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Comment by tpmx | Hacker News Reader

Giving further evidence to this study that came out in preprint about a month ago or so:

https://www.sciencedirect.com/science/article/pii/S096007602...

“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”

This one was actually about giving some patients calcifediol/vitamin D doses as part of the treatment, and comparing what happened to those who received the vitamin injection and those who didn't.

tldr: "of 50 patients treated with calcifediol, one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50 %).")

Performed at Reina Sofia University Hospital, Córdoba, Spain.

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This study is incredibly significant. If there is not a systematic error or fraud, it just revolutionizes Covid-19 treatment. And the numbers are NOT too small to be statistically relevant: They took 76 patients coming to their hospital, and randomly assigned them into the calcifediol (Vitamin D) group (probability 2/3) or the non-calcifediol group (probability 1/3). 50 ended up in the calcifediol group, 26 in the non-calcifediol group. In the end 14 of these 76 patients were going to the ICU. Only 1(!!) came from the large calcifediol group, but 13 from the non-calcifediol group.

Let's just calculate the probability of the event that at most one of the 14 patients, who ended up in the ICU, were randomly assigned into the calcifediol group (despite having a 2/3 chance to be assigned there): It is (1/3)^14 for the probability that ALL of them were assigned to the non-calcifediol group. Then (1/3)^13 * 2/3, for the probability that the first ICU patient was assigned to the calcifediol, but all others to the non-calcifediol group. Then the same for the second ICU patient. We get the total probability 14 * (1/3)^13 * 2/3 + (1/3)^14 that at most one of the ICU patents was randomly assigned to the calcifediol group (and that is what happened). That is a probability of 1 : 160.000 (!!!). So extremely significant. It means that is mathematically almost impossible that calcifediol did not influence the ICU outcome (provided that there was no other problem in study design as study fraud, or a bias to not bring the calcifediol patients to the ICU or whatever). Why isn't this getting the attention it should??? The effect is very significant, numbers are definitely not too low to draw conclusions. If you take these numbers seriously, calcifediol treatment lowers mortality by an amount that Covid-19 really becomes comparable to regular flu in mortality. This is a complete revolution! Why isn't it getting more attention?

This is great as it isolates vit D from other factors (e.g. balanced diet, spending more time in the sun).

Dr. Fauci says to take vitamin D if you're deficient to boost immune system

https://www.cnbc.com/2020/09/14/supplements-white-house-advi...

And a large proportion of people are deficient, probably most people actually. I’d rather he advised all people to get outside, do things outside under the sun and let your skin do its work, making all of the things it does, including D3.

For a lot of people who live in the Northern Hemisphere who are about to go into a period of long, dark nights during winter, your advice of "get outside, do things outside under the sun and let your skin do its work" is not really as helpful as taking vitamin D supplements.

Harvard Gazette 2017:

Study confirms vitamin D protects against colds and flu

https://news.harvard.edu/gazette/story/2017/02/study-confirm...

so vitamin d through the sun is not the same or what?

From what I’ve read it is the same, but most people don’t get enough due to modern lifestyle of working indoors and wearing clothes. If you’re working outside with your shirt off you’ll probably have good levels in the summer months at least, but sadly many of us are largely trapped inside with clothes on :-(

It would explain why there was a surge in positive rates in Arizona when summer hit. Everyone was inside where the AC was, not getting sun.

not op, but I don't think that's what's being implied. Just that there might be other benefits from spending time in the sun - so a study where the only variable is that one group got injections of vitamin D means that the difference is caused by the vitamin D not any of the other things that might be associated with high vitamin D levels (time in the sun, diet, etc).

The correlation observed for many things associated with vitamin D, is that healthy people spend more time outside than unhealthy people, not that being out in the sun is an inherently healthier activity. E.g. runners/athletes spend more time outside than those who are not, and the increased vitamin D exposure is mostly incidental. People with busier social lives tend to spend more time outside than those who do not. Etc.

Vitamin D levels can be increased by either UV light exposure or dietary supplements. It's the same hormone in the end. However, bright sunlight exposure has other effects including changing levels of cortisol and nitric oxide. It's plausible that some of those other effects could also impact COVID-19 outcomes but we don't have any reliable data on that yet.

More vit D from more sun could be a side effect of better health. Sort of like if you found that using TikTok a lot was strongly correlated to very low covid-19 mortality; it would just be a marker for youth. This study makes it look much more likely that it's an actual effective intervention.

Thanks for that! Dr John :-) has an excellent read-through the main points of the paper at https://www.youtube.com/watch?v=V8Ks9fUh2k8. Yes, the study looks very good. The number of patients (76) is not large, hence "pilot". Other than that - solid evidence, as good as it gets. Fwiw, in England/UK, there is a permanent recommendation to supplement Vitamin D b/c of endemic deficiency, given out by the public health bodies: Public Health England (PHE) (https://www.gov.uk/government/news/phe-publishes-new-advice-...) and NICE (https://www.nice.org.uk/guidance/ph56). This is not strictly Covid-19 related, it predates it. I understand earlier in the year NICE urgent review of available evidence found the evidence wanting: of low quality and insufficient (https://www.gov.uk/government/news/insufficient-evidence-for...). I wonder if they will re-review in light of more evidence put forward recently. Given the balance of likely costs of intervention (Vitamin D is safe, cheap, prior knowledge that good portion of population are deficient, prior knowledge it helps in respiratory illness) versus not (major pandemic) if I were a temporary benevolent dictator, would institute a mass public supplementation programme.

Why don't we see official recommendations to take more vit D to mitigate the effects of covid?

Is there still something these studies miss?

And to tack onto this question, what IS the amount being used in these studies and is it recommended we take it? I remember that Dr from earlier in the month posting a blog series about Vitamin D and even there is still no answer as to how much. She said she was seeing problems when patients were taking something like 4000 IU/day or more...or something like that.

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