Effects of vitamin D on COVID-19 risk and hospitalisation in the UK biobank

Monroy-Iglesias et al., PLoS One, doi:10.1371/journal.pone.0328232, Jul 2025

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Vitamin D for COVID-19

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Case-control analysis of 151,543 UK Biobank participants showing higher odds of COVID-19 hospitalisation for those with low baseline serum vitamin D, and slightly lower risk of cases. Vitamin D measurements were taken a decade before the pandemic.

This is the 223rd COVID-19 sufficiency study for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 4,044,100,105,864 vigintillion).

Standard of Care (SOC) for COVID-19 in the study country, the United Kingdom, is very poor with very low average efficacy for approved treatments1. The United Kingdom focused on expensive high-profit treatments, approving only one low-cost early treatment, which required a prescription and had limited adoption. The high-cost prescription treatment strategy reduces the probability of early treatment due to access and cost barriers, and eliminates complementary and synergistic benefits seen with many low-cost treatments.

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risk of hospitalization, 26.5% lower, OR 0.74, p < 0.001, high D levels (≥50nmol/L) 69,746, low D levels (<25nmol/L) 19,358, adjusted per study, inverted to make OR<1 favor high D levels (≥50nmol/L), deficiency, model B, multivariable, RR approximated with OR.

risk of hospitalization, 16.0% lower, OR 0.84, p < 0.001, high D levels (≥50nmol/L) 69,746, low D levels (<50nmol/L) 81,797, adjusted per study, inverted to make OR<1 favor high D levels (≥50nmol/L), deficiency, model B, multivariable, RR approximated with OR.

risk of case, 5.3% higher, OR 1.05, p = 0.03, high D levels (≥50nmol/L) 69,746, low D levels (<25nmol/L) 19,358, adjusted per study, inverted to make OR<1 favor high D levels (≥50nmol/L), deficiency, model B, multivariable, RR approximated with OR.

risk of case, 3.1% higher, OR 1.03, p = 0.05, high D levels (≥50nmol/L) 69,746, low D levels (<50nmol/L) 81,797, adjusted per study, inverted to make OR<1 favor high D levels (≥50nmol/L), deficiency, model B, multivariable, RR approximated with OR.

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1. c19early.org, c19early.org/soc/united-kingdom.html.c19early.org/soc/united-kingdom.html.

Monroy-Iglesias et al., 18 Jul 2025, retrospective, United Kingdom, peer-reviewed, mean age 56.0, 8 authors, study period March 2020 - October 2020. Contact: maria.j.monroy_iglesias@kcl.ac.uk.

This Paper Vitamin D All

Effects of vitamin D on COVID-19 risk and hospitalisation in the UK biobank

Maria J Monroy-Iglesias, Rathesh Thavarajah, Kerri Beckmann, Debra H Josephs, Sheeba Irshad, Sophia N Karagiannis, Mieke Van Hemelrijck, Aida Santaolalla

doi:10.1371/journal.pone.0328232

Background Vitamin D (VitD) plays an important role in immune modulation. VitD deficiency is associated with increased susceptibility to acute respiratory syndrome as observed in COVID-19. We evaluated potential associations between serum VitD levels and risk of COVID-19 infection and hospitalisation, within the overall and cancer populations. Methods We performed a nested case-control study within the UK biobank cohort, among all individuals with at least one serum VitD level measurement at baseline (2006)(2007)(2008)(2009)(2010) and a COVID-19 polymerase chain reaction (PCR) results recorded, and individuals with previous cancer diagnosis. Binary multivariable logistic regression was performed to assess associations between VitD levels and risk of COVID-19 infection (positive PCR), and hospitalisation (COVID-19-positive PCR in hospital), and stratified by ethnicity. Results Of 151,543 participants, 21,396 tested positive for COVID-19. Of 24,400 individuals with cancer, 2,608 tested positive. In the total cohort, VitD insufficiency (Adjusted Odds Ratio (aOR) 0.97, 95% Confidence Interval (CI) 0.94-1.00) and deficiency (aOR 0.95, 95%CI 0.90-0.99) were associated with slightly lower odds of COVID-19 infection. In contrast, both VitD insufficiency (aOR 1.19, 95%CI 1.08-1.31) and deficiency (aOR 1.36, 95%CI 1.19-1.56) were associated with higher odds of COVID-19 hospitalisation. Among Asian (aOR 1.50; 95%CI 1.08-2.07) and Black (aOR 1.57; 95%CI 1.14-2.16) participants, VitD deficiency was associated with higher odds of COVID-19 infection. Among White participants, VitD insufficiency was associated with slightly lower odds of COVID-19 infection (aOR 0.97; 95%CI 0.86-0.95), while both VitD insufficiency (aOR 1.19; 95%CI 1.08-1.32) and deficiency (aOR 1.44; 95%CI 1.25-1.66) were associated with increased odds of hospitalisation. In the cancer population, vitamin D deficiency was associated with higher odds of infection only among Black participants (aOR 3.50; 95%CI 1.22-10.01); no other associations were observed. Conclusions Low VitD levels were associated with an increased risk of COVID-19 hospitalisation but showed only a weak association with infection risk. Black and Asian populations had higher infection risk associated with VitD deficiency, but this did not translate to increased hospitalisation. In contrast, White populations with low VitD levels exhibited a higher risk of hospitalisation. There was no evidence of an interaction between VitD levels and ethnicity affecting infection or hospitalisation risk. In the cancer cohort, no significant associations were observed for COVID-19 infection or hospitalisation. provided the original author and source are credited.

Supporting information S1

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