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The First Randomized Controlled Trial on Vitamin D and Covid-19

552 点作者 wavepruner超过 4 年前

39 条评论

maxander超过 4 年前
From the results:<p>“Of 50 patients treated with calcifediol, one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50%) p value X2 Fischer test p &lt; 0.001.”<p>Which sounds like as strong a signal as a study of this scale could hope to show.
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asah超过 4 年前
Non-white skinned people: sunlight may not be enough to increase your vitamin D.<p><a href="https:&#x2F;&#x2F;www.google.com&#x2F;search?q=dark+skin+vitamin+d+minutes" rel="nofollow">https:&#x2F;&#x2F;www.google.com&#x2F;search?q=dark+skin+vitamin+d+minutes</a>
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dilippkumar超过 4 年前
Previously on HN, a physician shared some thoughts on treating Vitamin D as a medication and not as a dietary supplement:<p>Part 1: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=24138590" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=24138590</a><p>Part 2: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=24261948" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=24261948</a><p>To summarize - popping in large doses of Vitamin D is not exactly safe.
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lrem超过 4 年前
Can someone tell what is the equivalent dose of said calcifedol in regular D3? The article claims 0.532 mg have been used, which seems too large. From [1] I gather it&#x27;s about 3x more potent, meaning we are talking about equivalent of 1.596mg of D3. Or, 10000% of RDA according to [2]. Is that right?<p>[1]: <a href="https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC5460735&#x2F;" rel="nofollow">https:&#x2F;&#x2F;www.ncbi.nlm.nih.gov&#x2F;pmc&#x2F;articles&#x2F;PMC5460735&#x2F;</a> [2]: <a href="https:&#x2F;&#x2F;ods.od.nih.gov&#x2F;factsheets&#x2F;VitaminD-HealthProfessional&#x2F;" rel="nofollow">https:&#x2F;&#x2F;ods.od.nih.gov&#x2F;factsheets&#x2F;VitaminD-HealthProfessiona...</a>
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sradman超过 4 年前
&gt; Serum 25OHD concentrations at baseline or during treatment are not available.<p>This is mind boggling. These 76 patients had extensive blood work done so why did the study design not include serum concentration testing before and after treatment?
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gshotwell超过 4 年前
This follows quite a lot of observational evidence. There are currently 11 studies that have found an association between serum vitamin D and Covid severity. These are listed here:<p><a href="https:&#x2F;&#x2F;github.com&#x2F;GShotwell&#x2F;vitamin_d_covid" rel="nofollow">https:&#x2F;&#x2F;github.com&#x2F;GShotwell&#x2F;vitamin_d_covid</a>
bdamm超过 4 年前
Noteworthy that this is in combination with anti-viral drugs at hospital admission: hydroxychloroquine (400 mg every 12 hours on the first day, and 200 mg every 12 hours for the following 5 days), azithromycin (500 mg orally for 5 days). Regardless, I&#x27;m going to assume this means being outside and getting sun is good for me.
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natcombs超过 4 年前
&gt; parallel pilot randomized open label, double-masked clinical trial.<p>Dumb questions: What is a parallel pilot | what is open label? And Is double-masked the same as double-blind?
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jonplackett超过 4 年前
Surly now it&#x27;s time to just start giving everyone some free vitamin D.<p>Best case scenario: Less dead people.<p>Worst case scenario: We all have healthier bones.
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stjohnswarts超过 4 年前
Very small scale but sounds promising. I&#x27;ve been taking 2000UI&#x2F;day for few years now since my doc found my vitamin D was pretty low, it&#x27;s now far up in the normal range now. I didn&#x27;t let him give me the massive doses that they want to give you for low vitamin D, and opted for just starting to take the supplement, when I went back in 3 months later everything was in the normal range. I don&#x27;t actually get much sunlight as a den dwelling programmer so it&#x27;s the next best thing.
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woeirua超过 4 年前
Looks promising, but I would want to see a true double blinded RCT on a few thousand people before we say that Vitamin D is an effective treatment.<p>Also, there&#x27;s going to be a confounding question based on this study: is it just Vitamin D, or is it Vitamin D in combination with HCQ &#x2F; Azithromyacin?<p>That said, it probably wouldn&#x27;t hurt you to supplement with Vitamin D this winter, even if it doesn&#x27;t treat Covid.
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ReflectedImage超过 4 年前
And that&#x27;s why I&#x27;ve been taking Vitamin D pills for the past 6 months. (It&#x27;s been suspected for some time to have an effect)<p>This doesn&#x27;t mean go outside and get covid.
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ptest1超过 4 年前
The problem I see with this trial is that it’s open-label, small n, and has subjective endpoints (ICU admission as the primary outcome). The study is underpowered to detect mortality. Given the open-label nature of the trial, the subjective outcome with the small n makes this result less strong.<p>Why is this the case? Well, for this trial the physicians treating patients knew who got the Vitamin D and who didn’t, and thus they may have been more likely to admit those who didn’t to the ICU (subjective). Something like mortality is not as subjective, but there are too few study participants to detect a mortality signal in this trial.<p>If I had been conducting this small open label trial I would have picked some less subjective outcomes, like maybe P&#x2F;F Ratio.
autokad超过 4 年前
when i was doing the covid19 kaggle competitions in march and april, someone asked me what I learned.<p>I was like I dont know, the data is messy but the sun seems to have something to do with reducing fatalities. (I used weather data as additional covariates)
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IAmNotBatman_超过 4 年前
Yeah we wear too much sunscreen, a significant number of people are vitamin D deficient. From the UltraMind Solution book, you need the active form cholecalciferol in your supplements. You can safely take 5000-10000 IU a day for 3 months to get up to the optimal levels, then 2000 IU a day for maintenance. The Ideal range is 50 to 80 ng&#x2F;ml in your blood tests. Also just minimal outdoor sun exposure is the best way to get it, no sunscreen. 15 minutes if you&#x27;re light skinned, 35 if you&#x27;re really dark.
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jamesfisher超过 4 年前
&gt; open label, double-masked clinical trial<p>Aren&#x27;t &quot;open label&quot; and &quot;double-masked&quot; contradictory?<p>&quot;An open-label trial, or open trial, is a type of clinical trial in which information is not withheld from trial participants. In particular, both the researchers and participants know which treatment is being administered.&quot; (Wikipedia)<p>&quot;Double-Masked Study. A type of clinical trial in which neither the participants nor the research team know which treatment a specific participant is receiving.&quot; (NIH)
Emphere超过 4 年前
This is not a strong signal. The adjusted odds ratio is 0.03 (95% CI: 0.003 - 0.25). For randomised trials, it makes no sense to say that the difference in baseline is not significant because we have already observed the outcomes. It is better to use ASDs and in such small trials, small differences in baseline matter a lot. In this case it&#x27;s pretty obvious the effect of vitamin D would easily be non significant if you shift around some variables. Reeks of p hacking imo
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amai超过 4 年前
Dai (2018): Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial <a href="https:&#x2F;&#x2F;pubmed.ncbi.nlm.nih.gov&#x2F;30541089&#x2F;" rel="nofollow">https:&#x2F;&#x2F;pubmed.ncbi.nlm.nih.gov&#x2F;30541089&#x2F;</a><p>&quot;Our findings suggest that optimal magnesium status may be important for optimizing 25(OH)D status. &quot;
mikenew超过 4 年前
There&#x27;s a handful of blood-test-by-mail sites you can use to do a vitamin D test. Cost is around $50.
epmaybe超过 4 年前
You know, at this point, I&#x27;m basically over debating the merits of vitamin d. Take it, don&#x27;t take it, I don&#x27;t really care, just please tell your doctor you&#x27;re taking it.<p>To pharmaceutical companies or supplement companies, or the NIH: fund a well powered study, pretty please?
gumby超过 4 年前
This seems pretty promising, though small n, result. Vitamin D is so ably we’ll well attested as a prophylaxis for pulmonary infections — in fact there was a large UK study published in January on this very facto.<p>Starting in February I went on a prophylactic supplement of Vit D, Vit C and aspirin because of the then-unnamed Covid-19 virus. The aspirin (actually started that in april) is because of the pervasive excess clotting and sudden strokes in young people showing up in ERs (less attested in the US than some other countries for reasons I’m not sure about). I’d never taken supplements before.<p>I’m immuno compromised so with my doctor we worked out the regime above plus some prescription drugs I won’t mention.<p>So far, so good, but I’m isolating&#x27; so this could be a case where I’m also preventing tiger attacks.
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koboll超过 4 年前
Can anyone here help demystify how &quot;oral calcifediol (0.532 mg)&quot; maps to an equivalent amount of Vitamin D in the form you can buy in a drugstore?
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longtimegoogler超过 4 年前
As someone with low vitamin D this kinda sucks. Does anyone know how effective OTC vitamin D is at raising vitamin D levels and what kind of doses to take?
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meiraleal超过 4 年前
Meat (vitamin B) and sun (vitamin D) are the bane of COVID. We definitely have not been fighting this pandemic with the right tools.
BiteCode_dev超过 4 年前
It this gets confirmed, we&#x27;ll have a dilemna: confined people will become deficient in D vitamin by lack of sun exposure.
mucinoab超过 4 年前
Anyone knows what rol sunscreen plays in vitamin D intake&#x2F;generation by sunlight?
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ilaksh超过 4 年前
In the future we may decide on windows that permit some UV B.
akimball超过 4 年前
(db)RCTs are good. Fetishizing them is bad.
afrojack123超过 4 年前
Every year they issue a winter influenza vaccine instead of making vitamin D pills and artificial sunlight available. Young people never take the winter flu vaccine and are fine.
fithisux超过 4 年前
GPT-3 ?
tus88超过 4 年前
Vaccine or bust.
MivLives超过 4 年前
Is there a trustable authority that measures the actual contents of supplements in the US? When I try to search it, it&#x27;s pretty heavily SEO&#x27;d.
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scott_paul超过 4 年前
Anyone else notice that Calcifediol is the most expensive vitamin-D analogue on the market? What a huge surprise that the study chose that form of vitamin-D specifically.
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sagebird超过 4 年前
It would be tragic if taking vitamin D supplements had a negative effect on Covid survivability.<p>I think that it is extremely unlikely, though possible unless a specific study has ruled this out.<p>EG: Perhaps vitamin D supplementation upon Covid-19 diagnoses is only effective if you have not been supplimenting.<p>Like: Maybe drinking alcohol at a party is helpful to court a new partner, unless you are an alcoholic already. Not the best analogy but I hope you&#x27;ll take my point in good faith.
robertofmoria超过 4 年前
This test really doesn&#x27;t hold a lot of useful data. It doesn&#x27;t calculate any of the statistics of those that died which is kinda of important when age and previous health conditions are important. It doesn&#x27;t gather BMI, physical activity levels, ethnicity, secondary&#x2F;multiple infections, cause of death, type 1 or 2 diabetes, etc. Medical trials are hard because of all the variables. I think it actually works against this trial having it randomized especially when there is no placebo group.
tboyd47超过 4 年前
Good on you, Spain. A study like this could never take place in the USA :(<p>Too many powerful people are heavily invested in the belief that there is no treatment for it.
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nautilus12超过 4 年前
&quot;Don&#x27;t go outside, you&#x27;ll get COVID&quot;, sounds more and more like horrible advice. Before knowing the virus died in sunlight, I still couldn&#x27;t fathom why people were avoiding going out to parks and stuff. It was totally non sequitor.
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notadoc超过 4 年前
&gt;All hospitalized patients received as best available therapy the same standard care, (per hospital protocol), of a combination of hydroxychloroquine (400 mg every 12 hours on the first day, and 200 mg every 12 hours for the following 5 days), azithromycin (500 mg orally for 5 days.<p>Fascinating how hydroxychloroquine is routinely used and considered standard of care in most countries where the drug has not been politicized.
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doublekill超过 4 年前
Experts and health authorities were adament to tell us that vitamins have zero effect against COVID. Not: we don&#x27;t know and taking a Vitamin C can&#x27;t hurt, unless you count an upset stomach. But: stop sharing fake health information, this is an infodemic! Just wash your hands.<p>So to add to the infodemic: selenium and iodine deficiency also increases severity. Take some iodized salt and Brazil nuts now, or wait 5 months for the authorities to understand that absence of evidence is not evidence of absence. And no matter what Youtube bans you for going against the WHO: tumeric is an efficient antiviral.
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