Critical COVID-19 patients draw no benefit from high-dose intramuscular vitamin D3

High-dose parenteral vitamin D3 does not reduce mortality, length of hospital stay, and need for intubation among coronavirus disease 2019 (COVID-19) patients with vitamin D deficiency on admission to the intensive care unit (ICU), a recent study has found.

A total of 175 patients with 25-hydroxyvitamin D levels <12 ng/mL participated in the study; all were admitted to the ICU. Vitamin D3 was given to 113 patients at a single intramuscular dose of 300,000 IU. Outcomes such as disease clinical course and in-hospital mortality were compared with the 62 no-treatment controls.

The median length of hospital stay in the vitamin D3 group was 9 days, not significantly shorter than that in controls (9 days; p=0.649). Endotracheal intubation likewise occurred comparably between groups, with corresponding rates of 39 percent and 50 percent (p=0.157).

High-dose vitamin D3 also exerted no significant impact on in-hospital mortality, which was observed in 38 percent of treated patients and in 48 percent of controls (p=0.185). C-reactive protein (CRP) and D-dimer concentrations, both markers of inflammation, were likewise not different between treatment groups.

Multivariate logistic regression analysis found that the following factors were significant correlates of mortality: corrected calcium (adjusted odds ratio [OR], 0.29, 95 percent confidence interval [CI], 0.14–0.62; p=0.002), CRP (adjusted OR, 1.12, 95 percent CI, 1.04–1.2; p=0.002), and endotracheal intubation (adjusted OR, 57, 95 percent CI, 17.8–182.3; p<0.001).

Of note, high-dose parenteral vitamin D3 administration also had no survival benefit (adjusted OR, 0.61, 95 percent CI, 0.23–1.6; p=0.320).