Fewer children died of pneumonia after 100,000 IU Vitamin D injection – RCT March 2021

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Vitamin D supplementation and improvement of pneumonic children at a tertiary pediatric hospital in Egypt: A randomized controlled trial

Medicine (Baltimore). 2021 Apr 2;100(13):e25011. doi: 10.1097/MD.0000000000025011
John Rene Labib 1, Sally Kamal Ibrahem 1, Mohamed M Ismail 1, Shaimaa A M Abd El Fatah 2, Amal Samir Sedrak 2, Mona Adel Soliman Attia 2, Hadeel Mohammad El-Hanafi 3, Mai Hamed Kamel 3

Background: Despite the well-recognized effect of vitamin D in metabolism and homeostasis, there is now growing interest in its probable association with pneumonia. This study aims to supply vitamin D3 (Cholecalciferol) (100,000 IU) to pneumonic children to minimize the duration of illness and improve their outcome.

Methods: A double-blinded, randomized, placebo-controlled trial was conducted in a Pediatric Cairo University affiliated hospital. An intervention arm (93 children) and a control arm (98 children), who had pneumonia with an insufficient or deficient level of vitamin D and whose parental permission was obtained, were enrolled in the trial. All children were treated with antibiotics according to WHO guidelines. Children were given a single injection of 1 mL of 100,000 IU of vitamin D3 or placebo. Clinical data were recorded every eight hours for all children. Outcomes were assessed 7 days after vitamin D injection.The primary outcome variable was the change in serum level of 25(OH)D, while the secondary outcomes were the medical state of the assigned cases (improvement or death) and duration between enrollment and hospital discharge for improved cases.

Results: In the supplementation group, the percentage of patients who suffered either deficient (38.7%) or insufficient levels (61.3%) of 25 (OH)D at day one had significantly decreased in the seventh day to (11.8%) and (52.7%), respectively. Kaplan- Meier plots highlighted that the median time to recover of the placebo group was significantly longer than that of the supplementation group (Log Rank P value < .001).

Conclusion: VDD was detected in pediatric critical care children. In pneumonic children with high VDD, it is illustrated that Vitamin D supplementation is accompanied by lowered mortality risk and pSOFA scores, reduced time to recover, and improved PaO2/FiO2.
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Probably fewer deaths if had gotten an oral loading dose BEFORE hospital

• Pneumonia and low vitamin D - many studies in VitaminDWiki
• Acute pneumonia in children 3X less likely if greater than 30 ng of vitamin D – Jan 2021
• Pneumonia in Egyptian Children 3.6 X more likely if poor Vitamin D Receptor – Aug 2018
• Recurrence of child pneumonia delayed by 100000 IU of vitamin D – RCT Oct 2010

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VitaminDwiki – Injection contains

65 items in Vitamin D Injection category

• Vitamin D injections last longer (3 month vs 2 month) than loading doses
• Getting Vitamin D into your body shows the many ways of getting Vitamin D

• Injections are currently made by medical professionals into muscle
• Home injection of Vitamin D appears to be possible in the future
• Injections are useful for people who might forget to take their periodic supplement (children, elderly, etc) and those who cannot swallow or have poor digestion
• While Vitamin D2 is historically the common form, Vitamin D3 is far better
• Should check (if there is time) for possible allergic reaction to Vitamin D or lack of Magnesium for both for loading dose and injection
• Note 600,000 IU Vitamin D loading dose via capsules is 1/20th the cost($2.40) of an injection, and does not require a prescription
• 100,000 IU single dose of vitamin D - 2010 has the following
  
• Vitamin D injection lasts longer and has bigger response than weekly oral – Jan 2017 has the following
  
• Non-oral Vitamin D should be a better form for MS, food allergy, PTSD, etc. – many studies might include injection

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