Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study (Federation of European Biochemical Societies Journal)
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Vitamin D deficiency is a worldwide pandemic
To evaluate associations of plasma 25(OH)D levels with the likelihood of coronavirus disease infection and hospitalization
N = 7, 807
February 1st to April 30th, 2020
Participants had one previous blood test for the plasma 25(OH)D level
Suboptimal’ or ‘low’ plasma 25(OH)D. Below 30 ng/mL
Sufficiency more than 30 ng/ml. (75 nmol/L)
Insufficiency, 20 – 29 ng/ml
Deficiency less than 20 ng/ml (50 nmol/L)
7, 807 individuals
Risk by age and sex were as expected
Obesity not significantly associated with increased risk for COVID‐19 infection or hospitalization
Sufficient vitamin D levels
7, 025 tested negative
Low vitamin D levels
782 tested positive
Increased likelihood of COVID‐19 infection
Odds ratio (OR) of 1.45
Increased likelihood of hospitalisation
OR of 1.95
We concluded that low plasma 25(OH)D levels appear to be an independent risk factor for COVID‐19 infection and hospitalization.
The link between vitamin D deficiency and Covid-19 in a large population
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52, 405 infected patients
524, 050 controls
Greater incidence of COVID-19 with lower vitamin D levels
Highest infection prevalence with lowest vitamin D levels
A significant protective effect in those who had supplemented over the previous 4 months
Joint Guidance on Vitamin D in the Era of COVID-19 from the ASBMR, AACE, Endocrine Society, ECTS, NOF, and IOF
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Spend at least 15-30 minutes with direct sun exposure each day
Most older and younger adults can safely take 400-1000 IU daily
Vitamin-D and COVID-19: do deficient risk a poorer outcome? (Lancet)
[ Ссылка ]30183-2/fulltext?fbclid=IwAR0qzV-kiZcVRQ-KeBAkru6hpGUUVVhbywbU3YgV_KSNaE7X7DVmblO9ysk
Comparing data across nations, mortality from COVID-19 is clearly higher in some countries than in others
Relative vitamin D status of populations
Vitamin D supplementation could be especially important for older people
Functions
Calcium and phosphate balance
Affecting bone growth and turnover
Low vitamin D status
Associated with increased susceptibility to infectious disease
Notably, upper respiratory tract infections
Treating the lowest levels gives most percentage benefit
Vitamin D and COVID-19
Virus emerged and started its spread in the northern hemisphere at the end of 2019
When levels of 25-hydroxyvitamin D are lowest
COVID-19 mortality was significantly associated with vitamin D status in different populations
Nordic countries, widespread fortification of foods
Italy and Spain, prevalence of vitamin D deficiency, surprisingly common
Black and minority ethnic people
UK, more than four times more likely to die from COVID-19
In COVID
Vitamin D supports production of antimicrobial peptides in the respiratory epithelium
Might help to reduce the inflammatory response
Vitamin D is known to interact angiotensin- converting enzyme 2
SARS-CoV-2 down regulates expression of ACE2
Vitamin D promotes expression of this gene
Rose Anne Kenny
Trinity College Dublin
Lead investigator of the Irish Longitudinal Study on Ageing
The circumstantial evidence is very strong
we don’t have randomised controlled trial evidence, but how long do you want to wait in the context of such a crisis?
We know vitamin D is important for musculoskeletal function, so people should be taking it anyway
Vitamin D supplements should normally be given to care home residents unless there is an extremely good reason not to do so.
Adrian Martineau
Queen Mary University of London
At best vitamin D deficiency will only be one of many factors involved in determining outcome of COVID-19
but it’s a problem that could be corrected safely and cheaply
there is no downside to speak of, and good reason to think there might be a benefit
Vitamin D dose
IU mcg
400 10mcg
800 20mcg
1,000 25mcg
2,000 50mcg
4,000 100mcg
