VitaminD supplementation for the prevention and treatment of COVID-19: a position statement from the Spanish Society of Geriatrics and Gerontology | Revista Española de Geriatría y Gerontología

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Tarazona-Santabalbina, Leonor Cuadra, José Manuel Cancio, Ferran Roca Carbonell, Juan Manuel Pérez-Castejón Garrote, Álvaro Casas-Herrero, Nicolás Martínez-Velilla, José Antonio Serra-Rexach, Francesc Formiga" "autores" => array:9 [ 0 => array:4 [ "nombre" => "Francisco J." 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CIBERFES, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departament of Geriatric Medicine and Palliative Care, Badalona Serveis Assistencials, Barcelona, Spain. Catalonia Geriatrics and Gerontology Society, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Centro Sociosanitario El Carme, Servicio de Geriatría y Cuidados Paliativos de BSA (Badalona Servicios Asistenciales), Badalona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Badalona Welfare Services: Badalona Serveis Assistencials SA, Badalona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio de Geriatría Hospital Universitari de la Santa Creu, Vic, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Hospital Universitari de Vic: Hospital General de Vic, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Doctor en Medicina por la UB Especialista en Geriatria, Jefe del Servicio de Geriatria y Cuidados Paliativos de Badalona Serveis Assistencials BSA, CSS El Carme Badalona, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Navarrabiomed, Complejo Hospitalario de Navarra (CHN), (UPNA), IdiSNA, Pamplona, Spain" "etiqueta" => "h" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain" "etiqueta" => "i" "identificador" => "aff0045" ] 9 => array:3 [ "entidad" => "Hospital de Navarra: Complejo Hospitalario de Navarra, Spain" "etiqueta" => "j" "identificador" => "aff0050" ] 10 => array:3 [ "entidad" => "Jefe del Servicio de Geriatría Hospital General Universitario Gregorio Marañón Profesor Titular de Medicina, Departarmento de Medicina, Facultad de Medicina Universidad Complutense CIBER-Fragilidad y Envejecimiento Saludable Madrid, Spain" "etiqueta" => "k" "identificador" => "aff0055" ] 11 => array:3 [ "entidad" => "Hospital General Universitario Gregorio Marañón: Hospital General Universitario Gregorio Maranon, Spain" "etiqueta" => "l" "identificador" => "aff0060" ] 12 => array:3 [ "entidad" => "Programa de Geriatría, Servicio medicina Interna, Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain" "etiqueta" => "m" "identificador" => "aff0065" ] 13 => array:3 [ "entidad" => "Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Ageing Program, Translational Medicine Area, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain" "etiqueta" => "n" "identificador" => "aff0070" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Suplementos de vitamina D para la prevención y el tratamiento de la COVID-19: declaración de posición de la Sociedad Española de Geriatría y Gerontología" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1971 "Ancho" => 2034 "Tamanyo" => 221317 ] ] "descripcion" => array:1 [ "en" => "Pathophysiology of COVID-19." ] ] ] "textoCompleto" => "The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), produces severe respiratory symptoms such as bilateral pneumonia associated to a high morbidity and mortality, especially in patients of advanced age. At this time, there is not known active treatment for this virus. Corticosteroids and biological immunomodulators are being used to treat the inflammatory phase of the disease.<a class="elsevierStyleCrossRef" href="#bib0175">1</a>The classic functions of vitamin D (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) are to regulate calcium-phosphorus homeostasis and to control bone metabolism. Nevertheless, vitamin D deficiency has been reported in several chronic conditions associated with increased inflammation and dysregulation of the immune system. These observations, together with experimental studies, suggest a critical role for vitamin D in modulating immune function. There are two findings that validate this important non-classical action of vitamin D. First, the vitamin D receptor (VDR) is expressed by most immune cells, including B and T lymphocytes, monocytes, macrophages, and dendritic cells. Second, the signaling of vitamin D and VDR together has an anti-inflammatory effect, promoting the differentiation of dendritic cells and regulatory T cells, reducing the response of T cells and the secretion of inflammatory cytokines. The main cause leading to the increase in mortality rate in people with COVID-19 could be due to acute respiratory distress syndrome (ARDS) by non-antagonized overproduction of pro-inflammatory cytokines<a class="elsevierStyleCrossRef" href="#bib0180">2</a> (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>In this context, some studies have reported that vitamin D treatment could be useful for the prevention and treatment of COVID-19.<a class="elsevierStyleCrossRef" href="#bib0185">3</a> Vitamin D plays an important role as a modulator of immunocompetence (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) with respect to both innate and adaptive immunity, and may play a role in the cytokine storm process as well as in the coagulopathy and the cardiac damage of COVID-19.<a class="elsevierStyleCrossRef" href="#bib0190">4</a><elsevierMultimedia ident="fig0015"></elsevierMultimedia>Each patient's immune defenses play a major role in mitigating the negative impact of SARS-CoV-2. Vitamin D is an important modulator of the immune system. Although serum 25-hydroxyvitamin D levels can be raised through diet or supplements, most vitamin D in the body is the result of dermal synthesis from ultraviolet radiation. The production of vitamin D in the skin, however, can be limited by latitude, skin-covering clothes, the use of sunblock, and skin pigmentation. Vitamin D deficiency affects a high percentage of the world population. Serum 25-hydroxyvitamin D levels are suboptimal, not only in specific risk groups but also in healthy adults from many countries. Low vitamin D levels, therefore, represent a risk factor for several different pathologies, including SAR-CoV-2. An ecological design study on the association between vitamin D deficiency and COVID-19 incidence, complications, and mortality across 46 countries Reported a population-level association between the prevalence of vitamin D deficiency and the risk of being infected with COVID-19, severity of the disease, and the risk of dying from it.<a class="elsevierStyleCrossRef" href="#bib0195">5</a>COVID-19 is less prevalent in pregnant women, children and in Japanese people,<a class="elsevierStyleCrossRef" href="#bib0200">6</a> whose rates of vitamin D deficiency are lower.<a class="elsevierStyleCrossRef" href="#bib0205">7</a> On the other hand, lower levels of vitamin D have been related to an increased risk of infection,<a class="elsevierStyleCrossRef" href="#bib0210">8</a> as well as poorer short-term prognosis in patients with COVID-19.<a class="elsevierStyleCrossRef" href="#bib0215">9</a> Furthermore it is an evidence that vitamin D insufficiency and deficiency are common in older adults.<a class="elsevierStyleCrossRefs" href="#bib0220">10,11</a>Over the last few months, some studies have hypothesized the possible beneficial effect of vitamin D supplementation in patients with COVID-19 in order to improve the immune balance and prevent the hyperinflammatory cytokine storm since immune dysregulation is a key feature of severe COVID-19. The restoration of immune balance could prevent the hyperinflammatory cytokine storm. It is known that vitamin D is necessary for the maintenance of normal immune function. Likewise, in the context of COVID-19, vitamin D could also play a dual role in controlling viral replication initially, and subsequently, dampening hyperinflammation could have beneficial effects.<a class="elsevierStyleCrossRefs" href="#bib0230">12,13</a> Vitamin D levels are very low in countries such as Spain, Italy and Switzerland,<a class="elsevierStyleCrossRef" href="#bib0240">14</a> where a correlation has been observed between vitamin D levels, the number of COVID-19 cases and mortality related to this disease.Some preliminary studies have already shown promising results with vitamin D supplementation in hospitalized COVID-19 patients. A meta-analysis<a class="elsevierStyleCrossRef" href="#bib0245">15</a> has described a lower mortality rate in patients in whom vitamin D was administered (10.6%) compared to controls (23.9%). Two retrospective studies<a class="elsevierStyleCrossRefs" href="#bib0250">16,17</a> included in this meta-analysis showed a decrease in the score of the OSCI scale (WHO Ordinal Scale for Clinical Improvement) in the group treated with vitamin D, a third study included demonstrated a lower rate of admission in intensive care units<a class="elsevierStyleCrossRef" href="#bib0260">18</a> and the fourth one showed a significant decrease in serum fibrinogen levels.<a class="elsevierStyleCrossRef" href="#bib0265">19</a> Likewise, in one of the studies,<a class="elsevierStyleCrossRef" href="#bib0255">17</a> administration of vitamin D3 in bolus occurred in the month before admission to hospital.The vitamin doses administered are heterogeneous across studies ranging from a single dose of 400,000IU of cholecalciferol the day of hospital admission to 50,000IU in patients who did not receive more than 800IU per day during the month prior to the hospital admission.<a class="elsevierStyleCrossRef" href="#bib0270">20</a>Vitamin D should be administered daily until adequate levels are achieved as it is a steroid hormone,<a class="elsevierStyleCrossRef" href="#bib0275">21</a> for that reason we have focused on guidelines that allow better conciliation with daily hospital activity. In this same context of SARS-CoV-2 infection, vitamin D behaves as a negative acute phase reactant (APR),<a class="elsevierStyleCrossRef" href="#bib0280">22</a> therefore a progressive decrease can be generated due to human consumption during the course of the infection.<a class="elsevierStyleCrossRef" href="#bib0285">23</a> Firstly, calcifediol (vitamin D2) is 3–6 times more powerful than cholecalciferol (vitamin D3) although its half-life is shorter; secondly, the objective of treatment should be to achieve quickly the adequate levels and maintain it for a minimum of 3 months; and finally, in case of obesity or malabsorption, the use of higher doses than those suggested in these recommendations should be considered.Recent studies recommend daily supplementation with 800–1000IU of vitamin D<a class="elsevierStyleCrossRef" href="#bib0270">20</a> to reduce the incidence and severity of symptoms of older patients with acute SARS-CoV-2 infection. However, these recommendations will focus on older patients with acute SARS-CoV-2 virus infection. This is supported by a study with a small sample size (n=76)<a class="elsevierStyleCrossRef" href="#bib0255">17</a> where high doses of calcifediol significantly reduced the need for admission to intensive care units.Despite the lack of evidence on specific doses of vitamin D to treat COVID-19 in older adults, we consider it is necessary to standardize the use in clinical practice. In fact, a recent review concluded that, despite limitations and remaining uncertainties, accumulating evidence strongly supports widespread vitamin D supplementation, in particular of high-risk populations, as well as high-dose supplementation of those infected. Given the dynamics of the COVID-19 pandemic, the benefit–risk ratio of such supplementation calls for immediate action even before results of ongoing large-scale randomized trials become available.<a class="elsevierStyleCrossRef" href="#bib0290">24</a> The first step to do that in hospitalized older adults should be to determine the amount of vitamin D on admission together with D-Dimer, C-reactive protein, ferritin, fibrinogen and other APR; and if needed to supplement vitamin D in a protocoled fashion as suggested in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> (based on expert opinions, level of evidence 5). The doses of calcifediol and cholecalciferol have been detailed to facilitate vitamin D supplementation regardless of the presentations available in the hospital pharmacies of each clinical center.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Finally, clinicians should be aware that supplementation with high doses of vitamin D can cause toxicity, especially hypercalcemia, which can manifest as irreversible cardiovascular and renal damage such as kidney stones<a class="elsevierStyleCrossRef" href="#bib0295">25</a> and the calcification of soft tissues and vascular territories, likewise patient may experience symptoms such as nausea, vomiting; likewise patients may experience increased thirst and depression during treatment.<a class="elsevierStyleCrossRef" href="#bib0300">26</a> However, the therapeutic window of vitamin D is wide and the toxicity associated with its supplementation is rare, with less than 0.1% of hypercalcemia associated with hypervitaminosis D.<a class="elsevierStyleCrossRef" href="#bib0305">27</a> For this reason, we consider it is convenient to measure calcium levels on a regular basis or when toxicity is suspected due to vitamin D supplementation.Recently, a NICE<a class="elsevierStyleCrossRef" href="#bib0310">28</a> guideline concluded that there was not enough evidence to recommend the use of vitamin D to prevent or treat SARS-CoV-2 infection alone. We recommend the use of calcifediol or cholecalciferol alone with those used to treat COVID-19 stated in international guidelines and protocols. Likewise, the aforementioned NICE guideline has received a wide response.<a class="elsevierStyleCrossRefs" href="#bib0315">29–31</a> One of this responses<a class="elsevierStyleCrossRef" href="#bib0315">29</a> indicates the results of a meta-analysis on the benefits of the administration of vitamin D in the prevention of respiratory infections. The second of the cited responses<a class="elsevierStyleCrossRef" href="#bib0320">30</a> emphasizes the presence of five ongoing clinical trials (<a href="ctgov:NCT04579640">NCT04579640</a>, <a href="ctgov:NCT04476680">NCT04476680</a>; <a href="ctgov:NCT04483635">NCT04483635</a>; <a href="ctgov:NCT04386850">NCT04386850</a>; <a href="ctgov:NCT04535791">NCT04535791</a>) on the effects of vitamin D in the treatment of patients with COVID-19, one of them compared to the British national recommendations of 400IU per day (<a href="ctgov:NCT04579640">NCT04579640</a>) and two of them to placebo arm (<a href="ctgov:NCT04386850">NCT04386850</a>, <a href="ctgov:NCT04535791">NCT04535791</a>). As the pandemic situation continues to get worse (and will possibly continue to worsen during the winter months before the effects of the vaccines are noticeable), additional evidence could come too late.<a class="elsevierStyleCrossRef" href="#bib0325">31</a> We know that in an ideal world, health decisions must be made based on overwhelming evidence, but a time of crisis such as the current one may require a slightly different set of rules.<a class="elsevierStyleCrossRef" href="#bib0330">32</a> In this sense, knowing the responsibility that absence forces based on resounding evidence, we offer these recommendations being aware that in the near future we must review them with the evidence generated.Conflict of interestThe authors declare that they have no conflicts of interest for this manuscript." "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:3 [ "identificador" => "xres1505780" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1366491" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1505779" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1366492" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 5 => array:2 [ "identificador" => "xack528226" "titulo" => "Acknowledgment" ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-01-22" "fechaAceptado" => "2021-02-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1366491" "palabras" => array:5 [ 0 => "COVID-19" 1 => "Vitamin D" 2 => "Frailty" 3 => "SARS-CoV-2" 4 => "Older adults" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1366492" "palabras" => array:5 [ 0 => "COVID-19" 1 => "Vitamina D" 2 => "Fragilidad" 3 => "SARS-CoV-2" 4 => "Adultos mayores" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "The coronavirus disease 2019 (COVID-19) produces severe respiratory symptoms such as bilateral pneumonia associated to a high morbidity and mortality, especially in patients of advanced age. Vitamin D deficiency has been reported in several chronic conditions associated with increased inflammation and dysregulation of the immune system. Vitamin D in modulates immune function too. Vitamin D receptor (VDR) is expressed by most immune cells, including B and T lymphocytes, monocytes, macrophages, and dendritic cells and the signalling of vitamin D and VDR together has an anti-inflammatory effect. Some studies have reported that vitamin D treatment could be useful for the prevention and treatment of COVID-19 because vitamin D plays an important role as a modulator of immunocompetence. Over the last few months, some studies have hypothesized the possible beneficial effect of vitamin D supplementation in patients with COVID-19 in order to improve the immune balance and prevent the hyperinflammatory cytokine storm. Some preliminary studies have already shown promising results with vitamin D supplementation in hospitalized COVID-19 patients. Vitamin D should be administered daily until adequate levels are achieved due to vitamin D behaves as a negative acute phase reactant (APR). Despite the lack of evidence on specific doses of vitamin D to treat COVID-19 in older adults, authors consider it is necessary to standardize the use in clinical practice. These recommendations advice supplement vitamin D in a protocoled fashion based on expert opinions, level of evidence 5." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "La enfermedad por coronavirus 2019 (COVID-19) produce síntomas respiratorios graves, como la neumonía bilateral, asociados a una elevada morbilidad y mortalidad, especialmente en pacientes de edad avanzada. La deficiencia de vitamina D se ha reportado en varias condiciones crónicas asociadas con el aumento de la inflamación y la desregulación del sistema inmunológico. La vitamina D también modula la función inmunitaria. El receptor de la vitamina D (VDR) se expresa en la mayoría de las células inmunitarias, incluidos los linfocitos B y T, los monocitos, los macrófagos y las células dendríticas, y la señalización conjunta de la vitamina D y el VDR tiene un efecto antiinflamatorio. Algunos estudios han informado de que el tratamiento con vitamina D podría ser útil para la prevención y el tratamiento de la COVID-19 porque la vitamina D desempeña un papel importante como modulador de la inmunocompetencia. En los últimos meses, algunos estudios han planteado la hipótesis del posible efecto beneficioso de la suplementación con vitamina D en pacientes con COVID-19 para mejorar el equilibrio inmunitario y prevenir la tormenta de citoquinas hiperinflamatorias. Algunos estudios preliminares ya han mostrado resultados prometedores con la suplementación de vitamina D en pacientes con COVID-19 hospitalizados. La vitamina D debe administrarse diariamente hasta que se alcancen los niveles adecuados debido a que la vitamina D se comporta como un reactante de fase aguda (RFA) negativo. A pesar de la falta de evidencia sobre las dosis específicas de vitamina D para tratar la COVID-19 en adultos mayores, los autores consideran que es necesario estandarizar su uso en la práctica clínica. Estas recomendaciones aconsejan suplementar la vitamina D de forma protocolizada en base a opiniones de expertos, nivel de evidencia 5." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1971 "Ancho" => 2034 "Tamanyo" => 221317 ] ] "descripcion" => array:1 [ "en" => "Pathophysiology of COVID-19." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2195 "Ancho" => 3425 "Tamanyo" => 358597 ] ] "descripcion" => array:1 [ "en" => "Summary of main pathways involved in the clinical evolution at the pulmonary level of positive COVID-19 patients (based on the studies of Mansur JL et al.<a class="elsevierStyleCrossRef" href="#bib0335">33</a> and Farid N et al.<a class="elsevierStyleCrossRef" href="#bib0340">34</a>)." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1951 "Ancho" => 2824 "Tamanyo" => 491256 ] ] "descripcion" => array:1 [ "en" => "Vitamin D: immunomodulatory role." ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Alternative administration of cholecalciferol in daily regimen:11-20 ng/mL: cholecalciferol “4,000” IU/daily for 120 days.21-30 ng/mL: cholecalciferol “3,000” IU/daily for 120 days.31-40 ng/mL: cholecalciferol “2,000” IU/daily for 120 days.41-60 ng/mL: cholecalciferol “1,000” IU/daily for 120 days.Cite: authors’ note." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patients with SARS-COV2 infection and recent determination of serum calcidiol level</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Calcidiol serum level (ng/ml) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Dose and frequency of cholecalciferol administration \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Duration \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><10ng/ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calcifediol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16,000IU per day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 days \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Later on 16,000IU per week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cholecalciferol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50,000UI/week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Later on 25,000UI/week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11–20ng/ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calcifediol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16,000IU per day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 days \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Later on 16,000IU per week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cholecalciferol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50,000UI/week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Later on 25,000UI/week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21–29ng/ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cholecalciferol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50,000UI/week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Later on 25,000UI/week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30–40ng/ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cholecalciferol50,000UI single dose \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Later on 25,000UI/week \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41–60ng/ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25,000UI biweekly \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No determination of serum calcidiol level \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cholecalciferol50,000IU/every 5 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 doses \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Later on \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25,000UI/weekly \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 weeks \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2586747.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Recommended dose of vitamin D supplementation." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0175" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathophysiology, transmission diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W.J. Wiersinga" 1 => "A. Rhodes" 2 => "A.C. Cheng" 3 => "S.J. Peacock" 4 => "H.C. Prescott" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2020.12839" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2020" "volumen" => "324" "paginaInicial" => "782" "paginaFinal" => "793" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32648899" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0180" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evidence for possible association of vitamin D status with cytokine storm and unregulated inflammation in COVID-19 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Daneshkhah" 1 => "V. Agrawal" 2 => "A. Eshein" 3 => "H. Subramanian" 4 => "J.K. Roy" 5 => "V. Backman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40520-020-01677-y" "Revista" => array:6 [ "tituloSerie" => "Aging Clin Exp Res" "fecha" => "2020" "volumen" => "32" "paginaInicial" => "2141" "paginaFinal" => "2158" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32876941" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0185" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.B. Grant" 1 => "H. Lahore" 2 => "S.L. McDonnell" 3 => "C.A. Baggerly" 4 => "C.B. French" 5 => "J.L. Aliano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu12040988" "Revista" => array:4 [ "tituloSerie" => "Nutrients" "fecha" => "2020" "volumen" => "12" "paginaInicial" => "988" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0190" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mechanisms in endocrinology: vitamin D and COVID-19" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. Bilezikian" 1 => "D. Bikle" 2 => "M. Hewison" 3 => "M. Lazaretti-Castro" 4 => "A.N. Formenti" 5 => "A. Gupta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1530/EJE-20-0665" "Revista" => array:6 [ "tituloSerie" => "Eur J Endocrinol" "fecha" => "2020" "volumen" => "183" "paginaInicial" => "R133" "paginaFinal" => "R147" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32755992" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0195" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between vitamin D deficiency and COVID-19 incidence, complications, and mortality in 46 countries: an ecological study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Mariani" 1 => "V.M. Marin Gimenez" 2 => "I. Bergam" 3 => "C. Tajer" 4 => "L. Antonietti" 5 => "F. Inserra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/hs.2020.0137" "Revista" => array:2 [ "tituloSerie" => "Health Secur" "fecha" => "2020" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0200" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Statista [sede web]. Hamburg: Statista; 2020. Cumulative number of patients diagnosed with coronavirus disease (COVID-19) in Japan. Available from: <a target="_blank" href="https://www.statista.com/statistics/1096478/japan-confirmed-cases-ofcoronavirus-by-state-of-health">https://www.statista.com/statistics/1096478/japan-confirmed-cases-ofcoronavirus-by-state-of-health</a> [accessed 13.01.21]." ] ] ] 6 => array:3 [ "identificador" => "bib0205" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.A. Ginde" 1 => "A.F. Sullivan" 2 => "J.M. Mansbach" 3 => "C.A. Camargo Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ajog.2009.11.036" "Revista" => array:5 [ "tituloSerie" => "Am J Obstet Gynecol" "fecha" => "2010" "volumen" => "202" "paginaInicial" => "436e1" "paginaFinal" => "436e8" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0210" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of vitamin D status and other clinical characteristics with COVID-19 Test results" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.O. Meltzer" 1 => "T.J. Best" 2 => "H. Zhang" 3 => "T. Vokes" 4 => "V. Arora" 5 => "J. Solway" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamanetworkopen.2020.19722" "Revista" => array:5 [ "tituloSerie" => "JAMA Netw Open" "fecha" => "2020" "volumen" => "3" "paginaInicial" => "e2019722" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32880651" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0215" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "deficiency and low serum calcium as predictors of poor prognosis in patients with severe COVID-19" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Bennouar" 1 => "A.B. Cherif" 2 => "A. Kessira" 3 => "D.E. Bennouar" 4 => "S. Abdi" 5 => "D. Vitamin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/07315724.2020.1856013" "Revista" => array:5 [ "tituloSerie" => "J Am Coll Nutr" "fecha" => "2021" "volumen" => "12" "paginaInicial" => "1" "paginaFinal" => "11" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0220" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of vitamin D insufficiency and evidence for disease prevention in the older population" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Kühn" 1 => "P. Trotz" 2 => "G.I. Stangl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00391-018-1390-z" "Revista" => array:6 [ "tituloSerie" => "Z Gerontol Geriatr" "fecha" => "2018" "volumen" => "51" "paginaInicial" => "567" "paginaFinal" => "572" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29666919" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0225" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D and COVID-19: evidence and recommendations for supplementation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Griffin" 1 => "M. Hewison" 2 => "J. Hopkin" 3 => "R. Kenny" 4 => "R. Quinton" 5 => "J. Rhodes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1098/rsos.201912" "Revista" => array:5 [ "tituloSerie" => "R Soc Open Sci" "fecha" => "2020" "volumen" => "7" "paginaInicial" => "201912" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33489300" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0230" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Xu" 1 => "D.J. Baylink" 2 => "C.S. Chen" 3 => "M.E. Reeves" 4 => "J. Xiao" 5 => "C. Lacy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12967-020-02488-5" "Revista" => array:4 [ "tituloSerie" => "J Transl Med" "fecha" => "2020" "volumen" => "18" "paginaInicial" => "322" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0235" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exploring links between vitamin D deficiency and COVID-19" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Mohan" 1 => "J.J. Cherian" 2 => "A. Sharma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.ppat.1008874" "Revista" => array:4 [ "tituloSerie" => "PLoS Pathog" "fecha" => "2020" "volumen" => "16" "paginaInicial" => "e1008874" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0240" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.C. Ilie" 1 => "S. Stefanescu" 2 => "L. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40520-020-01570-8" "Revista" => array:6 [ "tituloSerie" => "Aging Clin Exp Res" "fecha" => "2020" "volumen" => "32" "paginaInicial" => "1195" "paginaFinal" => "1198" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32377965" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0245" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Nikniaz L, Akbarzadeh MA, Hosseinifard H, Hosseini MS. The impact of vitamin D supplementation on mortality rate and clinical outcomes of COVID-19 patients: a systematic review and meta-analysis. Version: 1. MedRxiv [Preprint]. [25p]. Available from: <a target="_blank" href="https://www.medrxiv.org/content/10.1101/2021.01.04.21249219v1.full.pdf+html">https://www.medrxiv.org/content/10.1101/2021.01.04.21249219v1.full.pdf+html</a> [posted 05.01.21]." ] ] ] 15 => array:3 [ "identificador" => "bib0250" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D and survival in COVID-19 patients: a quasi-experimental study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Annweiler" 1 => "B. Hanotte" 2 => "C.G. de l’Eprevier" 3 => "J.M. Sabatier" 4 => "L. Lafaie" 5 => "T. Celarier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jsbmb.2020.105771" "Revista" => array:5 [ "tituloSerie" => "J Steroid Biochem Mol Biol" "fecha" => "2020" "volumen" => "204" "paginaInicial" => "105771" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33065275" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0255" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D supplementation associated to better survival in hospitalized frail elderly COVID-19 patients: the GERIA-COVID Quasi-Experimental study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Annweiler" 1 => "M. Corvaisier" 2 => "J. Gautier" 3 => "V. Dubee" 4 => "E. Legrand" 5 => "G. Sacco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu12113377" "Revista" => array:4 [ "tituloSerie" => "Nutrients" "fecha" => "2020" "volumen" => "12" "paginaInicial" => "3377" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0260" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: a pilot randomized clinical study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Entrenas Castillo" 1 => "L.M. Entrenas Costa" 2 => "J.M. Vaquero Barrios" 3 => "J.F. Alcala Diaz" 4 => "J. Lopez Miranda" 5 => "R. Bouillon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jsbmb.2020.105751" "Revista" => array:5 [ "tituloSerie" => "J Steroid Biochem Mol Biol" "fecha" => "2020" "volumen" => "203" "paginaInicial" => "105751" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32871238" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0265" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Rastogi" 1 => "A. Bhansali" 2 => "N. Khare" 3 => "V. Suri" 4 => "N. Yaddanapudi" 5 => "N. Sachdeva" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/postgradmedj-2020-139065" "Revista" => array:3 [ "tituloSerie" => "Postgrad Med J" "fecha" => "2020" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1754527" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0270" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Covid-19 and high-dose Vitamin D supplementation TRIAL in high-risk older patients (COVIT-TRIAL): study protocol for a randomized controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Annweiler" 1 => "M. Beaudenon" 2 => "J. Gautier" 3 => "R. Simon" 4 => "V. Dubee" 5 => "J. Gonsard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13063-020-04928-5" "Revista" => array:5 [ "tituloSerie" => "Trials" "fecha" => "2020" "volumen" => "21" "paginaInicial" => "1031" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33371905" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0275" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preventing vitamin D deficiency during the COVID-19 pandemic: UK definitions of vitamin D sufficiency and recommended supplement dose are set too low" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Griffin" 1 => "M. Hewison" 2 => "J. Hopkin" 3 => "R.A. Kenny" 4 => "R. Quinton" 5 => "J. Rhodes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7861/clinmed.2020-0858" "Revista" => array:5 [ "tituloSerie" => "Clin Med (Lond)" "fecha" => "2021" "volumen" => "21" "paginaInicial" => "e48" "paginaFinal" => "e51" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0280" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D: a negative acute phase reactant" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Waldron" 1 => "H.L. Ashby" 2 => "M.P. Cornes" 3 => "J. Bechervaise" 4 => "C. Razavi" 5 => "O.L. Thomas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jclinpath-2012-201301" "Revista" => array:6 [ "tituloSerie" => "J Clin Pathol" "fecha" => "2013" "volumen" => "66" "paginaInicial" => "620" "paginaFinal" => "622" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23454726" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0285" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D status in hospitalized patients with SARS-CoV-2 infection" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Hernández" 1 => "D. Nan" 2 => "M. Fernandez-Ayala" 3 => "M. García-Unzueta" 4 => "M.A. Hernández-Hernández" 5 => "M. López-Hoyos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/clinem/dgaa733" "Revista" => array:3 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "2020" "paginaInicial" => "dgaa733" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0290" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D supplementation to prevent COVID-19 infections and deaths—accumulating evidence from epidemiological and intervention studies calls for immediate action" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Brenner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu13020411" "Revista" => array:5 [ "tituloSerie" => "Nutrients" "fecha" => "2021" "volumen" => "13" "paginaInicial" => "411" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33525447" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0295" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "SCAN [sitio web]. England: The Scientific Advisory Committee on Nutrition; 2016. SACN. Vitamin D and health report. SACN: reports and position statements and Obesity and healthy eating. Available from: <a target="_blank" href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf">https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf</a> [accessed 11.12.20]." ] ] ] 25 => array:3 [ "identificador" => "bib0300" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efectiveness and safety of vitamin D in relation to bone health" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Cranney" 1 => "T. Horsley" 2 => "S. O’Donnell" 3 => "H. Weiler" 4 => "D. Ooi" 5 => "S. Atkinson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Evid Rep Technol Assess (Full Rep)" "fecha" => "2007" "paginaInicial" => "1" "paginaFinal" => "235" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0305" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of hypercalcemia related to hypervitaminosis D in clinical practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Perez-Barrios" 1 => "E. Hernandez-Alvarez" 2 => "I. Blanco-Navarro" 3 => "B. Perez-Sacristan" 4 => "F. GranadoLorencio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2016.02.017" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "1354" "paginaFinal" => "1358" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26995293" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0310" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "NICE. [Sede Web]. England: National Institute for Health and Care Excellence; 2020. NICE. Covid-19 rapid guideline: vitamin D. Available from: <a target="_blank" href="http://www.nice.org.uk/guidance/ng187">www.nice.org.uk/guidance/ng187</a> [accessed 19.12.20]." ] ] ] 28 => array:3 [ "identificador" => "bib0315" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Covid-19: evidence is lacking to support vitamin D's role in treatment and prevention" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Wise" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.m4912" "Revista" => array:4 [ "tituloSerie" => "BMJ" "fecha" => "2020" "volumen" => "371" "paginaInicial" => "m4912" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0320" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Osayande Eregie C. RE: vitamin D and COVID-19 – this is no time for procrastination. [Internet]. BMJ. Available from <a target="_blank" href="https://www.bmj.com/content/371/bmj.m4912/rr-6">https://www.bmj.com/content/371/bmj.m4912/rr-6</a> [posted 22.12.20], [cited 29.01.21]." ] ] ] 30 => array:3 [ "identificador" => "bib0325" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D and COVID-19: why the controversy?" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "The Lancet Diabetes Endocrinology" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2213-8587(21)00003-6" "Revista" => array:5 [ "tituloSerie" => "Lancet Diabetes Endocrinol" "fecha" => "2021" "volumen" => "9" "paginaInicial" => "53" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33444566" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0330" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Joliffe DA, Carmargo CA Jr, Sluyter JD, Aglipay M, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory infections: systematic review and meta-analysis of aggregate data from randomised controlled trials. Version 1. MedRxiv [Preprint]. [33p]. Available from: <a target="_blank" href="https://www.medrxiv.org/content/10.1101/2020.07.14.20152728v1.full.pdf+html">https://www.medrxiv.org/content/10.1101/2020.07.14.20152728v1.full.pdf+html</a> [posted 17.07.20]." ] ] ] 32 => array:3 [ "identificador" => "bib0335" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vitamin D high doses supplementation could represent a promising alternative to prevent or treat COVID-19 infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.L. Mansur" 1 => "C. Tajer" 2 => "J. Mariani" 3 => "F. Inserra" 4 => "L. Ferder" 5 => "W. Manucha" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arteri.2020.05.003" "Revista" => array:6 [ "tituloSerie" => "Clin Investig Arterioscler" "fecha" => "2020" "volumen" => "32" "paginaInicial" => "267" "paginaFinal" => "277" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32718670" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0340" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Active vitamin D supplementation and COVID-19 infections: review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Farid" 1 => "N. Rola" 2 => "E.A.T. Koch" 3 => "N. Nakhoul" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11845-020-02452-8" "Revista" => array:4 [ "tituloSerie" => "Ir J Med Sci" "fecha" => "2021" "paginaInicial" => "1" "paginaFinal" => "4" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack528226" "titulo" => "Acknowledgment" "texto" => "The authors would like to thank Juan María de la Cámara de las Heras, librarian and archivist of Hospital Universitario de la Ribera, for his help in carrying out the necessary literature search for this review." 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Special article

VitaminD supplementation for the prevention and treatment of COVID-19: a position statement from the Spanish Society of Geriatrics and Gerontology

Suplementos de vitamina D para la prevención y el tratamiento de la COVID-19: declaración de posición de la Sociedad Española de Geriatría y Gerontología

Francisco J. Tarazona-Santabalbinaa,

Corresponding author

fjtarazonas@gmail.com
tarazona_frasan@gva.es

Corresponding author.

, Leonor Cuadrab, José Manuel Cancioc,d, Ferran Roca Carbonelle,f, Juan Manuel Pérez-Castejón Garroteg,d, Álvaro Casas-Herreroh,i,j, Nicolás Martínez-Velillah,i,j, José Antonio Serra-Rexachk,l, Francesc Formigam,n

a Geriatric Service, Hospital Universitario de la Ribera, Alzira, Valencia, Spain. CIBERFES, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable, Madrid, Spain

b Departament of Geriatric Medicine and Palliative Care, Badalona Serveis Assistencials, Barcelona, Spain. Catalonia Geriatrics and Gerontology Society, Barcelona, Spain

c Centro Sociosanitario El Carme, Servicio de Geriatría y Cuidados Paliativos de BSA (Badalona Servicios Asistenciales), Badalona, Spain

d Badalona Welfare Services: Badalona Serveis Assistencials SA, Badalona, Spain

e Servicio de Geriatría Hospital Universitari de la Santa Creu, Vic, Spain

f Hospital Universitari de Vic: Hospital General de Vic, Spain

g Doctor en Medicina por la UB Especialista en Geriatria, Jefe del Servicio de Geriatria y Cuidados Paliativos de Badalona Serveis Assistencials BSA, CSS El Carme Badalona, Spain

h Navarrabiomed, Complejo Hospitalario de Navarra (CHN), (UPNA), IdiSNA, Pamplona, Spain

i CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain

j Hospital de Navarra: Complejo Hospitalario de Navarra, Spain

k Jefe del Servicio de Geriatría Hospital General Universitario Gregorio Marañón Profesor Titular de Medicina, Departarmento de Medicina, Facultad de Medicina Universidad Complutense CIBER-Fragilidad y Envejecimiento Saludable Madrid, Spain

l Hospital General Universitario Gregorio Marañón: Hospital General Universitario Gregorio Maranon, Spain

m Programa de Geriatría, Servicio medicina Interna, Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

n Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Ageing Program, Translational Medicine Area, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Spain

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These observations&#44; together with experimental studies&#44; suggest a critical role for vitamin D in modulating immune function&#46; There are two findings that validate this important non-classical action of vitamin D&#46; First&#44; the vitamin D receptor &#40;VDR&#41; is expressed by most immune cells&#44; including B and T lymphocytes&#44; monocytes&#44; macrophages&#44; and dendritic cells&#46; Second&#44; the signaling of vitamin D and VDR together has an anti-inflammatory effect&#44; promoting the differentiation of dendritic cells and regulatory T cells&#44; reducing the response of T cells and the secretion of inflammatory cytokines&#46; The main cause leading to the increase in mortality rate in people with COVID-19 could be due to acute respiratory distress syndrome &#40;ARDS&#41; by non-antagonized overproduction of pro-inflammatory cytokines<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In this context&#44; some studies have reported that vitamin D treatment could be useful for the prevention and treatment of COVID-19&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">3</span></a> Vitamin D plays an important role as a modulator of immunocompetence &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; with respect to both innate and adaptive immunity&#44; and may play a role in the cytokine storm process as well as in the coagulopathy and the cardiac damage of COVID-19&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">4</span></a></p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Each patient&#39;s immune defenses play a major role in mitigating the negative impact of SARS-CoV-2&#46; Vitamin D is an important modulator of the immune system&#46; Although serum 25-hydroxyvitamin D levels can be raised through diet or supplements&#44; most vitamin D in the body is the result of dermal synthesis from ultraviolet radiation&#46; The production of vitamin D in the skin&#44; however&#44; can be limited by latitude&#44; skin-covering clothes&#44; the use of sunblock&#44; and skin pigmentation&#46; Vitamin D deficiency affects a high percentage of the world population&#46; Serum 25-hydroxyvitamin D levels are suboptimal&#44; not only in specific risk groups but also in healthy adults from many countries&#46; Low vitamin D levels&#44; therefore&#44; represent a risk factor for several different pathologies&#44; including SAR-CoV-2&#46; An ecological design study on the association between vitamin D deficiency and COVID-19 incidence&#44; complications&#44; and mortality across 46 countries Reported a population-level association between the prevalence of vitamin D deficiency and the risk of being infected with COVID-19&#44; severity of the disease&#44; and the risk of dying from it&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">5</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">COVID-19 is less prevalent in pregnant women&#44; children and in Japanese people&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a> whose rates of vitamin D deficiency are lower&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">7</span></a> On the other hand&#44; lower levels of vitamin D have been related to an increased risk of infection&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">8</span></a> as well as poorer short-term prognosis in patients with COVID-19&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a> Furthermore it is an evidence that vitamin D insufficiency and deficiency are common in older adults&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">10&#44;11</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Over the last few months&#44; some studies have hypothesized the possible beneficial effect of vitamin D supplementation in patients with COVID-19 in order to improve the immune balance and prevent the hyperinflammatory cytokine storm since immune dysregulation is a key feature of severe COVID-19&#46; The restoration of immune balance could prevent the hyperinflammatory cytokine storm&#46; It is known that vitamin D is necessary for the maintenance of normal immune function&#46; Likewise&#44; in the context of COVID-19&#44; vitamin D could also play a dual role in controlling viral replication initially&#44; and subsequently&#44; dampening hyperinflammation could have beneficial effects&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">12&#44;13</span></a> Vitamin D levels are very low in countries such as Spain&#44; Italy and Switzerland&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> where a correlation has been observed between vitamin D levels&#44; the number of COVID-19 cases and mortality related to this disease&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Some preliminary studies have already shown promising results with vitamin D supplementation in hospitalized COVID-19 patients&#46; A meta-analysis<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">15</span></a> has described a lower mortality rate in patients in whom vitamin D was administered &#40;10&#46;6&#37;&#41; compared to controls &#40;23&#46;9&#37;&#41;&#46; Two retrospective studies<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">16&#44;17</span></a> included in this meta-analysis showed a decrease in the score of the OSCI scale &#40;WHO Ordinal Scale for Clinical Improvement&#41; in the group treated with vitamin D&#44; a third study included demonstrated a lower rate of admission in intensive care units<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">18</span></a> and the fourth one showed a significant decrease in serum fibrinogen levels&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">19</span></a> Likewise&#44; in one of the studies&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">17</span></a> administration of vitamin D<span class="elsevierStyleInf">3</span> in bolus occurred in the month before admission to hospital&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The vitamin doses administered are heterogeneous across studies ranging from a single dose of 400&#44;000<span class="elsevierStyleHsp" style=""></span>IU of cholecalciferol the day of hospital admission to 50&#44;000<span class="elsevierStyleHsp" style=""></span>IU in patients who did not receive more than 800<span class="elsevierStyleHsp" style=""></span>IU per day during the month prior to the hospital admission&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Vitamin D should be administered daily until adequate levels are achieved as it is a steroid hormone&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a> for that reason we have focused on guidelines that allow better conciliation with daily hospital activity&#46; In this same context of SARS-CoV-2 infection&#44; vitamin D behaves as a negative acute phase reactant &#40;APR&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">22</span></a> therefore a progressive decrease can be generated due to human consumption during the course of the infection&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a> Firstly&#44; calcifediol &#40;vitamin D2&#41; is 3&#8211;6 times more powerful than cholecalciferol &#40;vitamin D3&#41; although its half-life is shorter&#59; secondly&#44; the objective of treatment should be to achieve quickly the adequate levels and maintain it for a minimum of 3 months&#59; and finally&#44; in case of obesity or malabsorption&#44; the use of higher doses than those suggested in these recommendations should be considered&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Recent studies recommend daily supplementation with 800&#8211;1000<span class="elsevierStyleHsp" style=""></span>IU of vitamin D<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a> to reduce the incidence and severity of symptoms of older patients with acute SARS-CoV-2 infection&#46; However&#44; these recommendations will focus on older patients with acute SARS-CoV-2 virus infection&#46; This is supported by a study with a small sample size &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>76&#41;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">17</span></a> where high doses of calcifediol significantly reduced the need for admission to intensive care units&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Despite the lack of evidence on specific doses of vitamin D to treat COVID-19 in older adults&#44; we consider it is necessary to standardize the use in clinical practice&#46; In fact&#44; a recent review concluded that&#44; despite limitations and remaining uncertainties&#44; accumulating evidence strongly supports widespread vitamin D supplementation&#44; in particular of high-risk populations&#44; as well as high-dose supplementation of those infected&#46; Given the dynamics of the COVID-19 pandemic&#44; the benefit&#8211;risk ratio of such supplementation calls for immediate action even before results of ongoing large-scale randomized trials become available&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">24</span></a> The first step to do that in hospitalized older adults should be to determine the amount of vitamin D on admission together with D-Dimer&#44; C-reactive protein&#44; ferritin&#44; fibrinogen and other APR&#59; and if needed to supplement vitamin D in a protocoled fashion as suggested in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> &#40;based on expert opinions&#44; level of evidence 5&#41;&#46; The doses of calcifediol and cholecalciferol have been detailed to facilitate vitamin D supplementation regardless of the presentations available in the hospital pharmacies of each clinical center&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Finally&#44; clinicians should be aware that supplementation with high doses of vitamin D can cause toxicity&#44; especially hypercalcemia&#44; which can manifest as irreversible cardiovascular and renal damage such as kidney stones<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">25</span></a> and the calcification of soft tissues and vascular territories&#44; likewise patient may experience symptoms such as nausea&#44; vomiting&#59; likewise patients may experience increased thirst and depression during treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">26</span></a> However&#44; the therapeutic window of vitamin D is wide and the toxicity associated with its supplementation is rare&#44; with less than 0&#46;1&#37; of hypercalcemia associated with hypervitaminosis D&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">27</span></a> For this reason&#44; we consider it is convenient to measure calcium levels on a regular basis or when toxicity is suspected due to vitamin D supplementation&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Recently&#44; a NICE<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a> guideline concluded that there was not enough evidence to recommend the use of vitamin D to prevent or treat SARS-CoV-2 infection alone&#46; We recommend the use of calcifediol or cholecalciferol alone with those used to treat COVID-19 stated in international guidelines and protocols&#46; Likewise&#44; the aforementioned NICE guideline has received a wide response&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">29&#8211;31</span></a> One of this responses<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">29</span></a> indicates the results of a meta-analysis on the benefits of the administration of vitamin D in the prevention of respiratory infections&#46; The second of the cited responses<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">30</span></a> emphasizes the presence of five ongoing clinical trials &#40;<a href="ctgov:NCT04579640">NCT04579640</a>&#44; <a href="ctgov:NCT04476680">NCT04476680</a>&#59; <a href="ctgov:NCT04483635">NCT04483635</a>&#59; <a href="ctgov:NCT04386850">NCT04386850</a>&#59; <a href="ctgov:NCT04535791">NCT04535791</a>&#41; on the effects of vitamin D in the treatment of patients with COVID-19&#44; one of them compared to the British national recommendations of 400<span class="elsevierStyleHsp" style=""></span>IU per day &#40;<a href="ctgov:NCT04579640">NCT04579640</a>&#41; and two of them to placebo arm &#40;<a href="ctgov:NCT04386850">NCT04386850</a>&#44; <a href="ctgov:NCT04535791">NCT04535791</a>&#41;&#46; As the pandemic situation continues to get worse &#40;and will possibly continue to worsen during the winter months before the effects of the vaccines are noticeable&#41;&#44; additional evidence could come too late&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">31</span></a> We know that in an ideal world&#44; health decisions must be made based on overwhelming evidence&#44; but a time of crisis such as the current one may require a slightly different set of rules&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">32</span></a> In this sense&#44; knowing the responsibility that absence forces based on resounding evidence&#44; we offer these recommendations being aware that in the near future we must review them with the evidence generated&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest for this manuscript&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The coronavirus disease 2019 &#40;COVID-19&#41; produces severe respiratory symptoms such as bilateral pneumonia associated to a high morbidity and mortality&#44; especially in patients of advanced age&#46; Vitamin D deficiency has been reported in several chronic conditions associated with increased inflammation and dysregulation of the immune system&#46; Vitamin D in modulates immune function too&#46; Vitamin D receptor &#40;VDR&#41; is expressed by most immune cells&#44; including B and T lymphocytes&#44; monocytes&#44; macrophages&#44; and dendritic cells and the signalling of vitamin D and VDR together has an anti-inflammatory effect&#46; Some studies have reported that vitamin D treatment could be useful for the prevention and treatment of COVID-19 because vitamin D plays an important role as a modulator of immunocompetence&#46; Over the last few months&#44; some studies have hypothesized the possible beneficial effect of vitamin D supplementation in patients with COVID-19 in order to improve the immune balance and prevent the hyperinflammatory cytokine storm&#46; Some preliminary studies have already shown promising results with vitamin D supplementation in hospitalized COVID-19 patients&#46; Vitamin D should be administered daily until adequate levels are achieved due to vitamin D behaves as a negative acute phase reactant &#40;APR&#41;&#46; Despite the lack of evidence on specific doses of vitamin D to treat COVID-19 in older adults&#44; authors consider it is necessary to standardize the use in clinical practice&#46; These recommendations advice supplement vitamin D in a protocoled fashion based on expert opinions&#44; level of evidence 5&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La enfermedad por coronavirus 2019 &#40;COVID-19&#41; produce s&#237;ntomas respiratorios graves&#44; como la neumon&#237;a bilateral&#44; asociados a una elevada morbilidad y mortalidad&#44; especialmente en pacientes de edad avanzada&#46; La deficiencia de vitamina D se ha reportado en varias condiciones cr&#243;nicas asociadas con el aumento de la inflamaci&#243;n y la desregulaci&#243;n del sistema inmunol&#243;gico&#46; La vitamina D tambi&#233;n modula la funci&#243;n inmunitaria&#46; El receptor de la vitamina D &#40;VDR&#41; se expresa en la mayor&#237;a de las c&#233;lulas inmunitarias&#44; incluidos los linfocitos B y T&#44; los monocitos&#44; los macr&#243;fagos y las c&#233;lulas dendr&#237;ticas&#44; y la se&#241;alizaci&#243;n conjunta de la vitamina D y el VDR tiene un efecto antiinflamatorio&#46; Algunos estudios han informado de que el tratamiento con vitamina D podr&#237;a ser &#250;til para la prevenci&#243;n y el tratamiento de la COVID-19 porque la vitamina D desempe&#241;a un papel importante como modulador de la inmunocompetencia&#46; En los &#250;ltimos meses&#44; algunos estudios han planteado la hip&#243;tesis del posible efecto beneficioso de la suplementaci&#243;n con vitamina D en pacientes con COVID-19 para mejorar el equilibrio inmunitario y prevenir la tormenta de citoquinas hiperinflamatorias&#46; Algunos estudios preliminares ya han mostrado resultados prometedores con la suplementaci&#243;n de vitamina D en pacientes con COVID-19 hospitalizados&#46; La vitamina D debe administrarse diariamente hasta que se alcancen los niveles adecuados debido a que la vitamina D se comporta como un reactante de fase aguda &#40;RFA&#41; negativo&#46; A pesar de la falta de evidencia sobre las dosis espec&#237;ficas de vitamina D para tratar la COVID-19 en adultos mayores&#44; los autores consideran que es necesario estandarizar su uso en la pr&#225;ctica cl&#237;nica&#46; Estas recomendaciones aconsejan suplementar la vitamina D de forma protocolizada en base a opiniones de expertos&#44; nivel de evidencia 5&#46;</p></span>"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Alternative administration of cholecalciferol in daily regimen&#58;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">11-20 ng&#47;mL&#58; cholecalciferol &#8220;4&#44;000&#8221; IU&#47;daily for 120 days&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">21-30 ng&#47;mL&#58; cholecalciferol &#8220;3&#44;000&#8221; IU&#47;daily for 120 days&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">31-40 ng&#47;mL&#58; cholecalciferol &#8220;2&#44;000&#8221; IU&#47;daily for 120 days&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">41-60 ng&#47;mL&#58; cholecalciferol &#8220;1&#44;000&#8221; IU&#47;daily for 120 days&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Cite&#58; authors&#8217; note&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patients with SARS-COV2 infection and recent determination of serum calcidiol level</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Calcidiol serum level &#40;ng&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Dose and frequency of cholecalciferol administration&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&#60;10<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Calcifediol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">16&#44;000<span class="elsevierStyleHsp" style=""></span>IU per day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Later on 16&#44;000<span class="elsevierStyleHsp" style=""></span>IU per week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Cholecalciferol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">50&#44;000<span class="elsevierStyleHsp" style=""></span>UI&#47;week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Later on 25&#44;000<span class="elsevierStyleHsp" style=""></span>UI&#47;week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#8211;20<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Calcifediol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;000<span class="elsevierStyleHsp" style=""></span>IU per day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Later on 16&#44;000<span class="elsevierStyleHsp" style=""></span>IU per week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cholecalciferol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;000<span class="elsevierStyleHsp" style=""></span>UI&#47;week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Later on 25&#44;000<span class="elsevierStyleHsp" style=""></span>UI&#47;week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#8211;29<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cholecalciferol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;000<span class="elsevierStyleHsp" style=""></span>UI&#47;week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Later on 25&#44;000<span class="elsevierStyleHsp" style=""></span>UI&#47;week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#8211;40<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cholecalciferol50&#44;000<span class="elsevierStyleHsp" style=""></span>UI single dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Later on 25&#44;000<span class="elsevierStyleHsp" style=""></span>UI&#47;week&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#8211;60<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;000<span class="elsevierStyleHsp" style=""></span>UI biweekly&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No determination of serum calcidiol level&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cholecalciferol50&#44;000<span class="elsevierStyleHsp" style=""></span>IU&#47;every 5 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 doses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Later on&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;000<span class="elsevierStyleHsp" style=""></span>UI&#47;weekly&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 weeks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2586747.png"
              ]
            ]
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Recommended dose of vitamin D supplementation&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:34 [
            0 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathophysiology&#44; transmission diagnosis&#44; and treatment of coronavirus disease 2019 &#40;COVID-19&#41;&#58; a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "W&#46;J&#46; Wiersinga"
                            1 => "A&#46; Rhodes"
                            2 => "A&#46;C&#46; Cheng"
                            3 => "S&#46;J&#46; Peacock"
                            4 => "H&#46;C&#46; Prescott"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2020.12839"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2020"
                        "volumen" => "324"
                        "paginaInicial" => "782"
                        "paginaFinal" => "793"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32648899"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence for possible association of vitamin D status with cytokine storm and unregulated inflammation in COVID-19 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Daneshkhah"
                            1 => "V&#46; Agrawal"
                            2 => "A&#46; Eshein"
                            3 => "H&#46; Subramanian"
                            4 => "J&#46;K&#46; Roy"
                            5 => "V&#46; Backman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40520-020-01677-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Aging Clin Exp Res"
                        "fecha" => "2020"
                        "volumen" => "32"
                        "paginaInicial" => "2141"
                        "paginaFinal" => "2158"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32876941"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46;B&#46; Grant"
                            1 => "H&#46; Lahore"
                            2 => "S&#46;L&#46; McDonnell"
                            3 => "C&#46;A&#46; Baggerly"
                            4 => "C&#46;B&#46; French"
                            5 => "J&#46;L&#46; Aliano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu12040988"
                      "Revista" => array:4 [
                        "tituloSerie" => "Nutrients"
                        "fecha" => "2020"
                        "volumen" => "12"
                        "paginaInicial" => "988"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mechanisms in endocrinology&#58; vitamin D and COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;P&#46; Bilezikian"
                            1 => "D&#46; Bikle"
                            2 => "M&#46; Hewison"
                            3 => "M&#46; Lazaretti-Castro"
                            4 => "A&#46;N&#46; Formenti"
                            5 => "A&#46; Gupta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1530/EJE-20-0665"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Endocrinol"
                        "fecha" => "2020"
                        "volumen" => "183"
                        "paginaInicial" => "R133"
                        "paginaFinal" => "R147"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32755992"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association between vitamin D deficiency and COVID-19 incidence&#44; complications&#44; and mortality in 46 countries&#58; an ecological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Mariani"
                            1 => "V&#46;M&#46; Marin Gimenez"
                            2 => "I&#46; Bergam"
                            3 => "C&#46; Tajer"
                            4 => "L&#46; Antonietti"
                            5 => "F&#46; Inserra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/hs.2020.0137"
                      "Revista" => array:2 [
                        "tituloSerie" => "Health Secur"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Statista &#91;sede web&#93;&#46; Hamburg&#58; Statista&#59; 2020&#46; Cumulative number of patients diagnosed with coronavirus disease &#40;COVID-19&#41; in Japan&#46; Available from&#58; <a target="_blank" href="https://www.statista.com/statistics/1096478/japan-confirmed-cases-ofcoronavirus-by-state-of-health">https&#58;&#47;&#47;www&#46;statista&#46;com&#47;statistics&#47;1096478&#47;japan-confirmed-cases-ofcoronavirus-by-state-of-health</a> &#91;accessed 13&#46;01&#46;21&#93;&#46;"
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;A&#46; Ginde"
                            1 => "A&#46;F&#46; Sullivan"
                            2 => "J&#46;M&#46; Mansbach"
                            3 => "C&#46;A&#46; Camargo Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ajog.2009.11.036"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Obstet Gynecol"
                        "fecha" => "2010"
                        "volumen" => "202"
                        "paginaInicial" => "436e1"
                        "paginaFinal" => "436e8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of vitamin D status and other clinical characteristics with COVID-19 Test results"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;O&#46; Meltzer"
                            1 => "T&#46;J&#46; Best"
                            2 => "H&#46; Zhang"
                            3 => "T&#46; Vokes"
                            4 => "V&#46; Arora"
                            5 => "J&#46; Solway"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamanetworkopen.2020.19722"
                      "Revista" => array:5 [
                        "tituloSerie" => "JAMA Netw Open"
                        "fecha" => "2020"
                        "volumen" => "3"
                        "paginaInicial" => "e2019722"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32880651"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "deficiency and low serum calcium as predictors of poor prognosis in patients with severe COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Bennouar"
                            1 => "A&#46;B&#46; Cherif"
                            2 => "A&#46; Kessira"
                            3 => "D&#46;E&#46; Bennouar"
                            4 => "S&#46; Abdi"
                            5 => "D&#46; Vitamin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/07315724.2020.1856013"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Coll Nutr"
                        "fecha" => "2021"
                        "volumen" => "12"
                        "paginaInicial" => "1"
                        "paginaFinal" => "11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of vitamin D insufficiency and evidence for disease prevention in the older population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; K&#252;hn"
                            1 => "P&#46; Trotz"
                            2 => "G&#46;I&#46; Stangl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00391-018-1390-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Z Gerontol Geriatr"
                        "fecha" => "2018"
                        "volumen" => "51"
                        "paginaInicial" => "567"
                        "paginaFinal" => "572"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29666919"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D and COVID-19&#58; evidence and recommendations for supplementation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Griffin"
                            1 => "M&#46; Hewison"
                            2 => "J&#46; Hopkin"
                            3 => "R&#46; Kenny"
                            4 => "R&#46; Quinton"
                            5 => "J&#46; Rhodes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1098/rsos.201912"
                      "Revista" => array:5 [
                        "tituloSerie" => "R Soc Open Sci"
                        "fecha" => "2020"
                        "volumen" => "7"
                        "paginaInicial" => "201912"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33489300"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The importance of vitamin d metabolism as a potential prophylactic&#44; immunoregulatory and neuroprotective treatment for COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Xu"
                            1 => "D&#46;J&#46; Baylink"
                            2 => "C&#46;S&#46; Chen"
                            3 => "M&#46;E&#46; Reeves"
                            4 => "J&#46; Xiao"
                            5 => "C&#46; Lacy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s12967-020-02488-5"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Transl Med"
                        "fecha" => "2020"
                        "volumen" => "18"
                        "paginaInicial" => "322"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exploring links between vitamin D deficiency and COVID-19"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Mohan"
                            1 => "J&#46;J&#46; Cherian"
                            2 => "A&#46; Sharma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.ppat.1008874"
                      "Revista" => array:4 [
                        "tituloSerie" => "PLoS Pathog"
                        "fecha" => "2020"
                        "volumen" => "16"
                        "paginaInicial" => "e1008874"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;C&#46; Ilie"
                            1 => "S&#46; Stefanescu"
                            2 => "L&#46; Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40520-020-01570-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Aging Clin Exp Res"
                        "fecha" => "2020"
                        "volumen" => "32"
                        "paginaInicial" => "1195"
                        "paginaFinal" => "1198"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32377965"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Nikniaz L&#44; Akbarzadeh MA&#44; Hosseinifard H&#44; Hosseini MS&#46; The impact of vitamin D supplementation on mortality rate and clinical outcomes of COVID-19 patients&#58; a systematic review and meta-analysis&#46; Version&#58; 1&#46; MedRxiv &#91;Preprint&#93;&#46; &#91;25p&#93;&#46; Available from&#58; <a target="_blank" href="https://www.medrxiv.org/content/10.1101/2021.01.04.21249219v1.full.pdf+html">https&#58;&#47;&#47;www&#46;medrxiv&#46;org&#47;content&#47;10&#46;1101&#47;2021&#46;01&#46;04&#46;21249219v1&#46;full&#46;pdf&#43;html</a> &#91;posted 05&#46;01&#46;21&#93;&#46;"
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D and survival in COVID-19 patients&#58; a quasi-experimental study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Annweiler"
                            1 => "B&#46; Hanotte"
                            2 => "C&#46;G&#46; de l&#8217;Eprevier"
                            3 => "J&#46;M&#46; Sabatier"
                            4 => "L&#46; Lafaie"
                            5 => "T&#46; Celarier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jsbmb.2020.105771"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Steroid Biochem Mol Biol"
                        "fecha" => "2020"
                        "volumen" => "204"
                        "paginaInicial" => "105771"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33065275"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D supplementation associated to better survival in hospitalized frail elderly COVID-19 patients&#58; the GERIA-COVID Quasi-Experimental study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Annweiler"
                            1 => "M&#46; Corvaisier"
                            2 => "J&#46; Gautier"
                            3 => "V&#46; Dubee"
                            4 => "E&#46; Legrand"
                            5 => "G&#46; Sacco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu12113377"
                      "Revista" => array:4 [
                        "tituloSerie" => "Nutrients"
                        "fecha" => "2020"
                        "volumen" => "12"
                        "paginaInicial" => "3377"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19&#58; a pilot randomized clinical study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Entrenas Castillo"
                            1 => "L&#46;M&#46; Entrenas Costa"
                            2 => "J&#46;M&#46; Vaquero Barrios"
                            3 => "J&#46;F&#46; Alcala Diaz"
                            4 => "J&#46; Lopez Miranda"
                            5 => "R&#46; Bouillon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jsbmb.2020.105751"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Steroid Biochem Mol Biol"
                        "fecha" => "2020"
                        "volumen" => "203"
                        "paginaInicial" => "105751"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32871238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short term&#44; high-dose vitamin D supplementation for COVID-19 disease&#58; a randomised&#44; placebo-controlled&#44; study &#40;SHADE study&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Rastogi"
                            1 => "A&#46; Bhansali"
                            2 => "N&#46; Khare"
                            3 => "V&#46; Suri"
                            4 => "N&#46; Yaddanapudi"
                            5 => "N&#46; Sachdeva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/postgradmedj-2020-139065"
                      "Revista" => array:3 [
                        "tituloSerie" => "Postgrad Med J"
                        "fecha" => "2020"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1754527"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Covid-19 and high-dose Vitamin D supplementation TRIAL in high-risk older patients &#40;COVIT-TRIAL&#41;&#58; study protocol for a randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Annweiler"
                            1 => "M&#46; Beaudenon"
                            2 => "J&#46; Gautier"
                            3 => "R&#46; Simon"
                            4 => "V&#46; Dubee"
                            5 => "J&#46; Gonsard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13063-020-04928-5"
                      "Revista" => array:5 [
                        "tituloSerie" => "Trials"
                        "fecha" => "2020"
                        "volumen" => "21"
                        "paginaInicial" => "1031"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33371905"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preventing vitamin D deficiency during the COVID-19 pandemic&#58; UK definitions of vitamin D sufficiency and recommended supplement dose are set too low"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Griffin"
                            1 => "M&#46; Hewison"
                            2 => "J&#46; Hopkin"
                            3 => "R&#46;A&#46; Kenny"
                            4 => "R&#46; Quinton"
                            5 => "J&#46; Rhodes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7861/clinmed.2020-0858"
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Med &#40;Lond&#41;"
                        "fecha" => "2021"
                        "volumen" => "21"
                        "paginaInicial" => "e48"
                        "paginaFinal" => "e51"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D&#58; a negative acute phase reactant"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Waldron"
                            1 => "H&#46;L&#46; Ashby"
                            2 => "M&#46;P&#46; Cornes"
                            3 => "J&#46; Bechervaise"
                            4 => "C&#46; Razavi"
                            5 => "O&#46;L&#46; Thomas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jclinpath-2012-201301"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Pathol"
                        "fecha" => "2013"
                        "volumen" => "66"
                        "paginaInicial" => "620"
                        "paginaFinal" => "622"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23454726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D status in hospitalized patients with SARS-CoV-2 infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Hern&#225;ndez"
                            1 => "D&#46; Nan"
                            2 => "M&#46; Fernandez-Ayala"
                            3 => "M&#46; Garc&#237;a-Unzueta"
                            4 => "M&#46;A&#46; Hern&#225;ndez-Hern&#225;ndez"
                            5 => "M&#46; L&#243;pez-Hoyos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/clinem/dgaa733"
                      "Revista" => array:3 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2020"
                        "paginaInicial" => "dgaa733"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vitamin D supplementation to prevent COVID-19 infections and deaths&#8212;accumulating evidence from epidemiological and intervention studies calls for immediate action"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Brenner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu13020411"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutrients"
                        "fecha" => "2021"
                        "volumen" => "13"
                        "paginaInicial" => "411"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33525447"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "SCAN &#91;sitio web&#93;&#46; England&#58; The Scientific Advisory Committee on Nutrition&#59; 2016&#46; SACN&#46; Vitamin D and health report&#46; SACN&#58; reports and position statements and Obesity and healthy eating&#46; Available from&#58; <a target="_blank" href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf">https&#58;&#47;&#47;assets&#46;publishing&#46;service&#46;gov&#46;uk&#47;government&#47;uploads&#47;system&#47;uploads&#47;attachment&#95;data&#47;file&#47;537616&#47;SACN&#95;Vitamin&#95;D&#95;and&#95;Health&#95;report&#46;pdf</a> &#91;accessed 11&#46;12&#46;20&#93;&#46;"
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efectiveness and safety of vitamin D in relation to bone health"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Cranney"
                            1 => "T&#46; Horsley"
                            2 => "S&#46; O&#8217;Donnell"
                            3 => "H&#46; Weiler"
                            4 => "D&#46; Ooi"
                            5 => "S&#46; Atkinson"
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                      "titulo" => "Prevalence of hypercalcemia related to hypervitaminosis D in clinical practice"
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                          "autores" => array:5 [
                            0 => "C&#46; Perez-Barrios"
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                            3 => "B&#46; Perez-Sacristan"
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                        "tituloSerie" => "Clin Nutr"
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                        "paginaFinal" => "1358"
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                  "referenciaCompleta" => "NICE&#46; &#91;Sede Web&#93;&#46; England&#58; National Institute for Health and Care Excellence&#59; 2020&#46; NICE&#46; Covid-19 rapid guideline&#58; vitamin D&#46; Available from&#58; <a target="_blank" href="http://www.nice.org.uk/guidance/ng187">www&#46;nice&#46;org&#46;uk&#47;guidance&#47;ng187</a> &#91;accessed 19&#46;12&#46;20&#93;&#46;"
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                      "titulo" => "Covid-19&#58; evidence is lacking to support vitamin D&#39;s role in treatment and prevention"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
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                    0 => array:2 [
                      "doi" => "10.1136/bmj.m4912"
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                        "tituloSerie" => "BMJ"
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                        "volumen" => "371"
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                  "referenciaCompleta" => "Osayande Eregie C&#46; RE&#58; vitamin D and COVID-19 &#8211; this is no time for procrastination&#46; &#91;Internet&#93;&#46; BMJ&#46; Available from <a target="_blank" href="https://www.bmj.com/content/371/bmj.m4912/rr-6">https&#58;&#47;&#47;www&#46;bmj&#46;com&#47;content&#47;371&#47;bmj&#46;m4912&#47;rr-6</a> &#91;posted 22&#46;12&#46;20&#93;&#44; &#91;cited 29&#46;01&#46;21&#93;&#46;"
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                    0 => array:2 [
                      "titulo" => "Vitamin D and COVID-19&#58; why the controversy&#63;"
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                        0 => array:2 [
                          "colaboracion" => "The Lancet Diabetes Endocrinology"
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                      "doi" => "10.1016/S2213-8587(21)00003-6"
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                        "tituloSerie" => "Lancet Diabetes Endocrinol"
                        "fecha" => "2021"
                        "volumen" => "9"
                        "paginaInicial" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33444566"
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                  ]
                ]
              ]
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                  "referenciaCompleta" => "Joliffe DA&#44; Carmargo CA Jr&#44; Sluyter JD&#44; Aglipay M&#44; Aloia JF&#44; Bergman P&#44; et al&#46; Vitamin D supplementation to prevent acute respiratory infections&#58; systematic review and meta-analysis of aggregate data from randomised controlled trials&#46; Version 1&#46; MedRxiv &#91;Preprint&#93;&#46; &#91;33p&#93;&#46; Available from&#58; <a target="_blank" href="https://www.medrxiv.org/content/10.1101/2020.07.14.20152728v1.full.pdf+html">https&#58;&#47;&#47;www&#46;medrxiv&#46;org&#47;content&#47;10&#46;1101&#47;2020&#46;07&#46;14&#46;20152728v1&#46;full&#46;pdf&#43;html</a> &#91;posted 17&#46;07&#46;20&#93;&#46;"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Vitamin D high doses supplementation could represent a promising alternative to prevent or treat COVID-19 infection"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Mansur"
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                            3 => "F&#46; Inserra"
                            4 => "L&#46; Ferder"
                            5 => "W&#46; Manucha"
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                        "tituloSerie" => "Clin Investig Arterioscler"
                        "fecha" => "2020"
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                        "paginaFinal" => "277"
                        "link" => array:1 [
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Article information

ISSN: 0211139X
Original language: English

DOI:10.1016/j.regg.2021.02.001

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	13	2	15
2024 October	86	30	116
2024 September	114	42	156
2024 August	102	35	137
2024 July	90	28	118
2024 June	81	23	104
2024 May	79	20	99
2024 April	74	15	89
2024 March	75	8	83
2024 February	77	14	91
2024 January	90	10	100
2023 December	87	15	102
2023 November	110	28	138
2023 October	128	17	145
2023 September	64	12	76
2023 August	84	13	97
2023 July	98	14	112
2023 June	94	10	104
2023 May	148	25	173
2023 April	128	9	137
2023 March	86	20	106
2023 February	92	27	119
2023 January	84	13	97
2022 December	102	39	141
2022 November	90	38	128
2022 October	82	45	127
2022 September	108	37	145
2022 August	112	24	136
2022 July	120	29	149
2022 June	157	24	181
2022 May	188	49	237
2022 April	251	47	298
2022 March	228	54	282
2022 February	175	45	220
2022 January	285	56	341
2021 December	339	48	387
2021 November	415	77	492
2021 October	411	73	484
2021 September	1357	109	1466
2021 August	1063	104	1167
2021 July	1281	148	1429
2021 June	769	115	884
2021 May	774	185	959
2021 April	119	76	195
2021 March	0	16	16
2021 February	0	8	8

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