Subsequently, 25(OH)D levels were assessed at day 7 and a weekly supplementation of 60000IU provided to those with 25(OH)D >50 ng/ml or else continued on daily vitamin D 60,000 IU supplementation for another 7 days up until day-14 in participants with 25(OH)D <50 ng/ml in the intervention arm. Patients unable to take oral supplementation like those requiring invasive ventilation or with significant comorbidities like uncontrolled hyperglycaemia or hypertension were excluded. Patients with vitamin D deficiency defined as 25 (OH)D level50 ng/ml or placebo (5 ml distilled water) for 7 days (control group). A written consent was obtained from all patients included in the study and protocol was approved by the Institute Ethics Committee. Therefore, we hypothesise that high-dose cholecalciferol supplementation in patients with SARS-CoV-2 infection and vitamin D deficiency may lead to SARS-CoV-2 negativity in greater proportions of patients with a decrease in serological markers of inflammation.Ĭonsecutive individuals with SARS-CoV-2 infection who were mildly symptomatic or asymptomaticwithor without co-morbidities (hypertension, diabetes mellitus, chronic obstructive airway disease, chronic liver disease, chronic kidney disease) admitted to tertiary care hospital in north India were invited for the study. A PCR-confirmed SARS-COV-2 infection from nasopharyngeal swab pertains to relevant clinical outcome in intervention trials 10 especially for asymptomatic individuals as an earlier SARS-CoV-2 negativity would have significant public health benefits in limiting the spread of the disease. The role of therapeutic vitamin D supplementation in asymptomatic individuals with vitamin-D deficiency and SARS-CoV-2 infection is not known. 8 However, the immune-modulatory effect of vitamin D is likely to be observed at 25(OH)D levels, which are considered higher than that required for its skeletal effects. It is noticed that those receiving vitamin D supplementation have fewer respiratory tract infections. 9 However, vitamin D levels were neither available at baseline nor during follow up in the study. 8 An intervention study with calcifediol noticed a reduction in requirement for intensive care among hospitalised patients for COVID19. 5–7 The role of vitamin D in SARS-CoV-2 infection is not explored in intervention studies despite the knowledge of an immunomodulatory role and protective effect of vitamin D against other viral infections.
It has been observed that vitamin D-deficient individuals have increased COVID-19 risk and mortality.
2 Anti-viral, anti-inflammatory drugs and convalescent plasma therapy have been used for COVID-19 with variable results. But identification of asymptomatic carriers of SARS-CoV-2 infection is paramount to contain viral infection. 3 Routine measures of social distancing, personal hand hygiene and limited outdoor contact activities have shown benefits to limit corona virus infection. 1 2 The transmission potential of SARS CoV-2 is potentially greater than earlier viral outbreaks of SARS-CoV and MERS-CoV because of its high transmissibility even from asymptomatic SARS-CoV-2 RNA positive individuals. Pre-symptomatic and asymptomatic SARS-CoV-2 positive individuals far outnumber the symptomatic ones or those with severe disease. Coronavirus-2019 (COVID-19) caused by severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) has affected the lives of millions of individuals globally and severely strained the medical community.