Vitamin D status and severity of COVID-19

Abstract

We explored the association between COVID-19 severity and vitamin D status using information from Danish nation-wide health registers, the COVID-19 surveillance database and stored blood samples from the national biobank. 25-hydroxyvitamin D (25(OH)D) was measured using tandem mass spectroscopy. The association between 25(OH)D levels and COVID-19 severity, classified hierarchical as non-hospitalized, hospitalized but not admitted to an intensive care unit (ICU), admitted to ICU, and death, was evaluated by proportional odds ratios (POR) assuming proportionality between the four degrees of severity. Among 447 adults tested SARS-CoV-2 positive in the spring of 2020, low levels of 25(OH)D were associated with a higher risk of severe COVID-19. Thus, odds of experiencing more severe COVID-19 among individuals with insufficient (25 to < 50 nmol/L) and sufficient (≥ 50 nmol/L) 25(OH)D levels were approximately 50% of that among individuals with deficient levels (< 25 nmol/L) (POR = 0.49 (95% CI 0.25–0.94), POR = 0.51 (95% CI 0.27–0.96), respectively). Dividing sufficient vitamin D levels into 50 to < 75 nmol/L and ≥ 75 nmol/L revealed no additional beneficial effect of higher 25(OH)D levels. In this observational study, low levels of 25(OH)D were associated with a higher risk of severe COVID-19. A possible therapeutic role of vitamin D should be evaluated in well-designed interventional studies.

Risk Factors of Severe COVID-19: A Review of Host, Viral and Environmental Factors

“…A recent review by Martineau and Cantorna [ 848 ] reported that out of 11 randomized controlled trials that had been published at the time of writing, only 4 reported significant associations. Two recent large studies and a systematic review on vitamin D supplementation reported lower severity and mortality in the treated groups compared to controls [ 854 , 855 , 856 ], a study using Mendelian randomization found no association between genetically predicted 25(OH)D levels and COVID-19 severity [ 857 ], and another genetic analysis demonstrated an association between a risk score constructed from several genetic variants that influence vitamin D pathways and with 25(OH)D levels, and between 25(OH)D levels with disease outcome [ 858 ]. Recently, a mechanistic link has been proposed between vitamin D supplementation and reduced COVID-19 severity through the increased expression of interferon stimulating genes and higher protein levels both in vitro and in vivo [ 859 ].…”

Should Young Covid-19 Patients be Suplemented with Vitamin D?

“…Over 29% of children in our nation lack adequate levels of vitamin D (15). Reduced circulating 25(OH)D concentrations have also been linked to Covid-19 severity and the risk of contacting the infection, according to reports (16). The outcome is more severe in some instances.…”

The association between vitamin D intake with inflammatory and biochemical indices and mortality in critically ill patients with COVID‐19: A case‐control study

“…Vitamin D (vit D) deficiency is identified as one of the most conspicuous nutritional risk factors that can potentially influence the disease progression and mortality rate. 9 Several studies reported that a lower serum level of vit D was associated with a higher COVID-19 infection rate and worse outcomes in these patients, for instance, an increased mortality rate. 10 Vit D is a steroid hormone endogenously produced on the skin following exposure to the ultraviolet radiation of the sun.…”

“…At present, one of the most imperative ways to deal with this disease is to control risk factors. Vitamin D (vit D) deficiency is identified as one of the most conspicuous nutritional risk factors that can potentially influence the disease progression and mortality rate 9 . Several studies reported that a lower serum level of vit D was associated with a higher COVID‐19 infection rate and worse outcomes in these patients, for instance, an increased mortality rate 10 …”