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0 0.5 1 1.5 2+ Case 44% Improvement Relative Risk c19early.org/d Meltzer et al. Vitamin D for COVID-19 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, 3:9, doi:10.1001/jamanetworkopen.2020.19722 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
Meltzer et al., Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results, JAMA network open, 3:9, doi:10.1001/jamanetworkopen.2020.19722
Sep 2020   Source   PDF  
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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.
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.
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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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