meta|Evidence - COVID-19
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Vitamin D (n=120) vs. placebo (n=120)
randomized controlled trial some concerns about risk of bias
Vitamin D3
Single oral dose of 200,000 IU of vitamin D3 dissolved in a 10-mL peanut oil solution.
Placebo
10 mL of a peanut oil solution.
The solutions were identical in color, taste, smell, consistency, and container.
COVID 19 hospitalized
Age 18 years or older; diagnosis of COVID-19 via PCR testing for SARS-CoV-2 from nasopharyngeal swabs or computed tomography scan findings compatible with the disease (bilateral multifocal ground-glass opacities ≥50%); and diagnosis of flu syndrome with institutional criteria for hospitalization on hospital admission, presenting respiratory rate greater than 24/min, saturation less than 93% while breathing room air, or risk factors for complications (eg, heart disease, diabetes, systemic arterial hypertension, neoplasms, immunosuppression, pulmonary tuberculosis, obesity) followed by COVID-19 confirmation. Patients were excluded if they were already admitted and receiving mechanical ventilation.
Double-blind.
Multicenter: 2 hospitals in Sao Paulo, Brazil.
The criteria used for patient discharge were no need for supplemental oxygen in the past 48 hours, no fever in the past 72 hours, and oxygen saturation greater than 93% without supplemental oxygen and without respiratory distress.
Vitamin D (n=50) vs. standard of care (n=26)
randomized controlled trial some concerns about risk of bias
Calcifediol
Day one: 0.532 mg of oral then 0.266 mg on day 3 and 7, and then weekly until discharge or ICU admission.
Standard care
Standard care only
All hospitalized patients received as best available therapy the same standard care, (per hospital protocol), of a combination of hydroxychloroquine (400 mg every 12 h on the first day, and 200 mg every 12 h for the following 5 days), azithromycin (500 mg orally for 5 days.)
COVID 19 hospitalized
open label
Single center: University hospital setting (Reina Sofia University Hospital), Cordoba, Spain.
Outcomes of effectiveness included rate of ICU admission and deaths. The list was accessible only to non-masked specialists in the study in an attempt to minimize observation bias.
hight dose vitamin D (n=130) vs. Vitamin D (n=130)
randomized controlled trial high risk of bias
high dose vitamin D3 (400,000 IU)
single oral high dose of cholecalciferol (vitamin D3) administered within 72 hours after the diagnosis of COVID-19
standard-dose vitamin D3 (50,000 IU)
COVID-19 mild to moderate
≥65 years, had SARS-CoV-2 infection of less than 3 days, and at least 1 COVID-19 worsening risk factor (among age ≥75 years, SpO2 ≤94%, or PaO2/FiO2 ≤300 mm Hg)
open-label
9 medical centers in France
ambiguous results table for mortality with 3 analysis methods without mention of the preplanned primary analysis. Whatever, the 14-days censured cox result is not robust given the others 14 days and 28 days results (in particular the 14-days death *rate* comparison, probable preplanned primary analysis according to the published protocol)
Vitamin D (n=16) vs. placebo (n=24)
randomized controlled trial risk of bias NA
Cholecalciferol high dose
Daily 60 000 IU of cholecalciferol (5 mL oral nano-liquid droplets) for 7 days with therapeutic target 25(OH)D>50 ng/ml.
Placebo.
Daily 5 ml distilled water for 7 days.
All the participants received standard care for the SARS-CoV-2 infection and pre-existing co-morbidities as per institute protocol.
COVID-19 mild to moderate
Patients requiring invasive ventilation or with significant comorbidities were excluded.
Double-blind.
1 center, tertiary care hospital in north India.
Vitamin D (n=274) vs. control (n=269)
randomized controlled trial high risk of bias
oral bolus of cholecalciferol (100,000 IU) administered at hospital admission
No vitamin D
COVID-19 severe or critically
open-label
multicentre, international
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