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Vitamin D status and seroconversion for COVID-19 in UK healthcare workers who isolated for COVID-19 like symptoms during the 2020 pandemic

Faniyi et al., medRxiv, doi:10.1101/2020.10.05.20206706
Oct 2020  
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Seropositive 29% Improvement Relative Risk Vitamin D for COVID-19  Faniyi et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Prospective study of 392 patients in the United Kingdom Lower seropositivity with higher vitamin D levels (p=0.0031) c19early.org Faniyi et al., medRxiv, October 2020 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
 
*, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments. c19early.org
Analysis of vitamin D status and anti-SARS-Cov-2 antibodies in UK healthcare workers finding that Vitamin D deficiency is a risk factor
for COVID-19 seroconversion.
This is the 19th of 199 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 835,162 vigintillion).
risk of seropositive, 28.8% lower, RR 0.71, p = 0.003, high D levels 170 of 331 (51.4%), low D levels 44 of 61 (72.1%), NNT 4.8, >30nmol/L.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Faniyi et al., 6 Oct 2020, prospective, United Kingdom, preprint, 10 authors.
This PaperVitamin DAll
Vitamin D status and seroconversion for COVID-19 in UK healthcare workers who isolated for COVID-19 like symptoms during the 2020 pandemic
Aduragbemi A Faniyi, Sebastian T Lugg, Sian E Faustini, Craig Webster, Joanne E Duffy, Martin Hewison, Adrian Shields, Peter Nightingale, Alex G Richter, Prof David R Thickett
doi:10.1101/2020.10.05.20206706
Background: It is clear that in UK healthcare workers, COVID-19 infections and deaths were more likely to be in staff who were of BAME origin. This has led to much speculation about the role of vitamin D in healthcare worker COVID-19 infections. We aimed to determine the prevalence of vitamin D deficiency in NHS staff who have isolated with symptoms suggestive of COVID-19 and relate this to vitamin D status. Methods: We recruited NHS healthcare workers between 12 th to 22 nd May 2020 as part of the COVID-19 convalescent immunity study (COCO). We measured anti-SARS-Cov-2 antibodies using a combined IgG, IgA and IgM ELISA (The Binding Site). Vitamin D status was determined by measurement of serum 25(OH)D 3 using the AB SCIEX Triple Quad 4500 mass spectrometry system. Findings: Of the 392 NHS healthcare workers, 214 (55%) had seroconverted for COVID-19. A total of 61 (15.6%) members of staff were vitamin D deficient (<30 nmol/l) with significantly more staff from BAME backgrounds or in a junior doctor role being deficient. Vitamin D levels were lower in those who were younger, had a higher BMI (>30 kg/m 2 ), and were male. Multivariate analysis revealed that BAME and COVID-19 seroconversion were independent predictors of vitamin D deficiency. Staff who were vitamin D deficient were more likely to self-report symptoms of body aches and pains but importantly not the respiratory symptoms of cough and breathlessness. Vitamin D levels were lower in those COVID-19 positive staff who reported fever, but this did not reach statistical significance. Within the whole cohort there was an increase in seroconversion in staff with vitamin D deficiency compared to those without vitamin D deficiency (n=44/61, 72% vs n=170/331, 51%; p=0•003); this was particularly marked in the proportion of BAME males who were vitamin D deficient compared to non-vitamin D deficient BAME males (n=17/18, 94% vs n=12/23, 52%; p=0•005). Multivariate analysis revealed that vitamin D deficiency was an independent risk factor for seroconversion (OR 2•6, 95%CI 1•41-4•80; p=0•002). Interpretation: In those healthcare workers who have isolated due to symptoms of COVID-19, those of BAME ethnicity are at the highest risk of vitamin D deficiency. Vitamin D deficiency is a risk factor for COVID-19 seroconversion for NHS healthcare workers especially in BAME male staff.
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{ 'institution': [{'name': 'medRxiv'}], 'indexed': {'date-parts': [[2024, 4, 8]], 'date-time': '2024-04-08T08:36:14Z', 'timestamp': 1712565374758}, 'posted': {'date-parts': [[2020, 10, 6]]}, 'group-title': 'Endocrinology (including Diabetes Mellitus and Metabolic Disease)', 'reference-count': 31, 'publisher': 'Cold Spring Harbor Laboratory', 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'accepted': {'date-parts': [[2020, 10, 6]]}, 'abstract': '<jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>It is ' 'clear that in UK healthcare workers, COVID-19 infections and deaths were more likely to be in ' 'staff who were of BAME origin. This has led to much speculation about the role of vitamin D ' 'in healthcare worker COVID-19 infections. We aimed to determine the prevalence of vitamin D ' 'deficiency in NHS staff who have isolated with symptoms suggestive of COVID-19 and relate ' 'this to vitamin D ' 'status.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We recruited NHS ' 'healthcare workers between 12<jats:sup>th</jats:sup>to 22<jats:sup>nd</jats:sup>May 2020 as ' 'part of the COVID-19 convalescent immunity study (COCO). We measured anti-SARS-Cov-2 ' 'antibodies using a combined IgG, IgA and IgM ELISA (The Binding Site). Vitamin D status was ' 'determined by measurement of serum 25(OH)D<jats:sub>3</jats:sub>using the AB SCIEX Triple ' 'Quad 4500 mass spectrometry ' 'system.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>Of the 392 NHS ' 'healthcare workers, 214 (55%) had seroconverted for COVID-19. A total of 61 (15.6%) members ' 'of staff were vitamin D deficient (&lt;30 nmol/l) with significantly more staff from BAME ' 'backgrounds or in a junior doctor role being deficient. Vitamin D levels were lower in those ' 'who were younger, had a higher BMI (&gt;30 kg/m<jats:sup>2</jats:sup>), and were male. ' 'Multivariate analysis revealed that BAME and COVID-19 seroconversion were independent ' 'predictors of vitamin D deficiency. Staff who were vitamin D deficient were more likely to ' 'self-report symptoms of body aches and pains but importantly not the respiratory symptoms of ' 'cough and breathlessness. Vitamin D levels were lower in those COVID-19 positive staff who ' 'reported fever, but this did not reach statistical significance. Within the whole cohort ' 'there was an increase in seroconversion in staff with vitamin D deficiency compared to those ' 'without vitamin D deficiency (n=44/61, 72%<jats:italic>vs</jats:italic>n=170/331, 51%; ' 'p=0·003); this was particularly marked in the proportion of BAME males who were vitamin D ' 'deficient compared to non-vitamin D deficient BAME males (n=17/18, ' '94%<jats:italic>vs</jats:italic>n=12/23, 52%; p=0·005). Multivariate analysis revealed that ' 'vitamin D deficiency was an independent risk factor for seroconversion (OR 2·6, 95%CI ' '1·41–4·80; ' 'p=0·002).</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p>In ' 'those healthcare workers who have isolated due to symptoms of COVID-19, those of BAME ' 'ethnicity are at the highest risk of vitamin D deficiency. Vitamin D deficiency is a risk ' 'factor for COVID-19 seroconversion for NHS healthcare workers especially in BAME male ' 'staff.</jats:p></jats:sec><jats:sec><jats:title>Funding</jats:title><jats:p>This study was ' 'funded internally by the University of Birmingham and University Hospitals Birmingham NHS ' 'Foundation Trust and supported by the National Institute for Health Research (NIHR)/Wellcome ' 'Trust Birmingham Clinical Research Facility. AAF and DRT are funded by the Medical Research ' 'Council (MR/S002782/1). The Binding Site (Edgbaston, UK) have provided reagents and plates ' 'for the SARS-CoV-2 ELISA free of charge.</jats:p></jats:sec><jats:sec><jats:title>Research in ' 'context</jats:title><jats:sec><jats:title>Evidence before this study</jats:title><jats:p>The ' 'ongoing COVID-19 pandemic has raised several questions, one of which is whether individuals ' 'with vitamin D deficiency were at a greater risk of being infected or having a severe outcome ' 'if infected. Among UK healthcare workers, and indeed the general population, individuals of ' 'BAME ethnicity are disproportionately affected by COVID-19. It is well established that ' 'individuals of BAME ethnicity have a higher prevalence of vitamin D deficiency, but it is ' 'unknown if vitamin D deficiency among UK NHS workers was connected to the risk of COVID-19 ' 'infection. Our search of the literature revealed no previous studies have established the ' 'prevalence of vitamin D deficiency within a UK NHS trust. Unsurprisingly, there is also no ' 'evidence to suggest if vitamin D deficiency was connected to the risk of infection among UK ' 'healthcare workers.</jats:p></jats:sec><jats:sec><jats:title>Added value of this ' 'study</jats:title><jats:p>In this study of healthcare workers who had isolated for COVID-19 ' 'symptoms towards the end of UK surge within a large UK NHS trust, 15.6% were vitamin D ' 'deficient. Our data also reveal that healthcare workers of BAME ethnicity and those who had ' 'seroconverted for COVID-19 were more likely to be vitamin D deficient. Multivariate analysis ' 'also show that vitamin D deficiency was the only predictor of COVID-19 seroconversion. ' 'Vitamin D deficient healthcare workers that are BAME and male had a 94% seroconversion for ' 'COVID-19 compared to non-deficient BAME males suggesting they are more at risk of COVID-19 if ' 'vitamin D deficient.</jats:p></jats:sec><jats:sec><jats:title>Implications of all the ' 'available evidence</jats:title><jats:p>There is an increased risk of COVID-19 infection in ' 'healthcare workers with vitamin D deficiency. Our data adds to the emerging evidence from ' 'studies in the UK and across the globe that individuals with severe COVID-19 are more vitamin ' 'D deficient than those with mild disease. Finally, ours and the available evidence ' 'demonstrate vitamin D supplementation in individuals at risk of vitamin D deficiency or shown ' 'to be deficient may help alleviate the impact of COVID-19.</jats:p></jats:sec></jats:sec>', 'DOI': '10.1101/2020.10.05.20206706', 'type': 'posted-content', 'created': {'date-parts': [[2020, 10, 6]], 'date-time': '2020-10-06T18:20:33Z', 'timestamp': 1602008433000}, 'source': 'Crossref', 'is-referenced-by-count': 7, 'title': 'Vitamin D status and seroconversion for COVID-19 in UK healthcare workers who isolated for ' 'COVID-19 like symptoms during the 2020 pandemic', 'prefix': '10.1101', 'author': [ {'given': 'Aduragbemi A', 'family': 'Faniyi', 'sequence': 'first', 'affiliation': []}, {'given': 'Sebastian T', 'family': 'Lugg', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sian E', 'family': 'Faustini', 'sequence': 'additional', 'affiliation': []}, {'given': 'Craig', 'family': 'Webster', 'sequence': 'additional', 'affiliation': []}, {'given': 'Joanne E', 'family': 'Duffy', 'sequence': 'additional', 'affiliation': []}, {'given': 'Martin', 'family': 'Hewison', 'sequence': 'additional', 'affiliation': []}, {'given': 'Adrian', 'family': 'Shields', 'sequence': 'additional', 'affiliation': []}, {'given': 'Peter', 'family': 'Nightingale', 'sequence': 'additional', 'affiliation': []}, {'given': 'Alex G', 'family': 'Richter', 'sequence': 'additional', 'affiliation': []}, {'given': 'David R', 'family': 'Thickett', 'sequence': 'additional', 'affiliation': []}], 'member': '246', 'reference': [ { 'key': '2020101914500680000_2020.10.05.20206706v1.1', 'unstructured': 'WHO Coronavirus Disease (COVID-19) Dashboard. 2020. 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