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0 0.5 1 1.5 2+ Case 44% Improvement Relative Risk Vitamin D for COVID-19  Meltzer et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 489 patients in the USA Fewer cases with higher vitamin D levels (p=0.02) Meltzer et al., JAMA network open, Sep 2020 Favors vitamin D Favors control

Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results

Meltzer et al., JAMA network open, 3:9, doi:10.1001/jamanetworkopen.2020.19722
Sep 2020  
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Retrospective 489 patients showing 44% lower risk for COVID-19 with vitamin D sufficiency, relative risk RR = 0.56, p = 0.02.
This is the 12th of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion).
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.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Meltzer et al., 3 Sep 2020, retrospective, USA, peer-reviewed, 6 authors.
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Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results
MD David O Meltzer, PhD Thomas J Best, PhD Hui Zhang, PhD Tamara Vokes, MD Vineet Arora, MD, MPP Julian Solway
JAMA Network Open, doi:10.1001/jamanetworkopen.2020.19722
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. OBJECTIVE To examine whether the last vitamin D status before COVID-19 testing is associated with COVID-19 test results. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study at an urban academic medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol level measured within 1 year before being tested for COVID-19 from March 3 to April 10, 2020. EXPOSURES Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL before COVID-19 testing. Treatment changes were defined by changes in vitamin D type and dose 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). 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 was associated with testing positive for COVID-19, controlling for demographic and comorbidity indicators. 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. 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); non-White race (relative risk, 2.54; 95% CI, 1.26-5.12; P = .009), and likely deficient vitamin D status (relative risk, 1.77; 95% CI, 1.12-2.81; P = .02) compared with likely sufficient vitamin D status. Predicted COVID-19 rates in the deficient group were 21.6% (95% CI, 14.0%-29.2%) vs 12.2%(95% CI, 8.9%-15.4%) in the sufficient group. (continued) Key Points Question Is vitamin D status, reflecting vitamin D levels and treatment, associated with test results for coronavirus disease 2019 (COVID-19)? Findings In this cohort study of 489 patients who had a vitamin D level measured in the year before COVID-19 testing, the relative risk of testing positive for COVID-19 was 1.77 times greater for patients..
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