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Vitamin D Deficiency In COVID-19 Quadrupled Death Rate

Written by medscape.com

Vitamin D deficiency on admission to hospital was associated with a 3.7-fold increase in the odds of dying from COVID-19, according to an observational study looking back at data from the first wave of the pandemic.

Nearly 60 percent of patients with COVID-19 were vitamin D deficient upon hospitalization, with men in the advanced stages of COVID-19 pneumonia showing the greatest deficit.

Importantly, the results were independent of comorbidities known to be affected by vitamin D deficiency, say the authors, led by Dieter De Smet, MD, from AZ Delta General Hospital, Roeselare, Belgium.

“[The findings] highlight the need for randomized controlled trials specifically targeting vitamin D–deficient patients at intake, and make a call for general avoidance of vitamin D deficiency as a safe and inexpensive possible mitigation of the SARS-CoV-2 pandemic,” say De Smet and colleagues in their article, published online November 25 in the American Journal of Clinical Pathology.

A search of ClinicalTrials.gov reveals there are currently close to 40 ongoing intervention trials with vitamin D in COVID-19 around the world for varying purposes, including prevention, and varying forms of treatment.

Consider Vitamin D To Prevent COVID-19 Infection

With regard to the potential role in prevention, “Numerous observational studies have shown that low vitamin D levels are a major predictor for poor COVID outcomes,” notes Jacob Teitelbaum, MD, an internist who specializes in treating chronic fatigue syndrome and fibromyalgia who also has an interest in COVID-19.

“This study shows how severe a problem this is,” Teitelbaum told Medscape Medical News. “A 3.7-fold increase in death rate if someone’s vitamin D level was below 20 [ng/mL] is staggering. It is arguably one of the most important risk factors to consider.”

“What is not clear is whether vitamin D levels are acting as an acute-phase reactant, dropping because of the infection, with larger drops indicating more severe disease, or whether vitamin D deficiency is causing worse outcomes,” added Teitelbaum, who is director of the Center for Effective CFIDS/Fibromyalgia Therapies, Kailua-Kona, Hawaii.

Also asked to comment, Andrea Giustina, MD, president of the European Society of Endocrinology, said: “The paper by De Smet et al confirms what we already hypothesized in BMJ last March: that patients with low vitamin D levels are at high risk of hospitalization for COVID-19 and developing severe and lethal disease.”

“This is likely due to the loss in the protective action of vitamin D on the immune system and against the SARS-CoV-2-induced cytokine storm.”

He said it is particularly interesting that the authors of the new study had reported more prevalent vitamin D deficiency among men than women, most likely because women are more often treated with vitamin D for osteoporosis.

The new study should prompt all clinicians and health authorities to seriously consider vitamin D supplementation as an additional tool in the fight against COVID-19, particularly for the prevention of infection in those at high risk of both COVID-19 and hypovitaminosis D, such the elderly, urged Giustina, of San Raffaele Vita-Salute University, Milan, Italy.

Results Adjusted For Multiple Confounders

De Smet and colleagues looked at serum 25-hydroxyvitamin D (25(OH)D) levels in 186 patients hospitalized for severe COVID-19 infection as a function of radiologic stage of COVID-19 pneumonia as well as the association between vitamin D status on admission and COVID-19 mortality.

Cognizant of the potential for confounding by multiple factors, they adjusted for age, sex, and known vitamin D–affected comorbidities such as diabetes, chronic lung disease, and coronary artery disease.

Patients were hospitalized from March 1 to April 7, 2020 (the peak of the first wave of the pandemic) at their institution, AZ Delta General Hospital, a tertiary network hospital.

The mean age of patients was 69 years, 41 percent were women, and 59 percent had coronary artery disease. Upon admission to hospital, median vitamin D level was 18 ng/mL (women, 20.7 ng/mL; men, 17.6 ng/mL).

A remarkably high percentage (59 percent, 109/186) of patients with COVID-19 were vitamin D deficient (25(OH)D < 20 ng/mL) when admitted (47 percent of women and 67 percent of men), write the authors.

“What surprises me,” said Teitelbaum, is that almost 60 percent “of these patients had 25(OH)D under 20 ng/mL but most clinicians consider under 50 to be low.”

All patients had a chest CT scan to determine the radiologic stage of COVID-19 pneumonia and serum vitamin D measurement on admission. Radiologic stage of pneumonia was used as a proxy for immunologic phase of COVID-19.

Vitamin D Deficiency Correlated With Worsening Pneumonia

Among men, rates of vitamin D deficiency increased with advancing disease, with rates of 55 percent in stage 1, 67 percent in stage 2, and up to 74 percent in stage 3 pneumonia.

There is therefore “a clear correlation between 25(OH)D level and temporal stages of viral pneumonia, particularly in male patients,” write the authors.

“Vitamin D dampens excessive inflammation,” said Teitelbaum. “In these patients with acute respiratory distress syndrome, the immune system has gone wild.”

“The study was carried out in Belgium, so there’s less sunlight there than some other places, but even here in Hawaii, with plenty of sunshine, we have vitamin D deficiency,” he added.

“More studies are needed, but I think there are enough data to suggest a multivitamin should be used to aid prophylaxis, and this is reflected in [some] infectious disease recommendations,” he noted.

 

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15 COMMENTS

  1. Following on a previous posting a few days ago we ordered and am now both taking a Vitamin D pill daily. Actually with the crap weather we have been having natural sunshine has been at a premium anyway.
    FJA

    7

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  2. More and more herbalists and naturopaths are coming out with immunity solutions. I had an email from one that will treat you for Covid or the Vaccine.

    And there there is this immunity advice:
    https://www.wanakahealthbridge.co.nz

    The Protocol:
    https://35dea398-f34a-4f65-a26b-c89217ecc29d.filesusr.com/ugd/f70a32_4cbd3afc7a8c4d2da27f91d707a38108.pdf

    THE FOUR STAGES:
    https://www.wanakahealthbridge.co.nz/four-stage-protocol

    EARLY ACTION FOR FASTER RECOVERY FROM COVID-19:
    https://35dea398-f34a-4f65-a26b-c89217ecc29d.filesusr.com/ugd/f70a32_274eeeaeb30d4f9ab5a1bd2ccea10677.pdf

    SHOPPING LIST OF SUPPLEMENTS:
    https://35dea398-f34a-4f65-a26b-c89217ecc29d.filesusr.com/ugd/f70a32_6982dc221a2343d3ab3a8b618aa75815.pdf

    And much more…

    5

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  3. NZ Doctors Speaking out with Science (you know, those rebels…) have produced a good blog post this week about boosting immunity. Re Vitamin D discussion: “Taking very large doses of Vitamin D can be harmful to health, so stick to the recommended doses.”

    I wonder how deficient we Kiwis are? For those that aren’t chained to their keyboards, and do outdoor stuff like gardening, exercise, etc we may not be that deficient, if at all. But as I spend too much time indoors, I am taking a daily Vit-D supplement, and also making sure I spend 20-30 minutes outside in the morning or early evening when the sun isn’t so fierce (Dr Matt Sheldon said that may be enough on a VFF video https://odysee.com/@voicesforfreedom:6/Freedom-TV-Dr-Matt-Shelton-Health-And-Natural-Immunity:6 )

    The big takeaway is that each of us needs to be responsible for our own health and well being. Good nutrition, adequate exercise, and fresh air, as well as sunlight in moderation. Again, from Dr Matt’s VFF video – if you feel your fair skin starting to burn then you have had enough Vit D exposure. Hence the 20 minute recommendation.

    https://nzdsos.com/2021/11/21/immunity-boosting-it/

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