Treatment With 25-Hydroxyvitamin D3 (Calcifediol) Is Associated With a Reduction in the Blood Neutrophil-to-Lymphocyte Ratio Marker of Disease Severity in Hospitalized Patients With COVID-19: A Pilot Multicenter, Randomized, Placebo-Controlled, Double-Blinded Clinical Trial.

Oct 15, 2021Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

Taking 25-Hydroxyvitamin D3 (Calcifediol) may lower the blood neutrophil-to-lymphocyte ratio, which indicates less severe disease in hospitalized COVID-19 patients.

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Abstract

76.4% of patients receiving oral 25-hydroxyvitamin D achieved sufficient vitamin D levels within 30 days.

In a clinical trial with 106 hospitalized patients, the treatment group showed a significant improvement in vitamin D status compared to the placebo group.
At 60 days, 100% of patients receiving 25-hydroxyvitamin D had sufficient circulating levels, while only ≤12.5% in the placebo group did.
Treatment with 25-hydroxyvitamin D was linked to an increase in lymphocyte percentage and a decrease in the neutrophil-to-lymphocyte ratio.
A lower neutrophil-to-lymphocyte ratio was associated with fewer intensive care unit admission days and reduced mortality.
The findings suggest that oral 25-hydroxyvitamin D may enhance immune function in vitamin D-deficient patients with COVID-19.

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OBJECTIVE: The goal of this randomized, double-blinded, placebo-controlled clinical trial was to investigate the therapeutic efficacy of oral 25-hydroxyvitamin D(25(OH)D) in improving vitamin D status in vitamin D-deficient/vitamin D-insufficient patients infected with the SARS-CoV-2 (COVID-19) virus. 3 3

METHODS: This is a multicenter, randomized, double-blinded, placebo-controlled clinical trial. Participants were recruited from 3 hospitals that are affiliated to [Institution Blinded for Review] and [Institution Blinded for Review].

RESULTS: A total 106 hospitalized patients who had a circulating 25(OH)Dconcentration of <30 ng/mL were enrolled in this study. Within 30 and 60 days, 76.4% (26 of 34) and 100% (24 of 24) of the patients who received 25(OH)Dhad a sufficient circulating 25(OH)Dconcentration, whereas ≤12.5% of the patients in the placebo group had a sufficient circulating 25(OH)Dconcentration during the 2-month follow-up. We observed an overall lower trend for hospitalization, intensive care unit duration, need for ventilator assistance, and mortality in the 25(OH)Dgroup compared with that in the placebo group, but differences were not statistically significant. Treatment with oral 25(OH)Dwas associated with a significant increase in the lymphocyte percentage and decrease in the neutrophil-to-lymphocyte ratio in the patients. The lower neutrophil-to-lymphocyte ratio was significantly associated with reduced intensive care unit admission days and mortality. 3 3 3 3 3 3

CONCLUSION: Our analysis indicated that oral 25(OH)Dwas able to correct vitamin D deficiency/insufficiency in patients with COVID-19 that resulted in improved immune function by increasing blood lymphocyte percentage. Randomized controlled trials with a larger sample size and higher dose of 25(OH)Dmay be needed to confirm the potential effect of 25(OH)Don reducing clinical outcomes in patients with COVID-19. 3 3 3

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Treatment With 25-Hydroxyvitamin D3 (Calcifediol) Is Associated With a Reduction in the Blood Neutrophil-to-Lymphocyte Ratio Marker of Disease Severity in Hospitalized Patients With COVID-19: A Pilot Multicenter, Randomized, Placebo-Controlled, Double-Blinded Clinical Trial.

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