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Association of Calcitriol Supplementation with Reduced COVID-19 Mortality in Patients with Chronic Kidney Disease: A Population-based Study

Oristrell et al., Biomedicines, doi:10.3390/biomedicines9050509 (date from preprint)

Apr 2021

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Vitamin D for COVID-19

8th treatment shown to reduce risk in October 2020

^*, now known with p < 0.00000000001 from 120 studies, recognized in 8 countries.

Lower risk for mortality, ICU admission, hospitalization, progression, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine complementary and synergistic treatments. ^* >10% efficacy in meta analysis with ≥3 clinical studies.

4,000+ studies for 60+ treatments. c19early.org

Retrospective study of calcitriol supplementation with chronic kidney disease patients in Catalonia showing lower cases, severe cases, and mortality with supplementation. A dose-response relationship was found for severe cases and mortality.

This is the 29th of 120 COVID-19 controlled studies for vitamin D, which collectively show efficacy with p<0.0000000001 (1 in 226 sextillion).

29 studies are RCTs, which show efficacy with p=0.0000035.

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risk of death, 43.0% lower, HR 0.57, p = 0.001, treatment 2,296, control 3,407, multivariate, patients with CKD stages 4-5.

risk of severe case, 43.0% lower, HR 0.57, p < 0.001, treatment 2,296, control 3,407, multivariate, patients with CKD stages 4-5.

risk of case, 22.0% lower, HR 0.78, p = 0.01, treatment 163 of 2,296 (7.1%), control 326 of 3,407 (9.6%), NNT 40, multivariate, patients with CKD stages 4-5.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Oristrell et al., 6 Apr 2021, retrospective, Spain, peer-reviewed, 10 authors, dosage calcitriol 0.3μg daily, mean daily dose.

This Paper Vitamin D All

Association of Calcitriol Supplementation with Reduced COVID-19 Mortality in Patients with Chronic Kidney Disease: A Population-Based Study

Joaquim Oristrell, Joan Carles Oliva, Isaac Subirana, Enrique Casado, Didier Domínguez, Andrea Toloba, Patricia Aguilera, Joan Esplugues, Pilar Fafián, Maria Grau

Biomedicines, doi:10.3390/biomedicines9050509

Treatment with calcitriol, the hormonal form of vitamin D, has shown beneficial effects in experimental models of acute lung injury. In this study, we aimed to analyze the associations between calcitriol supplementation and the risk of SARS-CoV2 infection or COVID-19 mortality. Individuals ≥18 years old living in Catalonia and supplemented with calcitriol from April 2019 to February 2020 were compared with propensity score matched controls. Outcome variables were SARS-CoV2 infection, severe COVID-19 and COVID-19 mortality. Associations between calcitriol supplementation and outcome variables were analyzed using multivariable Cox proportional regression. A total of 8076 patients were identified as being on calcitriol treatment. Advanced chronic kidney disease and hypoparathyroidism were the most frequent reasons for calcitriol supplementation in our population. Calcitriol use was associated with reduced risk of SARS-CoV2 infection (HR 0.78 [CI 95% 0.64-0.94], p = 0.010), reduced risk of severe COVID-19 and reduced COVID-19 mortality (HR 0.57 (CI 95% 0.41-0.80), p = 0.001) in patients with advanced chronic kidney disease. In addition, an inverse association between mean daily calcitriol dose and COVID-19 severity or mortality was observed in treated patients, independently of renal function. Our findings point out that patients with advanced chronic kidney disease could benefit from calcitriol supplementation during the COVID-19 pandemic.

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