Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results
Retrospective 489 patients showing 44% lower risk for COVID-19 with vitamin D sufficiency, relative risk RR = 0.56, p = 0.02.
risk of case, 43.5% lower, RR 0.56, p = 0.02, high D levels 39 of 317 (12.3%), low D levels 32 of 172 (18.6%), NNT 16, adjusted per study, inverted to make RR<1 favor high D levels, >20ng/mL.
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Meltzer et al., 3 Sep 2020, retrospective, USA, peer-reviewed, 6 authors.
Abstract: Original Investigation | Infectious Diseases
Association of Vitamin D Status and Other Clinical Characteristics
With COVID-19 Test Results
David O. Meltzer, MD, PhD; Thomas J. Best, PhD; Hui Zhang, PhD; Tamara Vokes, MD; Vineet Arora, MD, MPP; Julian Solway, MD
Abstract
Key Points
IMPORTANCE Vitamin D treatment has been found to decrease the incidence of viral respiratory
tract infection, especially in patients with vitamin D deficiency. Whether vitamin D is associated with
coronavirus disease 2019 (COVID-19) incidence is unknown.
Question Is vitamin D status, reflecting
vitamin D levels and treatment,
associated with test results for
coronavirus disease 2019 (COVID-19)?
OBJECTIVE To examine whether the last vitamin D status before COVID-19 testing is associated with
Findings In this cohort study of 489
COVID-19 test results.
patients who had a vitamin D level
measured in the year before COVID-19
DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study at an urban academic
testing, the relative risk of testing
medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol
positive for COVID-19 was 1.77 times
level measured within 1 year before being tested for COVID-19 from March 3 to April 10, 2020.
greater for patients with likely deficient
vitamin D status compared with patients
EXPOSURES Vitamin D deficiency was defined by the last measurement of
with likely sufficient vitamin D status, a
25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL
difference that was statistically
before COVID-19 testing. Treatment changes were defined by changes in vitamin D type and dose
significant.
between the date of the last vitamin D level measurement and the date of COVID-19 testing. Vitamin
D deficiency and treatment changes were combined to categorize the most recent vitamin D status
before COVID-19 testing as likely deficient (last level deficient and treatment not increased), likely
sufficient (last level not deficient and treatment not decreased), and 2 groups with uncertain
deficiency (last level deficient and treatment increased, and last level not deficient and treatment
decreased).
Meaning These findings appear to
support a role of vitamin D status in
COVID-19 risk; randomized clinical trials
are needed to determine whether broad
population interventions and
interventions among groups at
increased risk of vitamin D deficiency
MAIN OUTCOMES AND MEASURES The outcome was a positive COVID-19 polymerase chain
reaction test result. Multivariable analysis tested whether vitamin D status before COVID-19 testing
and COVID-19 could reduce COVID-19
incidence.
was associated with testing positive for COVID-19, controlling for demographic and comorbidity
indicators.
+ Supplemental content
RESULTS A total of 489 patients (mean [SD] age, 49.2 [18.4] years; 366 [75%] women; and 331
[68%] race other than White) had a vitamin D level measured in the year before COVID-19 testing.
Author affiliations and article information are
listed at the end of this article.
Vitamin D status before COVID-19 testing was categorized as likely deficient for 124 participants
(25%), likely sufficient for 287 (59%), and uncertain for 78 (16%). Overall, 71 participants (15%)
tested positive for COVID-19. In multivariate analysis, testing positive for COVID-19 was associated
with increasing age up to age 50 years (relative risk, 1.06; 95% CI, 1.01-1.09; P = .02);..
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