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Cannata-Andía JB, Díaz-Sottolano A, Fernández P, Palomo-Antequera C, Herrero-Puente P, Mouzo R, Carrillo-López N, Panizo S, Ibañez GH, Cusumano CA, Ballarino C, Sánchez-Polo V, Pefaur-Penna J, Maderuelo-Riesco I, Calviño-Varela J, Gómez MD, Gómez-Alonso C, Cunningham J, Naves-Díaz M, Douthat W, Fernández-Martín JL. A single-oral bolus of 100,000 IU of cholecalciferol at hospital admission did not improve outcomes in the COVID-19 disease: the COVID-VIT-D-a randomised multicentre international clinical trial. BMC Med 2022; 20:83. [PMID: 35177066 PMCID: PMC8853840 DOI: 10.1186/s12916-022-02290-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/09/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Vitamin D status has been implicated in COVID-19 disease. The objective of the COVID-VIT-D trial was to investigate if an oral bolus of cholecalciferol (100,000 IU) administered at hospital admission influences the outcomes of moderate-severe COVID-19 disease. In the same cohort, the association between baseline serum calcidiol levels with the same outcomes was also analysed. METHODS The COVID-VIT-D is a multicentre, international, randomised, open label, clinical trial conducted throughout 1 year. Patients older than 18 years with moderate-severe COVID-19 disease requiring hospitalisation were included. At admission, patients were randomised 1:1 to receive a single oral bolus of cholecalciferol (n=274) or nothing (n=269). Patients were followed from admission to discharge or death. Length of hospitalisation, admission to intensive care unit (ICU) and mortality were assessed. RESULTS In the randomised trial, comorbidities, biomarkers, symptoms and drugs used did not differ between groups. Median serum calcidiol in the cholecalciferol and control groups were 17.0 vs. 16.1 ng/mL at admission and 29.0 vs. 16.4 ng/mL at discharge, respectively. The median length of hospitalisation (10.0 [95%CI 9.0-10.5] vs. 9.5 [95%CI 9.0-10.5] days), admission to ICU (17.2% [95%CI 13.0-22.3] vs. 16.4% [95%CI 12.3-21.4]) and death rate (8.0% [95%CI 5.2-12.1] vs. 5.6% [95%CI 3.3-9.2]) did not differ between the cholecalciferol and control group. In the cohort analyses, the highest serum calcidiol category at admission (>25ng/mL) was associated with lower percentage of pulmonary involvement and better outcomes. CONCLUSIONS The randomised clinical trial showed the administration of an oral bolus of 100,000 IU of cholecalciferol at hospital admission did not improve the outcomes of the COVID-19 disease. A cohort analysis showed that serum calcidiol at hospital admission was associated with outcomes. TRIAL REGISTRATION COVID-VIT-D trial was authorised by the Spanish Agency for Medicines and Health products (AEMPS) and registered in European Union Drug Regulating Authorities Clinical Trials (EudraCT 2020-002274-28) and in ClinicalTrials.gov ( NCT04552951 ).
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Affiliation(s)
- Jorge B Cannata-Andía
- Hospital Universitario Central de Asturias (HUCA), Avda. Roma s/n., 33011, Oviedo, Spain. .,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. .,Universidad de Oviedo, Oviedo, Spain. .,Retic REDinREN-ISCIII, Madrid, Spain.
| | - Augusto Díaz-Sottolano
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Centro de Salud Roces Montevil, Gijón, Spain
| | - Pehuén Fernández
- Hospital Privado Universitario de Córdoba, Córdoba, Argentina.,Hospital Raúl Ángel Ferreyra, Córdoba, Argentina.,Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Córdoba, Argentina
| | - Carmen Palomo-Antequera
- Hospital Universitario Central de Asturias (HUCA), Avda. Roma s/n., 33011, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Universidad de Oviedo, Oviedo, Spain
| | - Pablo Herrero-Puente
- Hospital Universitario Central de Asturias (HUCA), Avda. Roma s/n., 33011, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Universidad de Oviedo, Oviedo, Spain
| | | | - Natalia Carrillo-López
- Hospital Universitario Central de Asturias (HUCA), Avda. Roma s/n., 33011, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Retic REDinREN-ISCIII, Madrid, Spain
| | - Sara Panizo
- Hospital Universitario Central de Asturias (HUCA), Avda. Roma s/n., 33011, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Retic REDinREN-ISCIII, Madrid, Spain
| | | | | | - Carolina Ballarino
- Hospital Militar Central Cirujano Mayor Dr. Cosme Argerich, Buenos Aires, Argentina
| | - Vicente Sánchez-Polo
- Hospital General de Enfermedades del Instituto Guatemalteco de Seguridad Social (IGSS), Ciudad de Guatemala, Guatemala
| | | | | | | | | | - Carlos Gómez-Alonso
- Hospital Universitario Central de Asturias (HUCA), Avda. Roma s/n., 33011, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Universidad de Oviedo, Oviedo, Spain.,Retic REDinREN-ISCIII, Madrid, Spain
| | - John Cunningham
- Centre for Nephrology, Royal Free Hospital and University College London, London, UK
| | - Manuel Naves-Díaz
- Hospital Universitario Central de Asturias (HUCA), Avda. Roma s/n., 33011, Oviedo, Spain. .,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. .,Retic REDinREN-ISCIII, Madrid, Spain.
| | - Walter Douthat
- Hospital Privado Universitario de Córdoba, Córdoba, Argentina.,Hospital Raúl Ángel Ferreyra, Córdoba, Argentina.,Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Córdoba, Argentina
| | - José L Fernández-Martín
- Hospital Universitario Central de Asturias (HUCA), Avda. Roma s/n., 33011, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.,Retic REDinREN-ISCIII, Madrid, Spain
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