[quote DianaT1969]@EmbarrassingAdmissions - the SACN link isn't a review of Cordoba. They have only carried out rapid reviews on other vitamin D trials.
The fact that the Cordoba patients were being treated with a drug (as per their treatment protocol at that time) is irrelevant because it was the group who were treated with calcifidiocol which had excellent outcomes. The other group, not treated with vitamin D (but still given the same drug) had significantly poorer outcomes.
The UK, to my knowledge, has never replicated the calcifidiocol treatment protocol on serious hospital admissions in a trial. Yet, if the results of the Cordoba trial were to be scaled up successfully, it would mean a few hundred deaths in the UK, as opposed to thousands.
When this is all over, during the review of the handling of Covid, questions will be asked about why the benefits of vitamin D, according to so many non-UK studies weren't acted upon. There isn't time to wait for peer reviews. For the sake of a few public announcements and a few pennies per person, we could have pulled the nation out of its deficient state easily by October. Several MPs have been raising it in the House since the summer, so the Department of Health won't be able to claim lack of knowledge, or interest.[/quote]
Cordoba is the Castillo paper that is discussed in the next section which is the rationale:
The panel were presented with evidence from the NICE evidence review of vitamin D for COVID-19 on using vitamin D supplements for treating COVID‑19. This comprised 1 small, very low-quality, randomised controlled trial in secondary care from Spain (Castillo et al. 2020) that used oral calcifediol (25[OH]D), which is the circulating metabolite of vitamin D, and not commonly used in the UK. The panel noted the very high dose used. This was estimated to be equivalent to around 5,000 micrograms (200,000 units) of vitamin D in the first week (about 700 micrograms [28,000 units] daily) and 1,300 micrograms in following weeks for the duration of the study (about 200 micrograms [8,000 units] daily). They also noted the lack of generalisability to UK practice. The panel had concerns about:
differences in comorbidities between the 2 comparator groups
use of 'standard care' including anti-inflammatory medicines that are not considered standard care for COVID‑19 in UK practice
the lack of blinding, which could result in biased estimates.
Based on direct evidence from the NICE evidence review, the panel agreed that there was not enough evidence to recommend using vitamin D for treating COVID‑19. They also agreed that the recommendation on vitamin D supplements and treatment should be considered for an update as additional evidence becomes available. Because of the lack of evidence identified, the panel made a research recommendation around the clinical effectiveness of vitamin D supplements for treating COVID‑19. They stressed that future studies should be high-quality randomised controlled trials.
www.nice.org.uk/guidance/ng187/chapter/Rationale