Effect of a single high dose of vitamin D3 on hospital length of dtay in patients with moderate to severe COVID-19: a randomized clinical trial

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dc.contributor.authorReis, Bruna Zavarize
dc.contributor.authorMurai, Igor Hisashi
dc.contributor.authorFernandes, Alan Lins
dc.contributor.authorSales, Lucas Peixoto
dc.contributor.authorPinto, Ana Jéssica
dc.contributor.authorGoessler, Karla Fabiana
dc.contributor.authorDuran, Camila da Silva Cendon
dc.contributor.authorSilva, Carla Baleeiro Rodrigues
dc.contributor.authorFranco, André Silva
dc.contributor.authorMacêdo, Marina Barguil
dc.contributor.authorDalmolin, Henrique Helson Herter
dc.contributor.authorBaggio, Janaina
dc.contributor.authorBalbi, Guilherme Guimarães Moreira
dc.contributor.authorAntonangelo, Leila
dc.contributor.authorCaparbo, Valéria de Falco
dc.contributor.authorGualano, Bruno
dc.contributor.authorPereira, Rosa Maria Rodrigues
dc.date.accessioned2024-03-04T19:42:05Z
dc.date.available2024-03-04T19:42:05Z
dc.date.issued2021-03
dc.description.resumoIMPORTANCE: The efficacy of vitamin D3 supplementation in coronavirus disease 2019 (COVID-19) remains unclear. OBJECTIVE: To investigate the effect of a single high dose of vitamin D3 on hospital length of stay in patients with COVID-19. DESIGN, SETTING, AND PARTICIPANTS: This was a multicenter, double-blind, randomized, placebo-controlled trial conducted in 2 sites in Sao Paulo, Brazil. The study included 240 hospitalized patients with COVID-19 who were moderately to severely ill at the time of enrollment from June 2, 2020, to August 27, 2020. The final follow-up was on October 7, 2020. INTERVENTIONS: Patients were randomly assigned to receive a single oral dose of 200 000 IU of vitamin D3 (n = 120) or placebo (n = 120). MAIN OUTCOMES AND MEASURES: The primary outcome was length of stay, defined as the time from the date of randomization to hospital discharge. Prespecified secondary outcomes included mortality during hospitalization; the number of patients admitted to the intensive care unit; the number of patients who required mechanical ventilation and the duration of mechanical ventilation; and serum levels of 25-hydroxyvitamin D, total calcium, creatinine, and C-reactive protein. RESULTS: Of 240 randomized patients, 237 were included in the primary analysis (mean [SD] age, 56.2 [14.4] years; 104 [43.9%] women; mean [SD] baseline 25-hydroxyvitamin D level, 20.9 [9.2] ng/mL). Median (interquartile range) length of stay was not significantly different between the vitamin D3 (7.0 [4.0-10.0] days) and placebo groups (7.0 [5.0-13.0] days) (log-rank P = .59; unadjusted hazard ratio for hospital discharge, 1.07 [95% CI, 0.82-1.39]; P = .62). The difference between the vitamin D3 group and the placebo group was not significant for in-hospital mortality (7.6% vs 5.1%; difference, 2.5% [95% CI, –4.1% to 9.2%]; P = .43), admission to the intensive care unit (16.0% vs 21.2%; difference, –5.2% [95% CI, –15.1% to 4.7%]; P = .30), or need for mechanical ventilation (7.6% vs 14.4%; difference, –6.8% [95% CI, –15.1% to 1.2%]; P = .09). Mean serum levels of 25-hydroxyvitamin D significantly increased after a single dose of vitamin D3 vs placebo (44.4 ng/mL vs 19.8 ng/mL; difference, 24.1 ng/mL [95% CI, 19.5-28.7]; P < .001). There were no adverse events, but an episode of vomiting was associated with the intervention. CONCLUSIONS AND RELEVANCE: Among hospitalized patients with COVID-19, a single high dose of vitamin D3, compared with placebo, did not significantly reduce hospital length of stay. The findings do not support the use of a high dose of vitamin D3 for treatment of moderate to severe COVID-19pt_BR
dc.identifier.citationMURAI, Igor Hisashi; FERNANDES, Alan Lins; SALES, Lucas Peixoto; PINTO, Ana Jéssica; GOESSLER, Karla Fabiana; DURAN, Camila da Silva Cendon; SILVA, Carla Baleeiro Rodrigues; FRANCO, André Silva; MACÊDO, Marina Barguil; DALMOLIN, Henrique Helson Herter; BAGGIO, Janaina; BALBI, Guilherme Guimarães Moreira; REIS, Bruna Zavarize; ANTONANGELO, Leila; CAPARBO, Valéria de Falco; GUALANO, Bruno; PEREIRA, Rosa Maria Rodrigues. Effect of a single high dose of vitamin D3 on hospital length of dtay in patients with moderate to severe COVID-19: a randomized clinical trial. Jama: Journal of the American Medical Association, [S.l.], v. 325, n. 11, p. 1053-1060, 16 mar. 2021. DOI: 10.1001/jama.2020.26848. Disponível em: https://jamanetwork.com/journals/jama/fullarticle/2776738. Acesso em: 19 fev. 2024.pt_BR
dc.identifier.doihttp://dx.doi.org/10.1001/jama.2020.26848
dc.identifier.urihttps://repositorio.ufrn.br/handle/123456789/57745
dc.languageenpt_BR
dc.publisherJAMA: The Journal of the American Medical Associationpt_BR
dc.subjectVitamin D3pt_BR
dc.subjectCOVID-19pt_BR
dc.subjectHospital Length of Staypt_BR
dc.subjectRandomized Clinical Trialpt_BR
dc.subjectModerate to Severept_BR
dc.subjectIneffectivept_BR
dc.titleEffect of a single high dose of vitamin D3 on hospital length of dtay in patients with moderate to severe COVID-19: a randomized clinical trialpt_BR
dc.typearticlept_BR

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