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0 0.5 1 1.5 2+ Symp. case, 20ng/mL 60% Improvement Relative Risk Symp. case 58% Vitamin D for COVID-19  Kalichuran et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Prospective study of 100 patients in South Africa (Sep 2020 - Feb 2021) Fewer symptomatic cases with higher vitamin D levels (p=0.0000089) Kalichuran et al., Southern African J..., Apr 2022 Favors vitamin D Favors control

Vitamin D status and COVID-19 severity

Kalichuran et al., Southern African Journal of Infectious Diseases, doi:10.4102/sajid.v37i1.359
Apr 2022  
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Prospective study of 100 COVID-19 patients in South Africa, 50 with COVID-19 pneumonia and 50 asymptomatic, showing higher risk of symptomatic COVID-19 with vitamin D deficiency and with lower exposure to sunlight.
Authors analyzed sunlight exposure in the previous week. It is not clear if this includes the time that patients could be symptomatic prior to going to the hospital. Symptomatic patients may be less likely to have sun exposure.
Sunlight exposure may be correlated with physical activity and may have additional benefits independent of vitamin D
This is the 129th of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion).
This study includes sunlight and vitamin D.
risk of symptomatic case, 60.0% lower, RR 0.40, p < 0.001, high D levels (≥20ng/mL) 56, low D levels (<20ng/mL) 44, inverted to make RR<1 favor high D levels (≥20ng/mL).
risk of symptomatic case, 58.2% lower, RR 0.42, p = 0.004, inverted to make RR<1 favor high D levels, higher sunlight exposure vs. lower sunlight exposure.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kalichuran et al., 26 Apr 2022, prospective, South Africa, peer-reviewed, survey, 4 authors, study period September 2020 - February 2021.
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This PaperVitamin DAll
Vitamin D status and COVID-19 severity
Senrina Kalichuran, Sarah A Van Blydenstein, Michelle Venter, Shahed Omar
Southern African Journal of Infectious Diseases, doi:10.4102/sajid.v37i1.359
Background: Age, body mass index (BMI) and pre-existing comorbidities are known risk factors of severe coronavirus disease 2019 (COVID-19). In this study we explore the relationship between vitamin D status and COVID-19 severity. Methods: We conducted a prospective, cross-sectional descriptive study. We enrolled 100 COVID-19 positive patients admitted to a tertiary level hospital in Johannesburg, South Africa. Fifty had symptomatic disease (COVID-19 pneumonia) and 50 who were asymptomatic (incidental diagnosis). Following written informed consent, patients were interviewed regarding age, gender and sunlight exposure during the past week, disease severity, BMI, calcium, albumin, magnesium and alkaline phosphatase levels. Finally, blood was collected for vitamin D measurement. Results: We found an 82% prevalence rate of vitamin D deficiency or insufficiency among COVID-19 patients. Vitamin D levels were lower in the symptomatic group (18.1 ng/mL ± 8.1 ng/mL) than the asymptomatic group (25.9 ng/mL ± 7.1 ng/mL) with a p-value of 0.000. The relative risk of symptomatic COVID-19 was 2.5-fold higher among vitamin D deficient patients than vitamin D non-deficient patients (confidence interval [CI]: 1.14-3.26). Additional predictors of symptomatic disease were older age, hypocalcaemia and hypoalbuminaemia. Using multiple regression, the only independent predictors of COVID-19 severity were age and vitamin D levels. The patients exposed to less sunlight had a 2.39-fold increased risk for symptomatic disease compared to those with more sunlight exposure (CI: 1.32-4.33). Conclusion: We found a high prevalence of vitamin D deficiency and insufficiency among patients admitted to hospital with COVID-19 and an increased risk for symptomatic disease in vitamin D deficient patients.
Authors' contributions S.K. wrote the proposal, obtained ethics approval, collected data and wrote the original article. S.A.v.B. contributed to the conceptualisation of the article, data collection as well as supervising and reviewing of protocol and article writing. M.V. assisted with reviewing of the protocol and manuscript. S.O. contributed to statistical analysis and reviewing of article writing. Disclaimer The views and opinions expressed in this article are those of the authors only.
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