Metabolic Healthy Obesity, Vitamin D Status, and Risk of COVID-19

Li et al., Aging and Disease, doi:10.14336/AD.2020.1108

Li et al., Metabolic Healthy Obesity, Vitamin D Status, and Risk of COVID-19, Aging and Disease, doi:10.14336/AD.2020.1108

Jan 2021 Source PDF

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UK Biobank retrospective 353,299 patients showing that vitamin D insufficiency and deficiency are associated with increased COVID-19 risk. This study also analyzes metabolic/obesity phenotypes and the combination with vitamin D status.

Note that the outcome definitions are unusual - COVID-19 hospitalization includes patients that tested negative, and severe COVID-19 was defined as hospitalized patients that tested positive.

This is the 39th of 175 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 18 vigintillion).

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risk of hospitalization, 36.2% lower, RR 0.64, p < 0.001, NNT 932, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >25nmol/L.

risk of case, 29.5% lower, RR 0.71, p < 0.001, NNT 823, inverted to make RR<1 favor high D levels, odds ratio converted to relative risk, >25nmol/L.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Li et al., 11 Jan 2021, retrospective, population-based cohort, United Kingdom, peer-reviewed, 6 authors.

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Metabolic Healthy Obesity, Vitamin D Status, and Risk of COVID-19

Shu Li, Zhi Cao, Hongxi Yang, Yuan Zhang, Fusheng Xu, Dr Yaogang Wang

Aging and disease, doi:10.14336/ad.2020.1108

Aging and obesity-related conditions seem to worsen the effect of Coronavirus Disease 2019 (COVID-19). This study assessed the possible roles of metabolic/obesity phenotypes and vitamin D status in increasing the greater severity of COVID-19. We studied 353,299 UK Biobank participants from England with a mean age of 67.7 years. Metabolic/obesity phenotypes were defined as a combination of metabolic components (hypertension, high cholesterol, and diabetes) and obesity. Multivariate logistic regression analysis was performed to test whether the addition of metabolic disorders and vitamin D insufficiency increased obesity associations with COVID-19 hospitalization, confirmed COVID-19, and severe COVID-19. Metabolically unhealthy obesity (MUHO) represented 12.3% of the total analytic samples, and 21.5%, 18.5%, and 19.8% of the included subpopulations with COVID-19 hospitalization, confirmed COVID-19, and severe COVID-19, respectively. Vitamin D insufficiency phenotypes represented 53.5% of the total analytic samples, and 59.5%, 61.7%, and 61.5% of the included subpopulations with COVID-19 hospitalization, confirmed COVID-19, and severe COVID-19, respectively. In multivariate logistic regression, MUHO and vitamin D insufficiency and their combination were significantly associated with COVID-19 illness severity (odds ratio [OR] for COVID-19 hospitalization = 2.33, 95% confidence interval [CI], 2.02-2.70; OR for confirmed COVID-19 = 2.06, 95% CI, 1.58-2.70; OR for severe COVID-19 = 2.06, 95% CI, 1.47-2.87). Elderly men were prone to have a higher risk of COVID-19 than women. Our findings showed that MUHO and vitamin D insufficiency are associated with a significantly increased risk of COVID-19 severity, especially for adults 65 years and older. Susceptible individuals should be aware of their conditions and avoid contact with new coronavirus.

Conflicts of interest The authors declare that they have no competing interests. Supplementary Materials The Supplemenantry data can be found online at: www.aginganddisease.org/EN/10.14336/AD.2020.1108.

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