Ontology highlight
ABSTRACT: Objective
To determine the effect of population level implementation of a test-and-treat approach to correction of suboptimal vitamin D status (25-hydroxyvitamin D (25(OH)D) <75 nmol/L) on risk of all cause acute respiratory tract infection and covid 19.Design
Phase 3 open label randomised controlled trial.Setting
United Kingdom.Participants
6200 people aged ≥16 years who were not taking vitamin D supplements at baseline.Interventions
Offer of a postal finger prick test of blood 25(OH)D concentration with provision of a six month supply of lower dose vitamin D (800 IU/day, n=1550) or higher dose vitamin D (3200 IU/day, n=1550) to those with blood 25(OH)D concentration <75 nmol/L, compared with no offer of testing or supplementation (n=3100). Follow-up was for six months.Main outcome measures
The primary outcome was the proportion of participants with at least one swab test or doctor confirmed acute respiratory tract infection of any cause. A secondary outcome was the proportion of participants with swab test confirmed covid-19. Logistic regression was used to calculate odds ratios and associated 95% confidence intervals. The primary analysis was conducted by intention to treat.Results
Of 3100 participants offered a vitamin D test, 2958 (95.4%) accepted and 2674 (86.3%) had 25(OH)D concentrations <75 nmol/L and received vitamin D supplements (n=1328 lower dose, n=1346 higher dose). Compared with 136/2949 (4.6%) participants in the no offer group, at least one acute respiratory tract infection of any cause occurred in 87/1515 (5.7%) in the lower dose group (odds ratio 1.26, 95% confidence interval 0.96 to 1.66) and 76/1515 (5.0%) in the higher dose group (1.09, 0.82 to 1.46). Compared with 78/2949 (2.6%) participants in the no offer group, 55/1515 (3.6%) developed covid-19 in the lower dose group (1.39, 0.98 to 1.97) and 45/1515 (3.0%) in the higher dose group (1.13, 0.78 to 1.63).Conclusions
Among people aged 16 years and older with a high baseline prevalence of suboptimal vitamin D status, implementation of a population level test-and-treat approach to vitamin D supplementation was not associated with a reduction in risk of all cause acute respiratory tract infection or covid-19.Trial registration
ClinicalTrials.gov NCT04579640.
SUBMITTER: Jolliffe DA
PROVIDER: S-EPMC9449358 | biostudies-literature | 2022 Sep
REPOSITORIES: biostudies-literature
Jolliffe David A DA Holt Hayley H Greenig Matthew M Talaei Mohammad M Perdek Natalia N Pfeffer Paul P Vivaldi Giulia G Maltby Sheena S Symons Jane J Barlow Nicola L NL Normandale Alexa A Garcha Rajvinder R Richter Alex G AG Faustini Sian E SE Orton Christopher C Ford David D Lyons Ronan A RA Davies Gwyneth A GA Kee Frank F Griffiths Christopher J CJ Norrie John J Sheikh Aziz A Shaheen Seif O SO Relton Clare C Martineau Adrian R AR
BMJ (Clinical research ed.) 20220907
<h4>Objective</h4>To determine the effect of population level implementation of a test-and-treat approach to correction of suboptimal vitamin D status (25-hydroxyvitamin D (25(OH)D) <75 nmol/L) on risk of all cause acute respiratory tract infection and covid 19.<h4>Design</h4>Phase 3 open label randomised controlled trial.<h4>Setting</h4>United Kingdom.<h4>Participants</h4>6200 people aged ≥16 years who were not taking vitamin D supplements at baseline.<h4>Interventions</h4>Offer of a postal fin ...[more]