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0 0.5 1 1.5 2+ Death/intubation -0% Improvement Relative Risk Walk et al. Vitamin D for COVID-19 Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 133 patients in Netherlands No significant difference in death/intubation Walk et al., medRxiv, doi:10.1101/2020.11.07.20227512 Favors vitamin D Favors control
Vitamin D - contrary to vitamin K - does not associate with clinical outcome in hospitalized COVID-19 patients
Walk et al., medRxiv, doi:10.1101/2020.11.07.20227512 (Preprint)
Walk et al., Vitamin D - contrary to vitamin K - does not associate with clinical outcome in hospitalized COVID-19 patients, medRxiv, doi:10.1101/2020.11.07.20227512 (Preprint)
Nov 2020   Source   PDF  
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Small retrospective study of 135 patients not finding a significant difference in vitamin D status. Patients with good outcomes had a median of 45.0 nmol/L versus 37.7 nmol/L for bad outcomes, p = 0.85.
Authors found that vitamin D sufficient persons had accelerated elastic fiber degradation, they hypothesize pro-calcification effects during COVID-19 and that vitamin K might compensate for this.
This is the 26th of 175 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 18 vigintillion).
risk of death/intubation, 0.4% higher, RR 1.00, p = 1.00, high D levels 48 of 110 (43.6%), low D levels 10 of 23 (43.5%), >25nmol/L.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Walk et al., 9 Nov 2020, retrospective, Netherlands, preprint, 5 authors.
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This PaperVitamin DAll
Vitamin D – contrary to vitamin K – does not associate with clinical outcome in hospitalized COVID-19 patients
Jona Walk, Anton S M Dofferhoff, Jody M W Van Den Ouweland, Henny Van Daal, Dr Rob Janssen
SARS-CoV-2 causes remarkably variable disease from asymptomatic individuals to respiratory insufficiency and coagulopathy. Vitamin K deficiency was recently found to associate with clinical outcome in a cohort of COVID-19 patients. Vitamin D has been hypothesized to reduce disease susceptibility by modulating inflammation, yet little is known about its role in disease severity. Considering the critical interaction between vitamin K and vitamin D in calcium and elastic fiber metabolism, we determined vitamin D status in the same cohort of 135 hospitalized COVID-19 patients by measuring blood 25(OH)D levels. We found no difference in vitamin D status between those with good and poor outcome (defined as intubation and/or death). Instead, we found vitamin D sufficient persons (25(OH)D >50 nmol/L) had accelerated elastic fiber degradation compared to those with mild deficiency (25(OH)D 25-50 nmol/L). Based on these findings, we hypothesize that vitamin D might have both favorable anti-inflammatory and unfavorable pro-calcification effects during COVID-19 and that vitamin K might compensate for the latter.
Basalyga, Elastin degradation and calcification in an abdominal aorta injury model: role of matrix metalloproteinases, Circulation
Boraldi, The mineralization process of insoluble elastin fibrillar structures: Ionic environment vs degradation, Int J Biol Macromol
Bouvet, Sequential activation of matrix metalloproteinase 9 and transforming growth factor beta in arterial elastocalcinosis, Arterioscler Thromb Vasc Biol
Cipriani, Effect of a single oral dose of 600,000 IU of cholecalciferol on serum calciotropic hormones in young subjects with vitamin D deficiency: a prospective intervention study, J Clin Endocrinol Metab
D'avolio, 25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2, Nutrients
Dirks, Various calibration procedures result in optimal standardization of routinely used 25(OH)D ID-LC-MS/MS methods, Clin Chim Acta
Dofferhoff, Reduced vitamin K status as a potentially modifiable risk factor of severe COVID-19, Clin Infect Dis
Fraser, Price, Induction of matrix Gla protein synthesis during prolonged 1,25-dihydroxyvitamin D3 treatment of osteosarcoma cells, Calcif Tissue Int
Greiller, Martineau, Modulation of the immune response to respiratory viruses by vitamin D, Nutrients
Hastie, Vitamin D concentrations and COVID-19 infection in UK Biobank, Diabetes Metab Syndr
Honardoost, Ghavideldarestani, Khamseh, Role of vitamin D in pathogenesis and severity of COVID-19 infection, Arch Physiol Biochem
Janssen, Vitamin K metabolism as the potential missing link between lung damage and thromboembolism in Coronavirus disease 2019, Br J Nutr
Janssens, Vitamin D and chronic obstructive pulmonary disease: hype or reality?, Lancet Respir Med
Lee, Elastin calcification in the rat subdermal model is accompanied by up-regulation of degradative and osteogenic cellular responses, Am J Pathol
Luo, Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA protein, Nature
Martineau, Forouhi, Vitamin D for COVID-19: a case to answer?, Lancet Diabetes Endocrinol
Mccann, Ames, Vitamin, an example of triage theory: is micronutrient inadequacy linked to diseases of aging?, Am J Clin Nutr
Mehta, Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data, Lancet
Niederhoffer, Aortic calcification produced by vitamin D3 plus nicotine, J Vasc Res
Panagiotou, Low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID-19 are associated with greater disease severity, Clin Endocrinol
Price, Buckley, Williamson, The amino bisphosphonate ibandronate prevents vitamin D toxicity and inhibits vitamin D-induced calcification of arteries, cartilage, lungs and kidneys in rats, J Nutr
Rucker, Calcium binding to elastin, Adv Exp Med Biol
Schurgers, Uitto, Reutelingsperger, Vitamin K-dependent carboxylation of matrix Gla-protein: a crucial switch to control ectopic mineralization, Trends Mol Med
Turino, Matrix elastin: a promising biomarker for chronic obstructive pulmonary disease, Am J Respir Crit Care Med
Ueland, Distinct and early increase in circulating MMP-9 in COVID-19 patients with respiratory failure, J Infect
Van Ballegooijen, Joint association of vitamins D and K status with longterm outcomes in stable kidney transplant recipients, Nephrol Dial Transplant
Van Ballegooijen, The Synergistic Interplay between Vitamins D and K for Bone and Cardiovascular Health: A Narrative Review, Int J Endocrinol
Winter, High prevalence of vitamin D deficiency in the south-west Netherlands
Zweifler, Esler, Factors influencing the choice of antihypertensive agents, Postgrad Med
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