Add Vitamin D Supplementation
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.
Prof. Dr. med. Hermann Brenner
Abteilung Klinische Epidemiologie und Alternsforschung
Deutsches Krebsforschungszentrum (DKFZ)
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|