Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The First Randomized Controlled Trial on Vitamin D and Covid-19

sciencedirect.com

Post reply on HN
Print view View original

141–150 of 401 posts

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#141

Post by notatoad »

notadoc wrote: post #110

>All hospitalized patients received as best available therapy the same standard care, (per hospital protocol), of a combination of hydroxychloroquine (400 mg every 12 hours on the first day, and 200 mg every 12 hours for the following 5 days), azithromycin (500 mg orally for 5 days. Fascinating how hydroxychloroquine is routinely used and considered standard of care in most countries where the drug has not been polit…

>The best available treatment that at the beginning of the outbreak in our hospital, included the use of hydroxychloroquine/azithromycin therapy [23,24,26]. However, taking into consideration more recent data on the safety and efficacy of chloroquine and hydroxychloroquine in small randomized clinical trials, case series, and observational studies this treatment is no longer considered effective [32] in treating COVID-19.

calling it the "standard of care" in the present tense is very disingenuous. it was briefly considered to be effective at the beginning of the outbreak. it was determined relatively quickly that it was not actually an effective treatment. this has nothing to do with politics.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#142

Post by hannob »

zamfi wrote: post #9
bdamm wrote: post #2

Noteworthy that this is in combination with anti-viral drugs at hospital admission: hydroxychloroquine (400 mg every 12 hours on the first day, and 200 mg every 12 hours for the following 5 days), azithromycin (500 mg orally for 5 days). Regardless, I'm going to assume this means being outside and getting sun is good for me.

To be clear, all patients received these supplemental drugs, as at the time they were considered the best standard of care. (Also to be clear: they're not anti-virals.) Of the 75 patients in the trial, 50 people received additionally Vitamin D3 supplementation (in the form of calcifediol), and 25 did not. Notably, though, diabetes and high blood pressure were substantially more frequent in the control group, which ar…

Hydroxychloroquine was never the "best standard of care". It's a quack treatment that was pushed by some bad studies.

Reading Hydroxychloroquine mentioned in this study should make one very suspicious.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#143

Post by blithedale »

tboyd47 wrote: post #118

Good on you, Spain. A study like this could never take place in the USA :( Too many powerful people are heavily invested in the belief that there is no treatment for it.

There are seven results for American trials found on clinicaltrials.gov for Condition= "COIVD19" and Drug = "VitaminD" run by institutions like Harvard/MGH, Brigham, UNC, Arizona State University, etc.

https://clinicaltrials.gov/ct2/results?term=vitamin+d&cond=C...

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#144

Post by D-Coder »

jhawk28 wrote: post #126
jonplackett wrote: post #114

Surly now it's time to just start giving everyone some free vitamin D. Best case scenario: Less dead people. Worst case scenario: We all have healthier bones.

Worst case is actually vitamin d toxicity. You can take too much.

I looked into that when I was told to take 2,000 IU daily, since I had no idea what an IU of vitamin D involved. A web search said that people who were taking megadoses of vitamin D, which was mislabeled and actually 10 times stronger than what they thought they were getting, started developing problems in a month or so.

It's available right off the shelf. As long as people aren't taking an entire bottle all at once, it seems pretty safe to me. (Disclaimer: Dammit Jim, I'm a software engineer, not a doctor.)

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#145

Post by DoofusOfDeath »

gnur wrote: post #66
asah wrote: post #30

Non-white skinned people: sunlight may not be enough to increase your vitamin D. https://www.google.com/search?q=dark+skin+vitamin+d+minutes

Actually, even lighter skinned people can have lots of trouble generating sufficient vitamin D. My wife's family has the lightest skin possible but they all have vitamin D deficiency, if you have some kind of fatigue it is truly worth having your vitamin levels checked!

If they're that fair-skinned, is it possible that they're so careful about sunburn/cancer that they're getting less UV than most people?

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#146

Post by mlyle »

Emphere wrote: post #76

This is not a strong signal. The adjusted odds ratio is 0.03 (95% CI: 0.003 - 0.25). For randomised trials, it makes no sense to say that the difference in baseline is not significant because we have already observed the outcomes. It is better to use ASDs and in such small trials, small differences in baseline matter a lot. In this case it's pretty obvious the effect of vitamin D would easily be non significant if yo…

> This is not a strong signal. The adjusted odds ratio is 0.03 (95% CI: 0.003 - 0.25)

Are you for real? Smallest effect in the 95% CI is a 4x reduction in ICU admission. Yes, it's probably closer to the bottom end of this range, but this is a fantastically different.

> For randomised trials, it makes no sense to say that the difference in baseline is not significant

For randomized trials, the baselines are not likely to be massively different. And, of course, the authors compared risk factors and ages to rule out some of the ways that the trial could be ridiculously tilted from the outset.

> In this case it's pretty obvious the effect of vitamin D would easily be non significant if you shift around some variables.

...??? The endpoint was pre-declared, and we're just comparing two pre-randomized groups. Exactly what variables would you shift around?

> Reeks of p hacking imo

If you're going to cast aspersions, be a little more concrete.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#147

Post by jeffbee »

notadoc wrote: post #110

>All hospitalized patients received as best available therapy the same standard care, (per hospital protocol), of a combination of hydroxychloroquine (400 mg every 12 hours on the first day, and 200 mg every 12 hours for the following 5 days), azithromycin (500 mg orally for 5 days. Fascinating how hydroxychloroquine is routinely used and considered standard of care in most countries where the drug has not been polit…

Doesn't that have more to do with the timing of the study than anything else? Studies showing that HCQ isn't effective didn't begin to emerge until June.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#148

Post by jschwartzi »

azinman2 wrote: post #96
Ensorceled wrote: post #72

Earlier quoted context omitted.

> My understanding is that it hasn’t been shown for elevators. I think ... Where are you getting this understanding? You are asking for evidence while providing none yourself...

Well the absence of anything is the default, so the burden of proof is on the person making the claim. I had read that somewhere in studying transmissions in NYC where elevators are common. I don’t remember where, it was a while ago.

It really depends on what the potential hazards are for the claim being correct versus the claim being incorrect. If the claim is that you can't get it from sharing an elevator, I would say the hazards if that claim is wrong are much greater than if that claim is correct. So, from a risk-management perspective, without any evidence, it's much better to assume that you can get COVID-19 from sharing an elevator until enough evidence accumulates to demonstrate that you can't. If you assume you can, the worst that happens is that you wait for another elevator. But if you assume you can't and you actually can, then you get COVID-19.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#149

Post by delecti »

koboll wrote: post #127

Can anyone here help demystify how "oral calcifediol (0.532 mg)" maps to an equivalent amount of Vitamin D in the form you can buy in a drugstore?

I take 5000 IU pills, and they're labeled as 125 mcg. The 0.532mg pills they were getting would thus be around 4.25x as much, or a bit over 21,000 IU based on how D3 is usually labeled for over-the-counter purchase.

Though my pills are "cholecalciferol" not "calcifediol", so there's not a perfect 1:1 correspondance, but your body converts cholecalciferol into calcifediol, so based on nothing else my above calculation is probably not far off.

Re: The First Randomized Controlled Trial on Vitamin D and Covid-19

#150

Post by blithedale »

dilippkumar wrote: post #140

Previously on HN, a physician shared some thoughts on treating Vitamin D as a medication and not as a dietary supplement: Part 1: https://news.ycombinator.com/item?id=24138590 Part 2: https://news.ycombinator.com/item?id=24261948 To summarize - popping in large doses of Vitamin D is not exactly safe.

Thank you thank you thank you. There is a craze for popping Vitamin D related to the raft of observational studies, here... so many of which never find a causal link.

Take my own particular condition: an inherited vascular dysplasia which causes frequent nose and GI bleeds. People with low Vitamin D seem to have a worse time of it in OBSERVATIONAL studies.

But people with GI bleeds so bad they have daily diarrhea from hemorrhages and anemia that disables them to the point they can't work aren't going to be out in the sun, and aren't going to be able to absorb as many vitamins in their gut due to the havoc the hemorrhaging is yielding.

Thinking really hard about the direction the arrow of causality runs here is massively important. Is it:

LOW VITAMIN D ---> BAD BLEEDING?

Or:

BAD BLEEDING ---> LOW VITAMIN D

And as the consequences of overdosing show, this isn't like popping an extra Metamucil cracker a day or something - dire stuff can happen.

Post reply on HN