Medscape

Pavankumar Kamat

Gerry Gajadharsingh writes:

“More evidence to suggest that keeping your vitamin D levels up will decrease risk of ending up in hospital with COVID-19.

 Testing levels of Vitamin D 25OH via a simple blood test, it’s common in both NHS and private sector settings. There is no doubt that over the past year, many patients have become aware that vitamin D is incredibly important as part of our immune response (it also is important for many other body functions). However, that message obviously still hasn’t got out to quite a few patients, we are still picking up patients with levels < 50 nmol/L.

 We need vitamin D from dietary sources/ supplements and also exposure to sunlight especially from the months of April to September in northern hemisphere countries. This is also probably one of the reasons why the prevalence of virus infection seems to be lower during the summer months (as well as the fact that people outside more and therefore have less exposure to viruses)

 We tend to suggest supplementing with a good quality vitamin D at 2500 international units for a few months and then moving to a maintenance dose of 1000 international units. We also need to be aware that vitamin di is a fat-soluble vitamin and some people can accumulate quite high levels which can be detrimental to the body so if you are supplementing with vitamin D it is advisable to perhaps check your levels again perhaps six months to 1 year after you start.

 I am also of the opinion it’s not just vitamin D which is important to support your immune system. However as with most things in medicine research money tends to go to the obvious low hanging fruit such as vitamin D. there are various other nutritional supplements dietary changes and other important factors such as finding ways to raise your heart rate variability, good quality sleep etc, which are really supportive towards the immune system.

 The research below looked at almost 80,000 patients between April 2019 and January 2021, so it’s a big study.”

 

Takeaway

  • Vitamin D deficiency was associated with an increased risk of severe SARS-CoV-2 infection requiring hospital admission.
  • However, no association was observed between vitamin D deficiency and excess mortality in COVID-19.

Why this matters

  • Findings highlight urgent action to address the high prevalence of vitamin D deficiency that increases COVID-19-related morbidity.

Study design

  • A retrospective case-control study included 79,602 participants with results of serum 25-hydroxyvitamin D (25[OH]D) between April 2019 and January 2021.
  • Of these, 58,368 participants were recruited to the primary cohort and 21,234  to the validation cohort.
  • Vitamin D levels were classified as deficiency (<25 nmoL/L) and insufficiency (25-50 nmoL/L).
  • Funding: None.

Key results

  • In the primary cohort:
    • Overall, 1036 (1.8%) participants were hospitalised with COVID-19, of whom 375 (36.2%) died.
    • Median serum 25(OH)D level was 50.0 (interquartile range [IQR], 34.2-66.9] nmoL/L in non-hospitalised patients vs 35.0 (IQR, 21.0-57.0) nmoL/L in hospitalised patients (P<.005).
  • In the validation cohort:
    • Overall, 772 (3.6%) participants were hospitalised with COVID-19, of whom 295 (38.2%) died.
    • Median serum 25(OH)D level was 47.1 (IQR, 31.8-64.7) nmoL/L in non-hospitalised patients vs 33.0 (IQR, 19.4-54.1) nmoL/L in hospitalised patients (P<.005).
  • Low vitamin D level (25[OH]D <50 nmol/L) was associated with increased odds of hospitalisation with COVID-19 in both (OR; 95% CI):
    • primary cohort (2.22; 1.93-2.53; P<.005); and
    • validation cohort (2.16; 1.83-2.54; P<.005).
  • There was no association between low vitamin D levels and in-patient hospital mortality from COVID-19 in either cohort.