Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study

Abstract

Vitamin D deficiency is a worldwide pandemic. The aim of this study was to evaluate associations of plasma 25(OH)D levels with the likelihood of coronavirus disease 2019 (COVID‐19) infection and hospitalization. The study population included the 14 000 members of Leumit Health Services, who were tested for COVID‐19 infection from February 1st to April 30th, 2020, and who had at least one previous blood test for the plasma 25(OH)D level. ‘Suboptimal’ or ‘low’ plasma 25(OH)D level was defined as plasma 25‐hydroxyvitamin D, or 25(OH)D, concentration below the level of 30 ng/mL. Of 7807 individuals, 782 (10.02%) were COVID‐19‐positive, and 7025 (89.98%) COVID‐19‐negative. The mean plasma vitamin D level was significantly lower among those who tested positive than negative for COVID‐19 [19.00 ng/mL (95% confidence interval (CI) 18.41–19.59) vs. 20.55 (95% CI: 20.32–20.78)]. Univariate analysis demonstrated an association between the low plasma 25(OH)D level and increased likelihood of COVID‐19 infection [crude odds ratio (OR) of 1.58 (95% CI: 1.24–2.01, P < 0.001)], and of hospitalization due to the SARS‐CoV‐2 virus [crude OR of 2.09 (95% CI: 1.01–4.30, P < 0.05)]. In multivariate analyses that controlled for demographic variables, and psychiatric and somatic disorders, the adjusted OR of COVID‐19 infection [1.45 (95% CI: 1.08–1.95, P < 0.001)] and of hospitalization due to the SARS‐CoV‐2 virus [1.95 (95% CI: 0.98–4.845, P = 0.061)] were preserved. In the multivariate analyses, age over 50 years, male gender and low–medium socioeconomic status were also positively associated with the risk of COVID‐19 infection; age over 50 years was positively associated with the likelihood of hospitalization due to COVID‐19. We concluded that low plasma 25(OH)D levels appear to be an independent risk factor for COVID‐19 infection and hospitalization.

Original publication: Low serum 25‐hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID‐19 are associated with greater disease severity

“…Furthermore, since the acceptance of our report, an erratum (and de facto partial retraction) of the UK Biobank prospective study now shows that historic lower 25(OH)D levels are associated with present higher risk for COVID-19,4,5 which was also confirmed by a recent large Israeli study6 and by a more comprehensiveand careful analysis of UK Biobank Data performed by other investigators. recent commentary 8 states that hospital-based clinical trials are underway elsewhere in the world, albeit National Institute for Health Research (NIHR) has declined to fund at least four UK grant applications for clinical trials of vitamin D3 in covid-19 disease prevention or mitigation.…”

Impact of Vitamin D Deficiency on COVID-19—A Prospective Analysis from the CovILD Registry

“…Contrasting results are reported from an Israeli population-based study, which, similar to this study, identified a high frequency of 25(OH)D deficiency in COVID-19 patients. Multivariate analysis, after controlling for demographic characteristics and medical conditions, confirmed an independent and significant association between a low 25(OH)D level and an increased likelihood of COVID-19 infection [28].…”

COVID‐19 and Vitamin D: A lesson from the skin

“…[42][43][44][45] In addition, several reports have found a strong association between vitamin D deficiency/insufficiency and enhanced COVID-19 severity and mortality [44][45][46][47][48][49][51][52][53] with the most recent study defining low plasma 25(OH)D 3 as an independent risk factor for COVID-19 infection and hospitalization. [54] Therefore, we retrospectively analysed microarray data of human epithelial cells treated with 20,23(OH) 2 D 3 and 1,25(OH) 2 D 3 . [24] We found the downregulation of pathways connected with influenza infection and viral RNA transcription, translation, replication, life cycle and of host interactions with influenza factors with 20,23(OH) 2 D 3 expressing higher antiviral potency Table 1.…”