The results of a new clinical study suggest that vitamin D supplements do not help people hospitalized with moderate to severe covid-19. Elsewhere, a controversial and preliminary paper that suggested that vitamin D was beneficial was now being pulled by the Lancet because of “concerns” about research design.
Vitamin D has emerged as a new covid-19 panacea for some on social media, replacing past favorites such as hydroxychloroquine. There are a lot of evidence that many people could use more vitamin D daily in their lives, especially in the winter. A deficiency of this vitamin, which can be taken as a supplement or synthesized in the skin in bright sunlight, can certainly affect the overall health of people. But the evidence that vitamin D plays a major factor in the severity of covid-19 or that supplementing it could help treat ongoing cases is much less solid.
At the end of January, a study freed on the SSRN prepress server – run by Lancet magazine – that image seemed to change. The authors said they found that calcifediol (a byproduct of vitamin D) reduced the risk of mortality in covid-19 patients hospitalized in Spain by a whopping 60% compared to people receiving standard care. For comparison, the drug for arthritis was tocilizumab recently found to reduce mortality in patients with severe covid-19 by 4% in a large UK study – modest results that are promising enough to enshrine it probably as standard treatment alongside steroids for critical cases.
But it wasn’t long before outside scientists It started to raise issues with those results. For example, the design of the study was described by both a randomized study and an observational study by authors at different points in the paper – two very different things. Randomized trials, in which some people are randomly assigned to receive treatment, are considered the gold standard of clinical evidence because they can better confirm that a drug has a real, beneficial effect on a disease. Observational studies, in which scientists simply observe differences between groups of people receiving different care, are important in medicine, but their conclusions are generally viewed with more caution because it is more difficult to know whether a particular treatment has actually caused the effect. Other criticisms of the paper included the lack of relevant patient data (such as some patients’ initial vitamin D levels), as well as potential statistical defects. And, of course, the findings would still be preliminary, no matter what, they have not yet gone through the peer review process.
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Friday, Lancet removed the paper on his prepress server, citing “concerns about the description of the research in this paper.” He also announced that he would launch an investigation into the study.
Meanwhile, the results of what appears to be a genuine randomized study of vitamin D for covid-19 have been published Wednesday in the Journal of the American Medical Association – the largest study of its kind to date. Researchers in Brazil said they randomized 240 people with moderate to severe covid-19 to hospital to receive a single high dose of vitamin D (200,000 IU compared to a daily dose of 600-800 IU recommended for an average adult) or a placebo.
However, they found no difference in length of hospital stay between people who took vitamin D and those who did not. There was also no difference in mortality rate or other important values, such as the likelihood that someone would need invasive ventilation. And while the treatment seemed safe, one patient had an episode of vomiting probably related to it.
The findings do not support the use of a high dose of vitamin D3 for the treatment of moderate to severe COVID-19, the authors wrote.
The JAMA study is still one process and nothing should be decided in medicine based on a single study. And again, too many people don’t get as much vitamin D as they need anyway, so there’s nothing wrong with checking your levels with a doctor. But the pandemic has seen countless others potential treatments come and go with little effectiveness to show for it.
In general, it is difficult to test the specific effect of vitamin D intake on any condition, as it is often an indicator of other things. Someone with high levels of vitamin D could also be someone who exercises often, for example, and it could be exercise or general health that really provides a protective boost.
If vitamin D has a benefit for covid-19, it is likely to be modest at best. And the lack of enthusiasm for it The treatment is certainly not evidence of a major conspiracy in which doctors minimize vitamin D just to be able to charge more expensive drugs, as some have suggested. After all, the most successful and life-saving drug for covid-19 to date is dexamethasone, a generic steroid that can cost less than $ 10 per treatment.