A well-established association that Vitamin D deficiency and COVID 19 infection susceptibility, severity and mortality stems from several observational studies (Jain, 2020) (Grant, 2020) (De Smet, 2020) (Merzon, 2020). Vitamin D has multi spectrum action against COVID 19, most importantly by reducing dysregulated production of self-damaging pro-inflammatory cytokines and promoting the expression of anti-inflammatory cytokines by immune cells (Gombart, 2020).
However, role of Vitamin D in various viral infections including has been explored including COVID 19, but the exact dosing still remains a question yet to be explored. We review evidences, which talk about the HIGH DOSE SUPPLEMENTATION THERAPY.
What is high dose supplementation therapy?
High dose vitamin D supplementation therapy is a targeted approach to increase the serum vitamin D level by using high dose (60,000 IUs) oral supplementation of vitamin D daily for a specific period determined by the individual’s BMI, initial level of vitamin D and the formulation (Lakkireddy, 2019).
Evidences:
SHADE STUDY (Rastogi A, 2020)
Participants were randomized to receive daily 60 000 IU of cholecalciferol (oral Nano-liquid droplets) for 7 days with therapeutic target 25(OH) D >50 ng/ml (intervention group) or placebo (control group). Greater proportion of vitamin D-deficient individuals with SARS-CoV-2 infection turned SARS-CoV-2 RNA negative with a significant decrease in fibrinogen on high-dose cholecalciferol supplementation.
IMPACT OF DAILY HIGH DOSE ORAL VITAMIN D THERAPY ON THE INFLAMMATORY MARKERS IN PATIENTS WITH COVID 19 DISEASE (Lakkireddy M. G., 2021)
87 patients of COVID 19 with hypovitaminosis D completed this study. In the treatment group, patients received High dose supplementation vitamin D therapy (targeted daily supplementation of 60,000 IUs of vitamin D for 8 or 10 days depending upon their BMI) in addition to the standard treatment. The other group received standard treatment alone. Daily cholecalciferol supplementation of 60,000 IU helps in achieving 25(OH)D>50 ng/ml in 75% of participants by day-14.Therapeutic, high-dose cholecalciferol supplementation led to SARS-CoV-2 RNA negative in additional 41.7% participants (p<0.001) and was useful for viral SARS-CoV-2 RNA clearance.
To conclude Vitamin D High dose supplementation therapy is being proposed to be effective and safe in COVID 19 patients and can be added as an adjuvant in current treatment protocols for COVID 19.
Please always ensure to check with your Doctor / Healthcare / Family Physician before starting with any new medication or therapy.
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References
- De Smet, D. D. (2020). Serum 25(OH)D level on hospital admission associated with COVID-19 stage and mortality. American Journal of Clinical Pathology .
- Gombart, A. F. (2020). A Review of micronutrients and the immune system-working in harmony to reduce the risk of infection. Nutrients , 12(1), 236.
- Grant, W. B. (2020). Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients, 12(4), 988.
- Jain, A. (2020). Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers. Sci. Rep, 10(1), 20191.
- Lakkireddy, M. (2019). Efficiency of vitamin D supplementation in patients with mechanical low back ache. J. Clin. Orthop. Trauma, 10(6), 1101–1110.
- Lakkireddy, M. G. (2021). Impact of daily high dose oral vitamin D therapy on the inflammatory markers in patients with COVID 19 disease. Sci Rep, 11, 10641.
- Merzon, E. (2020). Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: An Israeli population-based study. FEBS J , 287(17), 3693–3702.
- Rastogi A, B. A. (2020). Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study). Postgraduate Medical Journal , published Online First: 12 November 2020. doi: 10.1136/postgradmedj-2020-139065.