Calcifediol Treatment and Hospital Mortality Due to COVID-19: A Cohort Study

Nutrients. 2021 May 21;13(6):1760. doi: 10.3390/nu13061760.

Abstract

Context: Calcifediol has been proposed as a potential treatment for COVID-19 patients.

Objective: To compare the administration or not of oral calcifediol on mortality risk of patients hospitalized because of COVID-19.

Design: Retrospective, multicenter, open, non-randomized cohort study.

Settings: Hospitalized care.

Patients: Patients with laboratory-confirmed COVID-19 between 5 February and 5 May 2020 in five hospitals in the South of Spain.

Intervention: Patients received calcifediol (25-hydroxyvitamin D3) treatment (0.266 mg/capsule, 2 capsules on entry and then one capsule on day 3, 7, 14, 21, and 28) or not.

Main outcome measure: In-hospital mortality during the first 30 days after admission.

Results: A total of 537 patients were hospitalized with COVID-19 (317 males (59%), median age, 70 years), and 79 (14.7%) received calcifediol treatment. Overall, in-hospital mortality during the first 30 days was 17.5%. The OR of death for patients receiving calcifediol (mortality rate of 5%) was 0.22 (95% CI, 0.08 to 0.61) compared to patients not receiving such treatment (mortality rate of 20%; p < 0.01). Patients who received calcifediol after admission were more likely than those not receiving treatment to have comorbidity and a lower rate of CURB-65 score for pneumonia severity ≥ 3 (one point for each of confusion, urea > 7 mmol/L, respiratory rate ≥ 30/min, systolic blood pressure < 90 mm Hg or diastolic blood pressure ≤ 60 mm Hg, and age ≥ 65 years), acute respiratory distress syndrome (moderate or severe), c-reactive protein, chronic kidney disease, and blood urea nitrogen. In a multivariable logistic regression model, adjusting for confounders, there were significant differences in mortality for patients receiving calcifediol compared with patients not receiving it (OR = 0.16 (95% CI 0.03 to 0.80).

Conclusion: Among patients hospitalized with COVID-19, treatment with calcifediol, compared with those not receiving calcifediol, was significantly associated with lower in-hospital mortality during the first 30 days. The observational design and sample size may limit the interpretation of these findings.

Keywords: COVID-19; COVID-19 drug treatment; SARS-CoV-2; calcifediol; vitamin D.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 / blood
  • COVID-19 / drug therapy*
  • COVID-19 / mortality
  • Calcifediol / administration & dosage*
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2 / metabolism*
  • Severity of Illness Index

Substances

  • Calcifediol

Supplementary concepts

  • COVID-19 drug treatment