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0 0.5 1 1.5 2+ Case 53% Improvement Relative Risk c19early.org/d Kaufman et al. Vitamin D for COVID-19 Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 51,511 patients in the USA Fewer cases with higher vitamin D levels (p=0.001) Kaufman et al., PLOS One, doi:10.1371/journal.pone.0239252 Favors vitamin D Favors control
SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels
Kaufman et al., PLOS One, doi:10.1371/journal.pone.0239252
Kaufman et al., SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels, PLOS One, doi:10.1371/journal.pone.0239252
Sep 2020   Source   PDF  
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Analysis of 191,779 patients in the US finding COVID-19 positivity strongly and inversely associated with circulating 25(OH)D levels. The relationship persists across latitudes, races/ethnicities, gender, and age ranges.
COVID-19 adjusted odds ratio OR 0.984 per ng/mL increment, p<0.001). The decrease in positivity rate appeared to plateau as values approached 55 ng/mL.
Patients with high D levels (>55 ng/mL) compared to patients with very low D levels (<20 ng/mL) have a much lower risk of COVID-19 cases, with unadjusted RR 0.47, p<0.001.
risk of case, 53.0% lower, RR 0.47, p < 0.001, high D levels 12,321, low D levels 39,190, >55 ng/mL vs. <20 ng/mL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kaufman et al., 17 Sep 2020, retrospective, population-based cohort, USA, peer-reviewed, median age 54.0, 5 authors.
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Abstract: PLOS ONE RESEARCH ARTICLE SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels Harvey W. Kaufman1, Justin K. Niles1, Martin H. Kroll1, Caixia Bi1, Michael F. Holick ID2* 1 Medical Informatics, Quest Diagnostics, Secaucus, New Jersey, United States of America, 2 Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America * mfholick@bu.edu a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Kaufman HW, Niles JK, Kroll MH, Bi C, Holick MF (2020) SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PLoS ONE 15(9): e0239252. https://doi.org/ 10.1371/journal.pone.0239252 Editor: Sakamuri V. Reddy, Charles P. Darby Children’s Research Institute, UNITED STATES Received: July 29, 2020 Accepted: September 3, 2020 Published: September 17, 2020 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0239252 Copyright: © 2020 Kaufman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Until treatment and vaccine for coronavirus disease-2019 (COVID-19) becomes widely available, other methods of reducing infection rates should be explored. This study used a retrospective, observational analysis of deidentified tests performed at a national clinical laboratory to determine if circulating 25-hydroxyvitamin D (25(OH)D) levels are associated with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) positivity rates. Over 190,000 patients from all 50 states with SARS-CoV-2 results performed mid-March through mid-June, 2020 and matching 25(OH)D results from the preceding 12 months were included. Residential zip code data was required to match with US Census data and perform analyses of race/ethnicity proportions and latitude. A total of 191,779 patients were included (median age, 54 years [interquartile range 40.4–64.7]; 68% female. The SARS-CoV-2 positivity rate was 9.3% (95% C.I. 9.2–9.5%) and the mean seasonally adjusted 25(OH)D was 31.7 (SD 11.7). The SARS-CoV-2 positivity rate was higher in the 39,190 patients with “deficient” 25(OH)D values (<20 ng/mL) (12.5%, 95% C.I. 12.2–12.8%) than in the 27,870 patients with “adequate” values (30–34 ng/mL) (8.1%, 95% C.I. 7.8–8.4%) and the 12,321 patients with values �55 ng/mL (5.9%, 95% C.I. 5.5–6.4%). The association between 25 (OH)D levels and SARS-CoV-2 positivity was best fitted by the weighted second-order polynomial regression, which indicated strong correlation in the total population (R2 = 0.96) and in analyses stratified by all studied demographic factors. The association between lower SARS-CoV-2 positivity rates and higher circulating 25(OH)D levels remained significant in a multivariable logistic model adjusting for all included demographic factors (adjusted odds ratio 0.984 per ng/mL increment, 95% C.I. 0.983–0.986; p<0.001). SARS-CoV-2 positivity is strongly and inversely associated with circulating 25(OH)D levels, a relationship that persists across latitudes, races/ethnicities, both sexes, and..
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