Benefits of standard dose and pulse dose vitamin D in the high-risk and confirmed hypovitaminosis D population with COVID-19: an Evidence-Based Case Report (EBCR)

Introduction
The Ministry of Health guidelines in Indonesia establish a protocol for administering vitamin D to people with COVID-19 as being 1,000 to 5,000 IU per day, both for adults and older adults. Objectives. This systematic review aims to investigate how much the optimal dose for patient COVID-19 within high-risk vitamin D deficiency is either geriatric population or have an underlying disease.

Material and methods
A 32-year-old female patient came with positive RT-PCR nasopharyngeal swab with clinical anosmia with hypovitaminosis D, and a 60-year-old patient with shortness of breath and cough complaints, positive RT-PCR nasopharyngeal swab. Both patients were given 1,000 IU/day vitamin D.

Results
A literature search was carried out from 2019 to 2021 on several search engines such as Pubmed, Clinical Trial.gov and Google Scholar. Four studies pooled and entered review synthesis.

Conclusions
Supplementation with pulse dose vitamin D provides a clinically significant improvement, decreasing inflammatory cytokine markers in the non-geriatric population with hypovitaminosis. In the geriatric population, standard vitamin D has been shown to reduce the risk of frailty and worsening clinical features in COVID-19. As clinicians, it is important to enhance clinical awareness when recognising special populations with COVID-19 who require vitamin D supplementation above the guideline dose.