Vitamin D deficiency may boost risk of coronavirus infection

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Led by David Meltzer, MD, PhD, Chief of Hospital Medicine at UChicago Medicine, the research team found that patients who had vitamin D deficiency (less than 20ng/ml) that was not treated were almost twice as likely to test positive for the COVID-19 coronavirus compared to patients who had sufficient levels of the vitamin.

“Vitamin D is important to the function of the immune system and vitamin D supplements have previously been shown to lower the risk of viral respiratory tract infections,” ​said Dr Meltzer. “Our statistical analysis suggests this may be true for the COVID-19 infection.”

A wave of scientific publications has suggested that vitamin D3 supplementation could be a potentially promising and safe approach to reduce risk of COVID-19 infections and deaths. Meta-analyses of randomized clinical trials (RCTs) have shown that vitamin D3 supplementation reduces the risk of acute respiratory tract infections​.

And with half of Americans deficient in Vitamin D, understanding whether treating Vitamin D deficiency changes COVID-19 risk could be of great importance locally, nationally and globally, said Dr Meltzer.

“Vitamin D is inexpensive, generally very safe to take, and can be widely scaled,” ​he said.

The sunshine vitamin

Vitamin D refers to two biologically inactive precursors – D3, also known as cholecalciferol, and D2, also known as ergocalciferol. Both D3 and D2 precursors are transformed in the liver and kidneys into 25- hydroxyvitamin D (25(OH)D), the non-active ‘storage’ form, and the active form 1,25-dihydroxyvitamin D (1,25(OH)2D).

While our bodies do manufacture vitamin D on exposure to sunshine, the levels in some northern countries are so weak during the winter months that our body makes no vitamin D at all, meaning that dietary supplements and fortified foods are seen by many as the best way to boost intakes of vitamin D.

Study details

Dr Meltzer and his co-workers analyzed data from 489 UChicago Medicine patients whose vitamin D level was measured within a year before being tested for COVID-19.

Data published in JAMA Network Open​ indicated that the relative risk of testing positive for COVID-19 was 1.77 times greater for people with vitamin D deficiency compared with people with sufficient levels. This result was statistically significant, stated the researchers.

“The findings of this study suggest a role of vitamin D status, based on deficiency of levels and treatment, in risk of COVID-19 infection,” ​wrote the researchers.

“Randomized clinical trials of interventions to reduce vitamin D deficiency are needed to determine if those interventions could reduce COVID-19 incidence, including both broad population interventions and interventions among groups at increased risk of vitamin D deficiency and/or COVID-19.”

Also in the literature

Recently, a team of researchers from Germany Cancer Research Center analyzed data​ from almost 10,000 people and found that vitamin D insufficiency and deficiency (25-hydroxyvitamin D blood levels of 30–50 and <30 nmol/L, respectively) were found to be common (44% and 15%, respectively), and compared to those with sufficient status, participants with vitamin D insufficiency and deficiency had strongly increased respiratory mortality.

In addition, researchers from Trinity College in Dublin, Ireland stated earlier this year that vitamin D deficiency is suggested to play an important role in the severity of COVID-19 infections.

Writing in Alimentary Pharmacology and Therapeutics​, the Trinity College scientists stated: “… the evidence supporting a protective effect of vitamin D against severe COVID‐19 disease is very suggestive, a substantial proportion of the population in the Northern Hemisphere will currently be vitamin D deficient, and supplements, for example, 1000 international units (25 micrograms) per day are very safe.

“It is time for governments to strengthen recommendations for vitamin D intake and supplementation, particularly when under lock‐down.”

Source: JAMA Network Open
2020;3(9):e2019722. doi: 10.1001/jamanetworkopen.2020.19722
“Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results”
Authors: D.O. Meltzer, et al.

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