Vitamin D in critical care: where are we now and what is next?
Study Goal
To summarize recent evidence on the role of vitamin D deficiency in critically ill patients and its potential role in COVID-19.
Results Summary
Vitamin D deficiency is a strong predictor of worse outcomes in critically ill patients and COVID-19. Supplementation may reduce respiratory infections, asthma exacerbations, and mortality risk in non-critically ill patients, but its role in acute settings remains unclear.
Population
Critically ill patients, COVID-19 patients, and elderly ICU survivors.
Effective Dosage
600-800 IU of native vitamin D3 (recommended standard dose for the healthy population).
Duration
Not specified.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
vitamin D supplementation | decrease | respiratory tract infections | noncritically ill patients | - | has been shown to reduce | #1 |
vitamin D supplementation | decrease | asthma exacerbations | noncritically ill patients | - | has been shown to reduce | #2 |
vitamin D supplementation | decrease | mortality risk | noncritically ill patients | - | has been shown to reduce | #3 |
vitamin D | neutral | outcomes | critically ill patients | - | is a strong predictor for worse outcomes | #4 |
vitamin D | neutral | outcomes | COVID-19 patients | - | is a strong predictor for worse outcomes | #5 |
vitamin D | neutral | bone health | - | - | has a role | #6 |
PURPOSE OF REVIEW: To summarize the recent evidence on the role of vitamin D deficiency in critically ill patients and emerging data claiming a role of vitamin D in COVID-19. RECENT FINDINGS: Vitamin D is a strong predictor for worse outcomes in critically ill patients, and as well in COVID-19. The vitamin D content in typical nutrition regimes is lower than what is recommended for the general population. Although its supplementation has been shown to reduce respiratory tract infections, asthma exacerbations and mortality risk in noncritically ill patients, its role in the acute setting is not yet clear. Several small intervention trials have shown interesting results in COVID-19, and larger studies are ongoing. SUMMARY: Although research on this topic is still ongoing, it appears reasonable to recommend at least the standard vitamin dose for the healthy population (600--800 IU of native vitamin D3). Many questions remain on the actual role, the best metabolite, regime, and so forth. However, the role for vitamin D in bone health is clear. Elderly ICU survivors have a high risk for osteoporosis/fractures, so at least in this population, an optimal vitamin D status should be targeted.