Study: Vitamin D influences the immune status of COVID-19-patients

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<0.001). The serum levels of vitamin D increased significantly in the intervention group compared to the control group. CBC The number of white blood cells decreased in both groups, but the decline in the intervention group was lower than in the control group (p <0.05). CRP The CRP mirror decreased in both groups, but the decline in the intervention group was significantly stronger than in the control group (p <0.05). B-cell subgroups There were no significant differences in the B cell subgroups between the two groups. The results of this study indicate that the supplementation with 10,000 IE/day vitamin D3 in hospitalized COVID 19 patients to an increase in vitamin D levels in ...
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<0.001). The serum levels of vitamin D increased significantly in the intervention group compared to the control group.

cbc
The number of white blood cells decreased in both groups, but the decline in the intervention group was lower than in the control group (p <0.05).

crp
The CRP mirror decreased in both groups, but the decline in the intervention group was significantly stronger than in the control group (p <0.05).

B cell subgroups
No significant differences in the B cell subgroups between the two groups were found.

The results of this study indicate that the supplementation with 10,000 IE/day vitamin D3 in hospitalized Covid-19 patients leads to an increase in vitamin D levels in the serum and has positive effects on inflammatory markers such as CRP and white blood cells.

Details of the study:

reference

Karonova TL, Golovatyuk Ka, Kudryavtsev IV, et al. Effect of the Cholecalciferol Supplementation on the clinical features and inflammatory markers in hospitalized covid 19 patients: a randomized, open, monocentric study. nutrients . 2022; 14 (13): 2602.

study goal

In order to evaluate the effect of vitamin D 3 The nutritional supplement has an impact on clinical features and inflammatory markers in COVID-19-patients

Key to take away

Supplement with 10,000 IE/day vitamin D 3 In patients with vitamin D deficiency or deficiency, the number of C-reactive protein (CRP) and the white blood cells improved compared to the control persons.

design

randomized, monocentric, open study

participant

The study included 129 hospitalized patients in St. Petersburg, Russia, between the ages of 18 and 75 (49 % female, 51 % male), in which Covid-19 was diagnosed by polymerase chain reaction (PCR) and/or breast computer tomography.

The study excluded from the study were patients who were 1,000 IE vitamin D or more, those who were contraindicated to take vitamin D, and patients with an estimated glomerular filtration rate (EGFR) <40 ml/min/1.73 m gastrointestinal and liver diseases, granulomatous diseases, cancer (less than 5 Years), immune deficiency as well as drug or alcohol addiction.

intervention

Vitamin-D 3 10,000 IE/day for 9 days or no dietary supplement

study parameters

The investigators rated the following parameters:

  • Changes of the 25 (OH) D level in the serum
  • complete blood count (CBC)
  • C-reactive protein (CRP)
  • B cell subgroups on the 9 th day of hospital stay compared to the 1 st tag
  • severity of the disease
  • oxygen supplement
  • recording rate in the intensive care unit
  • clinical results
  • duration of the hospital stay

primary results

The researchers evaluated the following measurements:

  • Changes of the 25 (OH) D level in the serum
  • cbc
  • crp
  • B cell subgroups on the 9 th day of hospital stay compared to the 1 st tag

most important knowledge

changes in the 25 (OH) D level in the serum

On the 9th day, significantly fewer patients in the intervention group had a vitamin D deficiency ( p <0.01).

After 9 days of supplement with vitamin d 3 increased the middle 25 (oh) D level from 16.4 ng/ml to 22.8 ng/ml ( p <0.001). In contrast, the control group recorded an average decrease in its 25 (OH) D levels by 2.6 ng/ml (13.9 ng/ml to 10.6 ng/ml) or –18.2 %.

In addition, after supplementing the middle serum-25 (OH) D level in the treatment group compared to the control group was significantly higher: 22.8 ng/ml vs. 10.6 ng/ml ( p <0.001)

cbc

After 9-day vitamin D supplementation, the neutrophil and lymphocyte numbers were significantly higher compared to the controls.

The mean neutrophilic number in the intervention group was 8.6 x 10 9 /l compared to 6.4 x 10 9 /l in the control group ( p = 0.04).

The mean lymphocyte number in the intervention group was 1.8 x 10 9 /l compared to 1.58 x 10 9 /l in the control group ( p = 0.02).

The middle neutrophil-to-lymphocyte ratio (NLR), however, does not differ significantly between the two groups: 4.5 in the treatment group vs. 4.4 in the control group ( p = 0.71).

crp

After 9-day vitamin D supplementation, the CRP was significantly lower compared to the control persons ( p = 0.02). In addition, CRP was negatively associated with the CRP values ​​(R = –0.28, p = 0.02).

The middle CRP in the intervention group was 2 mg/l compared to 3 ng/ml in the control group ( p = 0.02).

B cell subgroups

on 9 Th Day of the hospital stay compared to the 1 st day:

  • The frequency of CD38 ++ CD27 transition cells was significantly lower in the treatment group compared to the control group (1.43 % or 2.74 %; p = 0.006).
  • The frequency of mature naive CD27-CD38+-B cells was significantly lower in the treatment group compared to the control group (57.57 % or 67.03 %; p = 0.02)
  • CD27-CD38 double gegative (DN) B cells were significantly higher in the treatment group compared to the control group (6.21 % vs. 4.19 %); p = 0.02)

sleeping days

In the intervention group there was a negative connection between Serum 25 (OH) D on 9 th day and the number of bed days (r = −0.23, p = 0.006); However, there were no significant differences between the groups with regard to the number of bed days or the percentage of the dismissed patients ( p = 0.87 and p = 0.93).

transparency

The other authors did not explain any conflict of interest; Bio-Tech Pharmacal, Inc (Fayetteville, AR), however, finances the Sunlight, Nutrition and Health Research Center, which employs co-author William A. Grant.

Effects and restrictions for practice

The pandemic (COVID-19), which was caused by the severe acute respiratory syndrome (SARS) in connection with the Coronavirus (Sars-Cov) and discovered in 2019

Studies have consistently shown an opposite connection between low vitamin D serum mirrors and the severity of Covid-19 and the mortality risk. 1 You also showed an inverse connection with the COVID 19-positive rates. In a large, retrospective observation analysis of 191,779 patients whose rehearsals were processed by Quest Diagnostics, each increase in serum-25 (OH) D was connected to 1 ng/ml with an uninfected ODDS ratio of 0.97 (95 %-KI: 0.977–0.980). For a positive Sars-Cov-2 PCR test result. The decline in the positive rate connected to Serum 25 (OH) D reached a plateau at 55 ng/ml.

While the current study showed an improvement in the laboratory markers, the absence of a significant improvement in the clinical results can be attributed to the fact that (1) an excessive dose was administered or (2) the wrong form of vitamin D was used.

The current study achieved a middle serum-25 (OH) D value of 22.8 ng/ml in the intervention group; However, this value can be too low to achieve clinical benefits.

In addition, taking vitamin D3 was associated with a 2.14-fold lower risk of death than taking without vitamin D3.

An earlier, prospective study resulted in vitamin d 3 to 95-hospitalized covid patients for up to 14 days. 3 All patients in the treatment group had to increase Serum-25 (0H) D levels of 30 ng/ml. The entire vitamin d 3 the quantities obtained during the treatment period fluctuated between 224,000 IE and 320,000 IE.

Compared to patients with a serum-25 (oh) d> 30 ng/ml, a serum-25 (oh) d <30 ng/ml was associated with a risk of 1.9 times higher to stay in the hospital for more than 8 days ( p = 0.02). In addition, was preserved with a 2.14-fold lower risk of death than if you did not get a vitamin D 3 ( p = 0.03, 95 %ki: 1.0585 to 4.3327).

The form of vitamin D can also be an important point of view. In acute hospital environments, research could finally confirm that the administration of calcifiediol (vitamin d 2 ) instead of cholecalciferol (vitamin d). 3 ) is superior. Vitamin-D 2 increases the Serum-25 (OH) D faster than vitamin d 3 . In a pharmacokinetic study with 35 healthy women between the ages of 50 and 70, the serum-25 (OH) d was 28 % higher st dose of vitamin d 2 compared to vitamin d 3 and 123 % higher after 15 weeks.

vitamin-D 2 was examined in a retrospective, multicenter cohort study of covid patients. Oral vitamin D 2 (532 µg) were administered during the hospital recording, then 266 µg on days 3 and 7, then 266 µg weekly until the intensive care unit. A total of 73 patients (average age 69 years, 53 % male) received vitamin d 2 . After 30 days, the risk of death for those who income was significantly smaller 2 (or 0.22 (95 % KI, 0.08–0,61), p <0.01) compared to patients who did not receive a vitamin D At some other time at some other time, this study available. Based on earlier studies, however, the authors speculate that the dose they administered was sufficient to raise the Serum-25 (OH) D level from 3 to over 30 to 40 ng/ml Rd Day of treatment.

Positive clinical results were supplemented by the addition of covid-19 patients with vitamin D (as d 2 or d 3 ). While it seems that a serum concentration over 30 ng/ml could be the threshold for achieving clinical results, the optimal form, the dosing scheme and the desired serum concentration for the best results are still unknown.

  1. Mercola J, Grant WB, Wagner Cl. Notes on vitamin D and the risk of a Covid 19 disease and its severity. nutrients . 2020; 12 (11): 3361.
  2. Kaufman HW, Niles JK, Kroll MH, BI C, Holick Mf. SARS-COV-2 positive rates related to circulating 25-hydroxyvitamin D mirrors. plus one . 2020; 15 (9): E0239252.
  3. treat MS, Alaylıoğlu M, Durcan e, et al. A quick and effective vitamin D supplementation can lead to better clinical results for Covid-19 (SARS-COV-2) patients by changing the serum-inos1, IL1B, IFNG, Cathelicidin-LL37 and ICAM1. nutrients . 2021; 13 (11): 4047.
  4. Jetter a, Egli a, Dawson-Hughes B, et al. Pharmacokinetics of oral vitamin D (3) and Calcifiediol. bones . 2014; 59: 14-19.
  5. Alcala-Diaz JF, Limia-Perez L, Gomez-Huelgas R, et al. Calcifiediol treatment and hospital mortality due to Covid-19: a cohort study. nutrients . 2021; 13 (6): 1760.