1 A study carried out on 254 elderly and frail patients
The COVIT-TRIAL scientific study led by the head of the geriatrics department of the CHU d’Angers, Pr Cédric Annweiler, was carried out on 254 patients in nine hospitals in France.
. Their profile: frail elderly people. Their median age was 88. From April 15 to December 17, 2020 – before the arrival of vaccines, therefore – two different groups received, after drawing lots, a “standard” dose of vitamin D or a “very high” dose, all at once, in the 72 hours following the start of the covid-19 infection.?
2 Survival increased by nearly 60% at 14 days
What did this work published in the peer-reviewed journal Plos Medicine show on Tuesday, May 31? “We found that people who received the high dose of vitamin D had an increased survival of almost 60% compared to the others, 14 days after its administration?. This is a very significant result, ”says Professor Cédric Annweiler to the Telegram. The study shows, in fact, that 8 of the 127 patients who received the high dose of vitamin D died within 14 days, compared to 14 of the 127 patients who received the standard dose. The study authors note that the high-dose vitamin D did not cause more frequent adverse effects than the lower dose.
3 But not many effects, 28 days later…
If the difference in mortality is significant, 14 days after taking vitamin D, it is no longer significant at 28 days: 19 deaths were, in fact, observed in the group receiving the high dose and 21 deaths in the group receiving the standard dose… “Indeed, beyond 14 days, the very strong effect on survival tends to diminish,” acknowledges Cédric Annweiler. But he points out that “the study was not built with the aim of reducing long-term mortality but to find out if such an effect existed in the short term”. Observing, after 28 days, a division by four of the concentration of vitamin D in patients, the COVIT-TRIAL team intends to carry out new work in order to measure the effects of the administration of daily or weekly doses after the onset of symptoms.
4 A solid but not perfect study
To precisely analyze the effect of a treatment, it must be studied on several groups, one of which receives a placebo. The COVIT-TRIAL study does not have a control group of this type, since the control group received vitamin D, at a lower dose. Cédric Annweiler explains this choice: “The majority of frail elderly people lack vitamin D, which is why we carried out the study on them. As a result, it seemed unthinkable to us to offer them a placebo since we are well aware of the anti-inflammatory effects of vitamin D. They are certainly very useful against covid, by regulating the endocrine system disrupted by the coronavirus and which can be at risk. origin of cytokine storms that lead to deaths”.
Another criticism: it is an open trial, that is to say that the patients were aware of the treatment and the dose received, which is usually considered a weak point. “It could have had an impact on the extent and duration of the symptoms, on their feelings. But here, we measure the effect on death, and the fact of being in an open trial is not serious, ”answers Cédric Annweiler. The “limited power” of the study is also one of the downsides. “We can always include more patients, but this is already one of the biggest trials compared to anything that exists today,” notes the geriatrician.
5 Vitamin D, not THE wonder drug
For Cédric Annweiler, things are clear: “Our conclusions cannot and should not be extended to other younger populations. In younger adults, the concentration of vitamin D is very often high enough and high-dose supplementation is unlikely to have any effect. The Angevin geriatrician, however, argues that “having a normal level of vitamin D is clearly associated with a favorable course of the disease, with greater survival”.
Beware, however, not to embark on a wild take of food supplements, potentially dangerous. The doctor recommends going to see your general practitioner to find out if you are deficient. “We must also continue to encourage natural intakes, a healthy diet, eating fatty fish, and having an outdoor activity, in the sun but without abusing it”. And out of the question to “shoot” alone at the dose of 400,000 units administered to the elderly in the study (a food supplement provides 1,000 units per day). “This high dose must imperatively be supervised by medical prescription”, warns Cédric Annweiler.
Finally, “vitamin D is not a panacea. It comes to improve the paraphernalia we have today. It in no way replaces other therapeutic weapons, vaccines or corticosteroids,” concludes the doctor.
* The CHUs of Angers, Bordeaux, Limoges, Nantes, Nice, Saint-Étienne, Tours, and the CHs of Le Mans and Saumur and in the nursing homes that depend on them.