVID-19. Radiology. 2020 Aug;296(2):E72-8.
- Health Encyclopedia. University of Rochester Medical Center. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=ferritin_blood#:~:text=The%20normal%20range%20for%20ferritin,females%2C%2018%20to%2039%20years. Last accessed 9 October 2021.
- NCBI resources. Covid-19 information. https://www.ncbi.nlm.nih.gov/books/NBK278991/table/diet-treatment-obes.table4clas/ last accessed 9 October 2021.
- Myall KJ, Mukherjee B, Castanheira AM, Lam JL, Benedetti G, Mak SM, Preston R, Thillai M, Dewar A, Molyneaux PL, West AG. Persistent Post–COVID-19 Interstitial Lung Disease. An Observational Study of Corticosteroid Treatment. Annals of the American Thoracic Society. 2021 May;18(5):799-806.]
- Pujhari S, Paul S, Ahluwalia J, Rasgon JL. Clotting disorder in severe acute respiratory syndrome coronavirus 2. Reviews in medical virology. 2021 May;31(3):e2177.
- Fudim M, Qadri YJ, Ghadimi K, MacLeod DB, Molinger J, Piccini JP, Whittle J, Wischmeyer PE, Patel MR, Ulloa L. Implications for neuromodulation therapy to control inflammation and related organ dysfunction in COVID-19. Journal of cardiovascular translational research. 2020 Dec;13:894-9.
- Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. The American journal of clinical nutrition. 2010 May 1;91(5):1255-60.
- Teymoori‐Rad M, Marashi SM. Vitamin D and Covid‐19: From potential therapeutic effects to unanswered questions. Reviews in medical virology. 2021 Mar;31(2):e2159.
- Pal R, Banerjee M, Bhadada SK, Shetty AJ, Singh B, Vyas A. Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis. Journal of endocrinological investigation. 2021 Jun 24:1-6.
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