Jaun Fabienne, Boesing Maria, Luethi-Corridori Giorgia, Abig Kristin, Bloch Nando, Giezendanner Stéphanie, Grillmayr Victoria, Haas Philippe, Leuppi-Taegtmeyer Anne B, Muser Jürgen, Raess Andrea, Schuetz Philipp, Brändle Michael, Leuppi Jörg D
University Center of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland.
Medical Faculty, University of Basel, 4001 Basel, Switzerland.
Biomedicines. 2023 Apr 25;11(5):1277. doi: 10.3390/biomedicines11051277.
Vitamin D and its role in the coronavirus-19 disease (COVID-19) pandemic has been controversially discussed, with inconclusive evidence about vitamin D3 (cholecalciferol) supplementation in COVID-19 patients. Vitamin D metabolites play an important role in the initiation of the immune response and can be an easily modifiable risk factor in 25-hydroxyvitamin D (25(OH)D)-deficient patients. This is a multicenter, randomized, placebo-controlled double-blind trial to compare the effect of a single high dose of vitamin D followed by treatment as usual (TAU) of daily vitamin D daily until discharge versus placebo plus TAU in hospitalized patients with COVID-19 and 25(OH)D-deficiency on length hospital stay. We included 40 patients per group and did not observe a significant difference in the median length of hospital stay (6 days in both groups, = 0.920). We adjusted the length of stay for COVID-19 risk factors (β = 0.44; 95% CI: -2.17-2.22), and center (β = 0.74; 95% CI: -1.25-2.73). The subgroup analysis in patients with severe 25(OH)D-deficiency (<25 nmol/L) showed a non-significant reduction in the median length of hospital stay in the intervention group (5.5 vs. 9 days, = 0.299). The competing risk model with death did not reveal significant differences between the group in the length of stay (HR = 0.96, 95% CI 0.62-1.48, = 0.850). Serum 25(OH)D level increased significantly in the intervention group (mean change in nmol/L; intervention: +26.35 vs. control: -2.73, < 0.001). The intervention with 140,000 IU vitamin D + TAU did not significantly shorten the length of hospital stay but was effective and safe for the elevation of serum 25(OH)D levels.
维生素D及其在冠状病毒病2019（COVID-19）大流行中的作用一直存在争议，关于COVID-19患者补充维生素D3（胆钙化醇）的证据尚无定论。维生素D代谢产物在免疫反应的启动中起重要作用，并且对于25-羟基维生素D（25(OH)D）缺乏的患者而言，它可能是一个易于改变的风险因素。这是一项多中心、随机、安慰剂对照的双盲试验，旨在比较单剂量高剂量维生素D继以每日常规治疗（TAU）直至出院与安慰剂加TAU对COVID-19合并25(OH)D缺乏的住院患者住院时间的影响。我们每组纳入40例患者，未观察到住院时间中位数有显著差异（两组均为6天，P = 0.920）。我们对COVID-19风险因素（β = 0.44；95%置信区间：-2.17至2.22）和中心（β = 0.74；95%置信区间：-1.25至2.73）进行了住院时间调整。对严重25(OH)D缺乏（<25 nmol/L）患者的亚组分析显示，干预组住院时间中位数有非显著性缩短（5.5天对9天，P = 0.299）。纳入死亡因素的竞争风险模型未显示两组在住院时间上有显著差异（风险比 = 0.96，95%置信区间0.62至1.48，P = 0.850）。干预组血清25(OH)D水平显著升高（以nmol/L为单位的平均变化；干预组：+26.35对对照组：-2.73，P < 0.001）。140,000 IU维生素D加TAU的干预措施未显著缩短住院时间，但对提高血清25(OH)D水平有效且安全。
