In recent years, vitamin D deficiency has been reported to be associated with cardiovascular disease including stroke. Low vitamin D levels could be associated with greater morbidity and mortality in stroke patients. Evidence from clinical studies is lacking.

A randomised controlled open-label trial was conducted in the Department of Neurology at the university hospital of Sahloul-Sousse-Tunisia from July 2018 to July 2019. Patients, suffering from acute stroke, were screened for serum 25 hydroxy vitamin D (25(OH)D) levels. Those with baseline 25(OH)D <30 ngl/mL well be  randomised into two arms. Group A will receive vitamin D supplementation (a single dose of 6-lac IU of Cholecalciferol Intramascular (IM) injection) along with optimal care   and Group B will receive optimal care alone. Primary outcome will be evaluated by modified Rankin Scale (mRs) score at 3 months. An informed written consent was obtained from the patients or their relatives.

A total of 149 stroke patients were included with mean age± SD of 65.37 ±12.5 years and male female rate ratio 1.67. The median serum 25 (OH) D concentration at admission was 11.35 (IQR, 7.37-17.71) ng/ml. At 3 months, the median serum 25 (OH) D concentration in the supplemented group was 36.9 (IQR 24.7-61.9) ng/ml. Seventy percent of patients had a good functional outcome (mRs<3).   In the multivariable model, only age (adjusted odds ratio (OR) = 1.1), decreasing NIHSS (OR =1.4) and higher serum 25 (OH) D concentration at admission (OR = 0.88),  were associated with favorable outcome.

Our findings suggest that vitamin D3 supplementation does not improve functional outcome after acute stroke but vitamin D deficiency was associated with severe NIHSS at admission. It needs to be validated by a larger trial.