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0 0.5 1 1.5 2+ Mortality 45% Improvement Relative Risk Mortality (b) 40% Mortality (c) 35% Mortality (d) 26% Mortality (e) 20% Mortality (f) 12% Hospitalization 22% Hospitalization (b) 20% Hospitalization (c) 17% Hospitalization (d) 12% Hospitalization (e) 9% Hospitalization (f) 5% Vitamin D for COVID-19  Seal et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective study in the USA Lower mortality (p=0.0013) and hospitalization (p=0.011) Seal et al., J. General Internal Medic.., Jan 2022 Favors vitamin D Favors control

Association of Vitamin D Status and COVID-19-Related Hospitalization and Mortality

Seal et al., Journal of General Internal Medicine, doi:10.1007/s11606-021-07170-0
Jan 2022  
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Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
*, now known with p < 0.00000000001 from 119 studies, recognized in 7 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 4,599 COVID+ veterans in the USA with vitamin D levels measured 15 to 90 days prior to testing positive, showing a significant independent inverse dose-response relationship between vitamin D levels (from 15 to 60ng/mL) and decreasing risk of hospitalization (24.1% to 18.7%, p = 0.009) and mortality (10.4% to 5.7%, p = 0.001).
This is the 113th of 192 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 611 vigintillion).
risk of death, 45.1% lower, RR 0.55, p = 0.001, adjusted per study, inverted to make RR<1 favor high D levels, 60ng/mL vs. 15 ng/mL.
risk of death, 40.5% lower, RR 0.60, p = 0.001, adjusted per study, inverted to make RR<1 favor high D levels, 50ng/mL vs. 15 ng/mL.
risk of death, 34.6% lower, RR 0.65, p = 0.001, adjusted per study, inverted to make RR<1 favor high D levels, 40ng/mL vs. 15 ng/mL.
risk of death, 25.9% lower, RR 0.74, p = 0.001, adjusted per study, inverted to make RR<1 favor high D levels, 30ng/mL vs. 15 ng/mL.
risk of death, 20.0% lower, RR 0.80, p = 0.001, adjusted per study, inverted to make RR<1 favor high D levels, 25ng/mL vs. 15 ng/mL.
risk of death, 11.5% lower, RR 0.88, p = 0.001, adjusted per study, inverted to make RR<1 favor high D levels, 20ng/mL vs. 15 ng/mL.
risk of hospitalization, 22.5% lower, RR 0.78, p = 0.01, adjusted per study, inverted to make RR<1 favor high D levels, 60ng/mL vs. 15 ng/mL.
risk of hospitalization, 20.0% lower, RR 0.80, p = 0.009, adjusted per study, inverted to make RR<1 favor high D levels, 50ng/mL vs. 15 ng/mL.
risk of hospitalization, 16.7% lower, RR 0.83, p = 0.007, adjusted per study, inverted to make RR<1 favor high D levels, 40ng/mL vs. 15 ng/mL.
risk of hospitalization, 12.3% lower, RR 0.88, p = 0.008, adjusted per study, inverted to make RR<1 favor high D levels, 30ng/mL vs. 15 ng/mL.
risk of hospitalization, 9.1% lower, RR 0.91, p = 0.01, adjusted per study, inverted to make RR<1 favor high D levels, 25ng/mL vs. 15 ng/mL.
risk of hospitalization, 4.8% lower, RR 0.95, p = 0.02, adjusted per study, inverted to make RR<1 favor high D levels, 20ng/mL vs. 15 ng/mL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Seal et al., 1 Jan 2022, retrospective, USA, peer-reviewed, 6 authors.
This PaperVitamin DAll
Association of Vitamin D Status and COVID-19-Related Hospitalization and Mortality
MD, MPH Karen H Seal, MPH Daniel Bertenthal, PhD Evan Carey, MD, PhD Carl Grunfeld, MD, PhD Daniel D Bikle, MD Chuanyi M Lu
Journal of General Internal Medicine, doi:10.1007/s11606-021-07170-0
BACKGROUND: The relationship between vitamin D status and COVID-19-related clinical outcomes is controversial. Prior studies have been conducted in smaller, singlesite, or homogeneous populations limiting adjustments for social determinants of health (race/ethnicity and poverty) common to both vitamin D deficiency and COVID-19 outcomes. OBJECTIVE: To evaluate the dose-response relationship between continuous 25(OH)D and risk for COVID-19related hospitalization and mortality after adjusting for covariates associated with both vitamin D deficiency and COVID-19 outcomes. DESIGN: Retrospective cohort study. PATIENTS: Veteran patients receiving care in US Department of Veteran Affairs (VA) health care facilities with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test and a blood 25(OH)D test between February 20, 2020, and November 8, 2020, followed for up to 60 days. MAIN MEASURES: Exposure was blood 25(OH)D concentration ascertained closest to and within 15 to 90 days preceding an index positive SARS-CoV-2 test. Co-primary study outcomes were COVID-19-related inpatient hospitalization requiring airborne, droplet, contact, or other isolation and mortality ascertained within 60 days of an index positive SARS-CoV-2 test. KEY RESULTS: Of 4,599 veterans with a positive SARS-CoV-2 test, vitamin D deficiency (< 20 ng/mL) was identified in 665 (14.5%); 964 (21.0%) were hospitalized; and 340 (7.4%) died. After adjusting for all covariates, including race/ethnicity and poverty, there was a significant independent inverse dose-response relationship between increasing continuous 25(OH)D concentrations (from 15 to 60 ng/mL) and decreasing probability of COVID-19related hospitalization (from 24.1 to 18.7%, p=0.009) and mortality (from 10.4 to 5.7%, p=0.001). In modeling 25(OH)D as a log-transformed continuous variable, the greatest risk for hospitalization and death was observed at lower 25(OH)D concentrations. CONCLUSIONS: Continuous blood 25(OH)D concentrations are independently associated with COVID-19related hospitalization and mortality in an inverse doseresponse relationship in this large racially and ethnically diverse cohort of VA patients. Randomized controlled trials are needed to evaluate the impact of vitamin D supplementation on COVID-19-related outcomes.
Supplementary Information The online version contains supplementary material available at
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