Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study
Eugene Merzon, Dmitry Tworowski, Alessandro Gorohovski, Shlomo Vinker, Avivit Golan Cohen, Ilan Green, Milana Frenkel‐morgenstern
The FEBS Journal, doi:10.1111/febs.15495
Vitamin D deficiency is a worldwide pandemic. The aim of this study was to evaluate associations of plasma 25(OH)D levels with the likelihood of coronavirus disease 2019 (COVID-19) infection and hospitalization. The study population included the 14 000 members of Leumit Health Services, who were tested for COVID-19 infection from February 1 st to April 30 th , 2020, and who had at least one previous blood test for the plasma 25(OH) D level. 'Suboptimal' or 'low' plasma 25(OH)D level was defined as plasma 25-hydroxyvitamin D, or 25(OH)D, concentration below the level of 30 ng/mL. Of 7807 individuals, 782 (10.02%) were COVID-19-positive, and 7025 (89.98%) COVID-19-negative. The mean plasma vitamin D level was significantly lower among those who tested positive than negative for COVID-19 [19.00 ng/mL (95% confidence interval (CI) 18. ]. Univariate analysis demonstrated an association between the low plasma 25(OH)D level and increased likelihood of COVID-19 infection [crude odds ratio (OR) of 1.58 (95% CI: 1.24-2.01, P < 0.001)], and of hospitalization due to the SARS-CoV-2 virus [crude OR of 2.09 (95% CI: 1.01-4.30, P < 0.05)]. In multivariate analyses that controlled for demographic variables, and psychiatric and somatic disorders, the adjusted OR of COVID-19 infection [1.45 (95% CI: 1.08-1.95, P < 0.001)] and of hospitalization due to the SARS-CoV-2 virus [1.95 (95% CI: 0.98-4.845, P = 0.061)] were preserved. In the multivariate analyses, age over 50 years, male gender and low-medium socioeconomic status were also positively associated with the risk of COVID-19 infection; age over 50 years was positively associated with the likelihood of hospitalization due to COVID-19. We concluded that low plasma 25(OH)D levels appear to be an independent risk factor for COVID-19 infection and hospitalization.
Abbreviations BMI, body mass index; COVID-19-N, COVID-19-negative; COVID-19-P, COVID-19-positive; LHS, Leumit Health Services; SES, socioeconomic status.
Authors' contribution EM, MFM, DT, IG, AVG and SV designed the project and contributed the research questions, EM, DT, MFM and IG performed data mining and analysed results. EM performed statistical analysis. MFM, EM and DT wrote and edited the manuscript. MFM, AG and DT presented results in visual forms, MFM and EM supervised the project, and both contributed to the project design. All the authors contributed to editing of the manuscript. No honorarium, grant or other form of payment was given to any of the authors to produce the manuscript.
Conflict of interest The authors declare no conflict of interest.
Ethical considerations This is a data-based study, and as such, has no clinical trial registration number. The study received approval from the Leumit Health Services research committee and the Shamir Medical Centre IRB.
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