The Vitamin D for COVID-19 Trial (VIVID) is a randomized, placebo-controlled clinical trial in 2024 men and women from across the U.S. and Mongolia to investigate whether taking a daily dietary supplement of vitamin D vs. placebo for 4 weeks reduces the rate of seeking healthcare for symptoms or concerns related to COVID-19 in participants recently diagnosed with COVID-19, and reduces the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in household contacts of individuals with newly diagnosed COVID-19.
Data from laboratory studies, epidemiologic research, and randomized clinical trials
conducted in the pre-COVID era strongly suggest that vitamin D is active in pathways relevant
to immune function and may reduce the risk of acute respiratory infections. More recently,
some observational studies have shown a significant association between low vitamin D status
and worse clinical outcomes among COVID-19 patients. Whether vitamin D supplementation can
reduce the risk of adverse clinical outcomes in recently diagnosed COVID-19 patients and/or
reduce risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2)
in those likely to have been exposed to the virus (post-exposure prophylaxis) is unknown.
The Vitamin D for COVID-19 Trial (VIVID) is a pragmatic, cluster-randomized clinical trial in
2024 men and women recruited nationwide from the U.S. and Mongolia. The trial is
investigating whether taking a daily dietary supplement of vitamin D3 vs. placebo for 4 weeks
reduces the rate of seeking healthcare visits (including hospitalizations, emergency room
visits, or ambulatory or virtual clinician visits) for symptoms or concerns related to
COVID-19 or deaths in people newly diagnosed with COVID-19, and reduces the risk of
SARS-CoV-2 infection in household contacts of individuals with newly diagnosed COVID-19.
The trial has enrolled 1747 individuals aged 18 or older who are newly diagnosed with
COVID-19 ("index cases") and 277 household contacts aged 18 or older.
Following receipt of informed consent, participants are randomized -- i.e., assigned by
chance (like a coin toss) -- to one of two groups: (1) daily vitamin D3 (9600 IU/day on days
1-2; 3200 IU/day on days 3-28) or (2) daily vitamin D placebo. Index cases and household
contacts of an index case (limited to at most one contact per household), if any, are
assigned to the same group (cluster randomization). Participants take three oral softgel
capsules on day 1, three capsules on day 2, and one capsule each day on days 3 through 28.
Participants receive a 4-week supply of study capsules via overnight courier service.
Participants fill out a short (15-20 minute) questionnaire each week during the 4-week
pill-taking period, as well as a follow-up questionnaire at 8 weeks after randomization.
These questionnaires ask about symptoms, general health, and use of medications and dietary
supplements. Questionnaires are completed online using a secure Internet-based system known
as the Research Electronic Data Capture (REDCap) system. Participants must have an e-mail
address to enroll in the study. Occasionally, participants (or their delegates) may receive a
telephone call from study staff to collect information or to clarify answers on the
questionnaire. Participants may contact investigators or staff using a toll-free number, if
they have any questions or need assistance.
Participants (or their delegates) who indicate on a study questionnaire that they have been
hospitalized are sent a medical release form to be signed and returned. The release form is
used to get medical records from the participant's physician or hospital to confirm the
specific reason for the hospitalization. In the event of a participant's death, the
participant's delegate is sent a medical release form to be signed and returned. The release
form is used to get medical records from the participant's physician or hospital to confirm
the specific cause of death.
Participants provide dried blood spot samples at baseline and week 4. Participants provide
these samples using a sample collection kit mailed to their homes. Blood samples are
collected through a finger prick onto a filter paper. Blood samples are stored and will be
used to measure vitamin D (25(OH)D) levels. A subsample of participants provide follow-up
dried blood spot samples at weeks 1, 2, or 3 to clarify the time course of 25(OH)D increase.
In participants who are not diagnosed with COVID-19 during the study, blood samples will also
be tested for COVID-19 antibodies.
Support for VIVID is provided by Harvard University and private philanthropy. Tishcon
Corporation (Salisbury, Maryland, USA) is donating the study capsules. The Karolinska
Institute (Stockholm, Sweden) is donating the serology assessment.
Dietary Supplement: vitamin D
Vitamin D softgel capsules; each capsule contains 3200 IU of vitamin D3. Three capsules per day (9600 IU/day) will be taken on days 1 and 2, and one capsule per day (3200 IU/day) will be taken on days 3 through 28
Other Name: Array
Dietary Supplement: Placebo
Placebo softgel capsules. Three capsules per day will be taken on days 1 and 2, and one capsule per day will be taken on days 3 through 28
Inclusion/exclusion criteria for INDEX CASES:
Inclusion criteria
1. Adults aged 18 years or older who are newly diagnosed with COVID-19 infection within 7
days of testing.
2. Ability and willingness to understand and provide informed consent.
Exclusion criteria
1. Known current pregnancy.
2. Current hospitalization.
3. Unable to complete online questionnaires or adhere to study requirements.
4. Consume more than 1000 IU per day of vitamin D from all supplemental sources combined
(individual vitamin D supplements, calcium plus vitamin D supplements, medications
with vitamin D [e.g., Fosamax Plus D], and multivitamins) in the past 4 weeks.
5. Use of prescription vitamin D treatments (Calcitriol [Rocaltrol, Calcitrol, Vectical,
Calcijex] or Paricalcitol [Zemplar]).
6. Consume supplements with more than 1200 mg calcium per day.
7. Known diagnosis of hypercalcemia or a condition associated with vitamin D
hypersensitivity.
8. Prior diagnosis of cancer *AND* currently undergoing radiation, chemotherapy, or
immunotherapy.
9. Kidney failure or dialysis; severe liver disease or cirrhosis.
10. Any parathyroid conditions.
11. Use of medications for seizures or epilepsy. Examples: Carbamazepine (Carbatrol,
Tegretol), Phenytoin (Dilantin, Phenytek), Valproic acid (Depakene), Oxcarbazepine
(Oxtellar, Trileptal), Phenobarbital, Topiramate (Topamax).
12. Use of digoxin.
13. Inability to receive an overnight express mail shipment of study pills at a home
address.
14. Participation in other COVID-19 trials.
Inclusion/exclusion criteria for HOUSEHOLD CONTACTS:
Inclusion criteria:
1. Persons aged 18 years or older who live in the same household with an index individual
and have been identified as the closest household contact within the same household
(limited to 1 per household).
2. Persons aged 18 years or older who live in household with someone who tested positive
for COVID-19 within past 7 days but not participating in VIVID.
3. Ability and willingness to understand and provide informed consent.
Exclusion criteria:
1. Known current pregnancy.
2. History of SARS-CoV-2 infection.
3. Receipt of a SARS-CoV-2 vaccination or monoclonal antibody.
4. Unable to complete online questionnaires or adhere to study requirements.
5. Consume more than 1000 IU per day of vitamin D from all supplemental sources combined
(individual vitamin D supplements, calcium plus vitamin D supplements, medications
with vitamin D [e.g., Fosamax Plus D], and multivitamins) in the past 4 weeks.
6. Use of prescription vitamin D treatments (Calcitriol [Rocaltrol, Calcitrol, Vectical,
Calcijex] or Paricalcitol [Zemplar]).
7. Consume supplements with more than 1200 mg calcium per day.
8. Known diagnosis of hypercalcemia or a condition associated with vitamin D
hypersensitivity.
9. Prior diagnosis of cancer *AND* currently undergoing radiation, chemotherapy, or
immunotherapy.
10. Kidney failure or dialysis; severe liver disease or cirrhosis.
11. Any parathyroid condition.
12. Use of medications for seizures or epilepsy. Examples: Carbamazepine (Carbatrol,
Tegretol), Phenytoin (Dilantin, Phenytek), Valproic acid (Depakene), Oxcarbazepine
(Oxtellar, Trileptal), Phenobarbital, Topiramate (Topamax).
13. Use of digoxin.
14. Inability to receive an overnight express mail shipment of study pills at a home
address.
15. Participation in other COVID-19 trials.
Brigham and Women's Hospital
Boston, Massachusetts, United States