All Studies Meta Analysis

Vitamin D Deficiency and Outcome of COVID-19 Patients

Radujkovic et al., Nutrients 2020, 12:9, 2757, doi:10.3390/nu12092757

Sep 2020

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Vitamin D for COVID-19

8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.

Lower risk for mortality, ICU admission, hospitalization, progression, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,100+ studies for 109 treatments. c19early.org

Observational study 185 patients in Germany shows an association between vitamin D status and severity and mortality. Adjusted hazard ratio of vitamin D sufficiency for combined mechanical ventilation and death was HR 0.16, p < 0.001, and for death HR 0.068, p < 0.001.

This is the 14th of 209 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 293,154,636 vigintillion).

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risk of death, 93.2% lower, HR 0.07, p = 0.001, high D levels 144, low D levels 12, >30nmol/L.

risk of death/intubation, 84.0% lower, HR 0.16, p < 0.001, high D levels 144, low D levels 12, >30nmol/L.

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Radujkovic et al., 10 Sep 2020, prospective, Germany, peer-reviewed, 6 authors.

This Paper Vitamin D All

Vitamin D Deficiency and Outcome of COVID-19 Patients

Aleksandar Radujkovic, Theresa Hippchen, Shilpa Tiwari-Heckler, Saida Dreher, Monica Boxberger, Uta Merle

Nutrients, doi:10.3390/nu12092757

Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses an enormous challenge to health care systems throughout the world. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. To explore possible associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients diagnosed with coronavirus disease 2019 (COVID-19) and treated at our center. VitD status at first presentation was assessed retrospectively using accredited laboratory methods. VitD deficiency was defined as serum total 25-hydroxyvitamin D level < 12 ng/mL (<30 nM). Primary endpoint was severe course of disease (i.e., need for invasive mechanical ventilation and/or death, IMV/D). Within a median observation period of 66 days (range 2-92), 23 patients required IMV. A total of 28 patients had IMV/D, including 16 deaths. Ninety-three (50%) patients required hospitalization (inpatient subgroup). A total of 41 (22%) patients were VitD deficient. When adjusted for age, gender, and comorbidities, VitD deficiency was associated with higher risk of IMV/D and death (HR 6.12, 95% CI 2.79-13.42, p < 0.001 and HR 14.73, 95% CI 4.16-52.19, p < 0.001, respectively). Similar correlations were observed in the inpatient subgroup. Our study demonstrates an association between VitD deficiency and severity/mortality of COVID-19, highlighting the need for interventional studies on VitD supplementation in SARS-CoV-2 infected individuals.

Conflicts of Interest: The authors declare no competing financial interest. Appendix A

References

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D'avolio, Avataneo, Manca, Cusato, De Nicolò et al., 25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2, Nutrients, doi:10.3390/nu12051359

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Faul, Kerley, Love, O'neill, Cody et al., Vitamin D Deficiency and ARDS after SARS-CoV-2 Infection, Ir. Med. J

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Holick, Vitamin, Deficiency, None, N. Engl. J. Med, doi:10.1056/NEJMra070553

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Martineau, Jolliffe, Hooper, Greenberg, Aloia et al., Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data, BMJ, doi:10.1136/bmj.i6583

Mitchell, Vitamin-D and COVID-19: Do deficient risk a poorer outcome?, Lancet Diabetes Endocrinol, doi:10.1016/S2213-8587(20)30183-2

Munshi, Hussein, Toraih, Elshazli, Jardak et al., Vitamin D insufficiency as a potential culprit in critical COVID-19 patients, J. Med. Virol, doi:10.1002/jmv.26360

Rabenberg, Scheidt-Nave, Busch, Rieckmann, Hintzpeter et al., Vitamin D status among adults in Germany-results from the German Health Interview and Examination Survey for Adults (DEGS1), BMC Public Health, doi:10.1186/s12889-015-2016-7

Rhodes, Subramanian, Laird, Kenny, Editorial: Low population mortality from COVID-19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity, Aliment. Pharmacol. Ther, doi:10.1111/apt.15777

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Shi, Yu, Zhao, Wang, Zhao et al., Host susceptibility to severe COVID-19 and establishment of a host risk score: Findings of 487 cases outside Wuhan, Crit. Care, doi:10.1186/s13054-020-2833-7

Verity, Okell, Dorigatti, Winskill, Whittaker et al., Estimates of the severity of coronavirus disease 2019: A model-based analysis, Lancet Infect. Dis, doi:10.1016/S1473-3099(20)30243-7

Yang, Zheng, Gou, Pu, Chen et al., Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: A systematic review and meta-analysis, Int. J. Infect. Dis, doi:10.1016/j.ijid.2020.03.017

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