Efficacy and Safety of Vitamin D Supplementation to Prevent COVID-19 in Frontline Healthcare Workers. A Randomized Clinical Trial

Miguel A Villasis-Keever, Mardia G López-Alarcón, Guadalupe Miranda-Novales, Jessie N Zurita-Cruz, Aly S Barrada-Vázquez, Joaquín González-Ibarra, Monserrat Martínez-Reyes, Concepción Grajales-Muñiz, Clara E Santacruz-Tinoco, Bernardo Martínez-Miguel, Jorge Maldonado-Hernández, Yazmín Cifuentes-González, Miguel Klünder-Klünder, Juan Garduño-Espinosa, Briseida López-Martínez, Israel Parra-Ortega, Miguel A Villasis-Keever, Mardia G López-Alarcón, Guadalupe Miranda-Novales, Jessie N Zurita-Cruz, Aly S Barrada-Vázquez, Joaquín González-Ibarra, Monserrat Martínez-Reyes, Concepción Grajales-Muñiz, Clara E Santacruz-Tinoco, Bernardo Martínez-Miguel, Jorge Maldonado-Hernández, Yazmín Cifuentes-González, Miguel Klünder-Klünder, Juan Garduño-Espinosa, Briseida López-Martínez, Israel Parra-Ortega

Abstract

Background: Associations between vitamin D (VD) deficiency and the risk of SARS-CoV-2 infection have been documented in cross-sectional population studies. Intervention studies in patients with moderate to severe COVID-19 have failed to consistently document a beneficial effect.

Objective: To determine the efficacy and safety of VD-supplementation in the prevention of SARS-CoV-2 infection in highly exposed individuals.

Methods: A double-blind, parallel, randomized trial was conducted. Frontline healthcare workers from four hospitals in Mexico City, who tested negative for SARS-CoV-2 infection, were enrolled between July 15 and December 30, 2020. Participants were randomly assigned to receive 4,000 IU VD (VDG) or placebo (PG) daily for 30 d. RT-PCR tests were taken at baseline and repeated if COVID-19 manifestations appeared during follow-up. Serum 25-hydroxyvitamin D3 and antibody tests were measured at baseline and at day 45. Per-protocol and intention-to-treat analysis were conducted.

Results: Of 321 recruited subjects, 94 VDG and 98 PG completed follow-up. SARS-CoV-2 infection rate was lower in VDG than in PG (6.4 vs. 24.5%, p <0.001). The risk of acquiring SARS-CoV-2 infection was lower in the VDG than in the PG (RR: 0.23; 95% CI: 0.09-0.55) and was associated with an increment in serum levels of 25-hydroxyvitamin D3 (RR: 0.87; 95% CI: 0.82-0.93), independently of VD deficiency. No significant adverse events were identified.

Conclusions: Our results suggest that VD-supplementation in highly exposed individuals prevents SARS-CoV-2 infection without serious AEs and regardless of VD status.

Trial registration: ClinicalTrials.gov NCT04535791.

Keywords: 25-hydroxyvitamin D3; COVID-19; Healthcare workers; SARS-CoV-2; Vitamin D.

Conflict of interest statement

Conflict of Interest Mardia G López-Alarcón, is the Editor-in-Chief of Archives of Medical Research. All other authors do not have any Conflict of Interest.

Copyright © 2022. Published by Elsevier Inc.

Figures

Figure 1
Figure 1
Flow diagram according to the consolidated standards of reporting clinical trials. VDG, vitamin D-supplemented group; PG placebo group.
Figure 2
Figure 2
A. Within comparisons of 25-hydroxyvitamin D3 concentration in vitamin D supplemented and placebo groups. Medians and 95% confidence intervals are presented. Statistical analysis was conducted with Wilcoxon. B. Deltas of 25-hydroxyvitamin D3 concentration are compared between vitamin D supplemented and placebo groups. Medians and 95% confidence intervals are presented. Statistical analysis was performed with Mann-Whitney U test.

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Source: PubMed

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