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0 0.5 1 1.5 2+ Case 39% Improvement Relative Risk Vitamin D for COVID-19  Cozier et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Prospective study of 1,974 patients in the USA Fewer cases with higher vitamin D levels (p=0.035) Cozier et al., PLoS ONE, July 2021 Favors vitamin D Favors control

Lower serum 25(OH)D levels associated with higher risk of COVID-19 infection in U.S. Black women

Cozier et al., PLoS ONE, doi:10.1371/journal.pone.0255132
Jul 2021  
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Prospective study of vitamin D levels and COVID-19 infection in the Black Women's Health Study, showing higher risk of infection for lower vitamin D levels. Vitamin D levels were from 3-7 years before infection. Levels at the time of infection may differ, which may reduce the size of the effect observed.
This is the 80th of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion).
risk of case, 38.6% lower, RR 0.61, p = 0.04, high D levels 94 of 1,601 (5.9%), low D levels 33 of 373 (8.8%), NNT 34, adjusted per study, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >20ng/mL, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cozier et al., 27 Jul 2021, prospective, USA, peer-reviewed, 6 authors.
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This PaperVitamin DAll
Lower serum 25(OH)D levels associated with higher risk of COVID-19 infection in U.S. Black women
Yvette C Cozier, Nelsy Castro-Webb, Natasha S Hochberg, Lynn Rosenberg, Michelle A Albert, Julie R Palmer
PLOS ONE, doi:10.1371/journal.pone.0255132
Objective Limited evidence suggests that higher levels of serum vitamin D (25(OH)D) protect against SARS-CoV-2 virus (COVID-19) infection. Black women commonly experience 25(OH)D insufficiency and are overrepresented among COVID-19 cases. We conducted a prospective analysis of serum 25(OH)D levels in relation to COVID-19 infection among participants in the Black Women's Health Study. Methods Since 1995, the Black Women's Health Study has followed 59,000 U.S. Black women through biennial mailed or online questionnaires. Over 13,000 study participants provided a blood sample in 2013-2017. 25(OH)D assays were performed in a certified national laboratory shortly after collection of the samples. In 2020, participants who had completed the online version of the 2019 biennial health questionnaire were invited to complete a supplemental online questionnaire assessing their experiences related to the COVID-19 pandemic, including whether they had been tested for COVID-19 infection and the result of the test. We used logistic regression analysis to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association of 25(OH)D level with COVID-19 positivity, adjusting for age, number of people living in the household, neighborhood socioeconomic status, and other potential confounders. Results Among 5,081 eligible participants whose blood sample had been assayed for 25(OH)D, 1,974 reported having had a COVID-19 test in 2020. Relative to women with 25(OH)D levels of 30 ng/mL (75 nmol/l) or more, multivariable-adjusted ORs for COVID-19 infection in
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