According to the COVIT-TRIAL study, which is promoted by CHU Angers and identified by the state as a priority in national studies, a high dose of vitamin D after the diagnosis of Covid-19 limits mortality. Explanation.
Vitamin D is finally recognized as effective in the fight against Covid-19! This is the COVIT-TRIAL study (COvid-19 and high doses LIFEamine additive D TRIAL PROBLEMS in high-risk elderly patients) who confirm this. Led by 73 experts and six scientific societies gathered around Professor Cedric Annweilerhead of the geriatrics department at Angers University Hospital, and Professor Jean-Claude Suberbil from the functional research department of the Necker-Enfants Malades hospital in Paris, this study demonstrates the interest of vitamin D in the fight against Covid-19, and its authors call for a complement to the entire French population.
For two years …
This is detected from March to April 2020 scientific publication, signed, in particular, by Emmanuel Focon and Jean-Marc Sabatier. Back in December 2020, Dr. Jean-Michel Wendling, scientific advisor to infodujour, published an article entitled “Covid: the incredible discoveries of France.” In January 2021, the title: “Vitamin D: a comprehensive plan to combat Covid-19”, in which we have already mentioned the benefits of vitamin D in the following terms: “Several scientific studies now confirm the useful role of vitamin D in the prevention of Covid-19” link to work with Cedric Annweiler and Jean-Claude Suberbil.
The information supplemented and argued by Jean-Marc Sabatier in our article, which offends AFP-Factual in a fictitious fact-finding, to which we responded shortly thereafter, point by point.
“Very high level of evidence”
Today, CHU d’Angers makes an impressive announcement. “Until the last wave of the Covid-19 epidemic ends, hospitalizations of Covid-19 patients, especially the elderly, have never stopped. It is for this reason that the results of the study COVIT-TRIAL, promoted by CHU Angers and identified by the state as a national research priority, is a lever for the care of elderly patients at high risk of death. COVIT-TRIAL, the findings of which are published in the scientific journal Plos Medicine this Tuesday 31 May 2022, shows with a very high level of evidence the benefits of a high dose of vitamin D, administered within 72 hours after diagnosis of Covid-19, weak elderly people who became infected. The results show a significant reduction in mortality in patients who received high doses of vitamin D compared to those who received a standard dose of vitamin D. Nine French hospitals and their nursing homes participated in this study, initiated by Professor Cedric Annweiler, head of the geriatric department at CHU d’Angers. »
Vitamin D, a natural hormone known for its effects on calcium metabolism and the risk of fractures, as well as its anti-inflammatory properties in infectious and cancerous diseases. For example, it helps prevent winter respiratory infections, which were observed long before the Covid-19 era.
“We quickly learned during the first wave of the Covid-19 pandemic that SARS-CoV2 (coronavirus 2) causes dysregulation of the renin-angiotensin system through the ACE2 receptor, the entry point of the virus into the body, causing the risk of an inflammatory chain. reactions (“cytokine storm”) and the risk of developing acute respiratory distress syndrome (ARDS), which is often fatal. However, vitamin D has a recognized anti-inflammatory effect and is involved in the regulation of the renin-angiotensin system. So we quickly imagined from March 2020that vitamin D can help fight severe forms of Covid-19, ”he recalls Professor Cedric Annweiler.
Examine the effectiveness of vitamin D supplements, tolerance and mortality
Therefore, the COVIT-TRIAL study was launched in April 2020, during the first wave of Covid-19, with the support of the CHU d’Angers Research and Innovation Division.
The main objectives of this multicenter randomized, controlled trial for treatment were:
- to investigate the effect of high doses of vitamin D on 14-day mortality compared to the standard dose in elderly patients with COVID-19 and at risk of severe course.
- to improve the tolerability and safety of vitamin D supplements in high doses compared to standard doses of vitamin D.
In France, 260 patients are included
Between April and December 2020 (before the arrival of the vaccines in France), the 9 participating French centers (CHUs Angers, Bordeaux, Limoges, Nantes, Nice, Saint-Etienne, Tours and Le Mans) included 260 patients in the period from April to December 2020 (before the arrival of vaccines in France). and Saumur) and in EHPAD, which depend on these institutions.
Their profile? “Either patients 65 years of age and older with Covid-19 with unfavorable evolutionary criteria (including oxygen dependence) or patients 75 years of age and older with Covid-19 without any other risk factor,” says Professor Cedric Annweiler.
Then these patients were randomly divided into 2 groups:
- a group called “Intervention” received a single dose of 400,000 IU of vitamin D (= high dose of vitamin D) within 72 hours after diagnosis of Covid-19
- a group called “Control” received a single dose of 50,000 IU within 72 hours after diagnosis of Covid-19
Investigators and patients knew what treatment was prescribed. In parallel with the study, all patients, of course, continued to receive, in both groups, the most well-known care from Covid-19 (corticosteroids, oxygen, etc.).
The efficacy of vitamin D in mortality has been demonstrated since day 6 of treatment
Compared with the Control group, the administration of a high dose of vitamin D in the Intervention group caused a significant and statistically significant reduction in the risk of death from day 6 after treatment. , ie when a cytokine storm can aggravate the disease.
“This result is important and consistent with what we knew about the anti-inflammatory effects of vitamin D, greatly reducing the risk of death after 14 days and clearly avoiding the inflammatory escape and cytokine storm observed in severe forms of Covid-19.” , says Professor Cedric Annweiler.
This remarkable efficacy of a high dose of vitamin D is actually maintained relative to mortality, all causes occurring within 14 days (primary endpoint) without causing more side effects than the standard dose.
It should be noted that secondary tests show a decrease in efficacy after 28 days, which could be expected given the life expectancy of vitamin D taken in a single dose at the beginning of the disease. The effectiveness of continuing maintenance therapy (daily or weekly vitamin D supplementation) after the first dose will be further investigated.
Recommendations of the authors
In addition to standard Covid-19 treatments, early administration (within 72 hours of diagnosis) of high doses of vitamin D is a simple and safe treatment that demonstrates its benefits in preventing severe Covid-19 in the elderly who experience new options and risk of immune escape.
At the end of the COVIT-TRIAL study, the authors called for achieving satisfactory vitamin D status in the elderly with Covid-19 as soon as possible, using high doses of vitamin D after diagnosis of Covid-19.
How does vitamin D affect Covid-19?
Vitamin D is a secosteroid hormone. It is able to activate or inhibit several hundred genes and thus can theoretically prevent and / or improve severe forms of Covid-19 by:
- modulating the activity of the renin-angiotensin system and, in particular, the expression of ACE inhibitors (using SARS-CoV-2 to infect host cells) and inhibiting renin synthesis. ACE2 has a protective effect against inflammation in several organs, including the lungs. During Covid-19, negative regulation of ACE2 SARS-CoV-2 leads to an inflammatory chain reaction called a cytokine storm, which can be complicated by acute respiratory distress syndrome with a high risk of death.
- regulation of innate and adaptive cellular immunity: synthesis of antimicrobial peptides with direct antiviral and anti-inflammatory action.
- Finally, hypovitaminosis D appears to be an independent risk factor for severe Covid-19. This point is potentially very interesting because, unlike other risk factors for severe Covid-19 (old age, obesity, multiple comorbidities), for which there is little (or no) effect, hypovitaminosis D is a risk. the ratio is very easily modified by simply taking supplements.
Vitamin D, Anjou experience
More than a year ago On January 8, 2021, 73 experts gathered around Pr Annweiler and Pr Souberbielle jointly signed a consensus article in La Revue du Praticien with the support of 6 French national scientific societies
. They called for ensuring that the entire French population receives satisfactory vitamin D levels in the dual context of the Covid-19 pandemic and the winter period during which vitamin D levels naturally decline.
At the time, more and more research showed that taking vitamin D (without a vaccine replacement) helped prevent the risk of severe forms of Covid-19 and going to the intensive care unit for the virus. The published results of the COVIT-TRIAL study now confirm with a high level of evidence,
the effectiveness of taking high doses of vitamin D in reducing the risk of death in elderly people who have suffered an infection.
French Rheumatism Association (AFLAR), French Society of Endocrinology (SFE), French Society of Geriatrics and Gerontology (SFGG), French Society of Pediatrics (SFP), French Society of Endocrinology and Pediatric Diabetes (SFEDP) ). See also the video of Jean-Marc Sabatier