More on Vitamin D and Covid-19

As of this article’s writing, there are over two hundred fifty articles on PubMed about the connection between vitamin D and COVID-19. As the research studies are undergoing, evidence is mounting that adequate vitamin D levels may be a protective factor against COVID-19 infection and severity. Here’s what the research shows.

Is there a role for vitamin D in the treatment of COVID-19? —

Yesterday I was going to post a link to an article “Over 80 percent of 200 COVID-19 patients in a hospital in Spain have vitamin D deficiency” when I realized I was unable to access or read the original study. It was late, I was tired, and I didn’t feel like crawling through PubMed to find the study. Well someone out there did the crawling for me. If you follow the link to the original article above you’ll find more links to more research on Vitamin D and Covid-19 like the following:

Evidence suggests that vitamin D supplementation could potentially be effective either in treatment or prevention of coronavirus disease 2019 (Covid‐19). Indeed, several studies and trials have begun to investigate the impact of vitamin D supplementation on patients with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. In this review, we focus on the potential mechanisms of vitamin D in the pathogenesis of Covid‐19. We consider whether deficiency of vitamin D may be one of the underlying biological factors that could explain the excess mortality seen among non‐Caucasians. We also raise several important questions which need to be addressed to provide a clear picture of the extent to which vitamin D supplementation may benefit patients with Covid‐19, particularly those with underlying risk factors.

Vitamin D and Covid‐19: From potential therapeutic effects to unanswered questions —

A little over a month ago I had my annual wellness check up. The medical nerd in me jotted a list of discussion items I wanted to cover during my visit. After catching up on family and checking off the items on my list I asked my doctor if there was anything else she wanted to talk to me about.

No, your list covered all of the things I wanted to talk about except for one. Tell your wife to start taking a Vitamin D supplement.

True story.

Vitamin D and Calcium Reduce Incidence of Recurrent Vertigo (BPPV)

The multi-center study included 957 people in South Korea with benign paroxysmal positional vertigo who had undergone canalith repositioning maneuvers—head movements that shift displaced calcium carbonate crystals in the inner ear. The intervention group included patients who received 400 IU vitamin D and 500 mg calcium carbonate twice daily for 1 year when their baseline serum vitamin D level was below 20 ng/mL along with patients who had higher baseline levels and took no supplements. An observation group had no baseline testing or interventions.

The supplements significantly reduced the annual vertigo recurrence rate by 24%. There were 0.83 recurrences per 1 person-year in the intervention group compared with 1.10 in the observation group. Patients with greater vitamin D deficiencies at baseline derived the most benefit.

JAMA. 2020;324(16):1599. doi:10.1001/jama.2020.18695 —

BPPV = benign paroxysmal positional vertigo. The original study in Neurology and the JAMA summary both use the word “prevent” in their respective titles. I think reduce is a more apt description. Semantics aside a 24% reduction in recurrent BPPV episodes is significant.

And yet another example of nutritional deficiencies underlying another disease.

Vitamin D Hypothesis – A Role in COVID-19 Mortality Rates?

Vitamin D Levels Appear to Play Role in COVID-19 Mortality Rates

By analyzing publicly available patient data from around the globe, Backman and his team discovered a strong correlation between vitamin D levels and cytokine storm — a hyperinflammatory condition caused by an overactive immune system — as well as a correlation between vitamin D deficiency and mortality.

The research is available on medRxiv, a preprint server for health sciences.

The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality

In conclusion, we found significant crude relationships between vitamin D levels and the number COVID-19 cases and especially the mortality caused by this infection. The most vulnerable group of population for COVID-19, the aging population, is also the one that has the most deficit Vitamin D levels.

Vitamin D has already been shown to protect against acute respiratory infections and it was shown to be safe. It should be advisable to perform dedicated studies about vitamin D levels in COVID-19 patients with different degrees of disease severity.

Many years ago I approached my former personal care physician and asked to have my Vitamin D level checked.

“What the hell for?”

“I would like to know my Vitamin D blood level to see if I need to take a supplement.”

“Just get outside in the sun for around 20 minutes a day.”

“Just order the test.”

And he did.  Less than a week later Doc called me back to let me know I had Vitamin D deficiency.  I’ve been taking a daily supplement since.

Vitamin D deficiency is now recognized as a pandemic. The major cause of vitamin D deficiency is the lack of appreciation that sun exposure in moderation is the major source of vitamin D for most humans. Very few foods naturally contain vitamin D, and foods that are fortified with vitamin D are often inadequate to satisfy either a child’s or an adult’s vitamin D requirement. Vitamin D deficiency causes rickets in children and will precipitate and exacerbate osteopenia, osteoporosis, and fractures in adults. Vitamin D deficiency has been associated with increased risk of common cancers, autoimmune diseases, hypertension, and infectious diseases. A circulating level of 25-hydroxyvitamin D of >75 nmol/L, or 30 ng/mL, is required to maximize vitamin D’s beneficial effects for health. In the absence of adequate sun exposure, at least 800–1000 IU vitamin D3/d may be needed to achieve this in children and adults. Vitamin D2 may be equally effective for maintaining circulating concentrations of 25-hydroxyvitamin D when given in physiologic concentrations.

The American Journal of Clinical Nutrition, Volume 87, Issue 4, April 2008, Pages 1080S–1086S,
Published: 01 April 2008

An interesting hypothesis that needs more research.

Update 05.16.20

Journal Reference:

  1. E. Laird, J. Rhodes, R.A. Kenny. Vitamin D and Inflammation: Potential Implications for Severity of Covid-19. Irish Medical Journal, 2020; 113 (5): P81 [link]

Journal Reference:

  1. Petre Cristian Ilie, Simina Stefanescu, Lee Smith. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clinical and Experimental Research, 2020; DOI: 10.1007/s40520-020-01570-8



Vitamin D Dosing: Too Low to Matter?

Autier and colleagues found that vitamin D deficiency, in the observational studies, was associated with cardiovascular diseases, inflammation, glucose metabolism disorders, infectious diseases, mood disorders, declines in cognitive function, and even all-cause mortality.

With the exception of colorectal cancer, being vitamin D sufficient did not appear to reduce the risk of developing various types of cancer.

Vitamin D sufficiency was associated with a lower risk of cardiovascular events (up to 58%), diabetes (up to 38%), colorectal cancer (up to 33%), and all-cause mortality (29%).

via Vitamin D Dosing: Too Low to Matter?.

Race Has Role in Vitamin D Link to Heart Risk

A 10-ng/mL decrease in 25(OH)D levels was associated with an increased risk of coronary heart disease events in whites (HR 1.26, 95% CI 1.06-1.49) and those with Chinese ancestry (HR 1.67, 95% CI 1.07-2.61), according to Ian de Boer, MD, of the University of Washington in Seattle, and colleagues.

But a similar relationship was not seen among blacks (HR 0.93, 95% CI 0.73-1.20) and Hispanics (HR 1.01, 95% CI 0.77-1.33), the investigators reported in the July 10 issue of the Journal of the American Medical Association.

via Race Has Role in Vitamin D Link to Heart Risk.

A couple of years ago I asked my primary care physician to check my Vitamin D level.  We were both surprised to discover the fact I was Vitamin D deficient.  Since then I’ve been on daily Vitamin D supplementation of 5000iu.

Simple blood test.  Just do it.

The researchers advised caution in interpreting the results in the Chinese and Hispanic participants because of the low sample sizes.

I’m still going to take my supplement.

Vitamin D Level Predicts Death in CABG

Patients with vitamin D deficiency or insufficiency, defined by levels of 25(OH)D, had significantly higher 90-day mortality after CABG than those who had sufficient levels of the vitamin (OR 5.24 and OR 4.61, respectively), Takuhiro Moromizato, MD, of Brigham and Women’s Hospital in Boston, and colleagues reported during an oral session at the Society of Critical Care Medicine meeting.

The study was limited by its observational design, which can’t prove causality, and by the potential for selection bias and unmeasured confounders.

via Vitamin D Level Predicts Death in CABG.