DÄ internationalArchive22/2021Add Vitamin D Supplementation
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In view of the current pandemic situation, the very rapid but nonetheless thorough development of a guideline for inpatient treatment of patients with COVID-19 deserves praise (1). Although the “may be considered” treatment with remdesivir is no longer recommended by the World Health Organization, the recommendations should urgently be extended to include vitamin D supplementation. Recent results from a clinical-epidemiological study from Germany (2), a quasi-experimental study from France (3), and a randomized trial from Spain (4) showed consistently that patients with COVID-19 who have untreated vitamin D deficiency or insufficiency (who in this patient population are the rule, rather than the exception) have consistently been shown to be at more than 10 times the risk for a severe or fatal disease course than patients with a satisfactory vitamin D status or sufficient supplementation. Although the results of large randomized intervention trials are not yet available, in view of these data and the safety of vitamin D supplementation that has been established for several decades, this should no longer be withheld from COVID-19 patients. In the best case scenario, in Germany alone this could help prevent thousands of severe COVID-19 courses and deaths as well as overloaded intensive care departments, at minimal expense. In the worst case scenario, if the expectation of a massive reduction in severe COVID-19 courses is, against all expectation, not confirmed by the ongoing randomized trials, patients can still benefit from other positive effects of vitamin D supplementation that have been confirmed by randomized trials. On the background of a high prevalence of vitamin D deficiency and insufficiency in the groups at risk for severe COVID-19 courses, vitamin D supplementation for these risk groups is urgently advised, before they require inpatient treatment.

DOI: 10.3238/arztebl.m2021.0180

Prof. Dr. med. Hermann Brenner

Abteilung Klinische Epidemiologie und Alternsforschung

Deutsches Krebsforschungszentrum (DKFZ)

Heidelberg

h.brenner@Dkfz-Heidelberg.de

Conflict of interest statement

The author declares that no conflict of interest exists.

1.
Kluge S, Janssens U, Spinner CD, Pfeifer M, Marx G, Karagiannidis C: Clinical practice guideline: recommendations on in-hospital treatment of patients with COVID-19. Dtsch Arztebl Int 2021; 118: 1–7 VOLLTEXT
2.
Radujkovic A, Hippchen T, Tiwari-Heckler S, Dreher S, Boxberger M, Merle U: Vitamin D deficiency and outcome of COVID-19 patients. Nutrients 2020; 12: 2757 CrossRef MEDLINE PubMed Central
3.
Annweiler G, Corvaisier M, Gautier J, et al.: Vitamin D supplementation associated to better survival in hospitalized frail elderly COVID-19 patients: the GERIA-COVID quasi-experimental study. Nutrients 2020; 12: E3377 CrossRef MEDLINE PubMed Central
4.
Entrenas Castillo M, Entrenas Costa LM, Vaquero Barrios JM, et al.: Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: a pilot randomized clinical study. J Steroid Biochem Mol Biol 2020; 203: 105751 CrossRef MEDLINE PubMed Central
1.Kluge S, Janssens U, Spinner CD, Pfeifer M, Marx G, Karagiannidis C: Clinical practice guideline: recommendations on in-hospital treatment of patients with COVID-19. Dtsch Arztebl Int 2021; 118: 1–7 VOLLTEXT
2.Radujkovic A, Hippchen T, Tiwari-Heckler S, Dreher S, Boxberger M, Merle U: Vitamin D deficiency and outcome of COVID-19 patients. Nutrients 2020; 12: 2757 CrossRef MEDLINE PubMed Central
3.Annweiler G, Corvaisier M, Gautier J, et al.: Vitamin D supplementation associated to better survival in hospitalized frail elderly COVID-19 patients: the GERIA-COVID quasi-experimental study. Nutrients 2020; 12: E3377 CrossRef MEDLINE PubMed Central
4.Entrenas Castillo M, Entrenas Costa LM, Vaquero Barrios JM, et al.: Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: a pilot randomized clinical study. J Steroid Biochem Mol Biol 2020; 203: 105751 CrossRef MEDLINE PubMed Central

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