The results of a new clinical trial suggest that vitamin D supplements do not help people hospitalized with moderate to severe covid-19. Elsewhere, a controversial and preliminary article that suggested that vitamin D does provide a benefit has now been pulled by the Lancet due to ‘concerns’ about the research design.
Vitamin D has become for some on social media a new miracle cure of covid-19, which has supplanted the favorites of the past such as hydroxychloroquine. There are a lot of testimony that many people can use more vitamin D daily, especially during the winter. A deficiency of this vitamin, which can be taken as a supplement or synthesized in strong sunlight in the skin, can definitely affect people’s overall health. But the evidence that vitamin D plays an important factor in the severity of covid-19, or that its supplementation can help treat persistent cases, is much less solid.
At the end of January, a study released on the preprint server SSRN – which is run by The Lancet magazine – apparently changed that picture. The authors claim that they found that calcipediol (a by-product 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 arthritis remedy was tocilizumab recently found to reduce the mortality rate in severe covid-19 patients by 4% in a large UK trial – modest results that are promising enough to probably establish it as a standard treatment alongside steroids for critical cases.
But it does not take long outside scientists start on issues raised with the results. The design of the study, for example, was described as a random and an observational study by the 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 the 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 is causing the effect. Other criticisms of the article include missing data on patients (such as some patients’ baseline vitamin levels), as well as possible statistical deficiencies. And of course, the findings, no matter what, will still be preliminary, as the peer review process has not yet gone through.
G / O Media can get a commission
On Friday is the Lancet remove the paper of the preprint server, with reference to ‘concerns about the description of the research in this article’. It also announced that it would launch an investigation into the study.
Meanwhile, the results of a true, randomized trial on vitamin D for covid-19 were 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 in the hospital to receive a single large dose of vitamin D (200,000 IU, compared to the daily dose of 600-800 IU). recommended for the average adult) or a placebo.
According to everyone, they found no difference in the duration of hospital stay between people who use vitamin D and those who do not. There was also no difference in mortality or other important measures, such as the likelihood that someone would need invasive ventilation. And although the treatment seemed safe, one patient did have an episode of vomiting that was probably linked 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 just one experiment, and nothing should be decided in medicine based on a single study. And again, these would mean that you have to spend for these processes and have no choice but to seek medical advice. But the pandemic has seen many 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 indication of other things. For example, someone with high vitamin D levels may be someone who exercises regularly outside, and it may be the exercise or their overall health that gives a protective boost.
If vitamin D does have a benefit for covid-19, it will probably be modest at best. And the lack of enthusiasm about this treatment is certainly not evidence of a major conspiracy in which doctors are lowering vitamin D just so they can charge for more expensive drugs, as some have suggested. The most successful and life-saving drug for covid-19 so far is dexamethasone, a generic steroid that can cost less than $ 10 per treatment.