that low levels of vitamin D patients do much worse than high levels of vitamin D patients.
Vitamin D deficiency prevalence and cardiovascular risk in Israel
https://pubmed.ncbi.nlm.nih.gov/20955219/
N = 34,874
Vit D levels, women, 22.7 ng mL
Vit D levels, men, 23.2 ng mL
Prevalence of vitamin D deficiency or insufficiency
(vitamin D levels less than 30 ng mL)
Women, 77·5%,
Men, 79·2%
Only little variation when stratified by age
Prevalence of deficiency in Israel, similar to less sunny regions
Two groups
Group with vitamin D less than 15 ng mL
Group with vitamin D levels more than 30 ng mL
less than 0·031 age-adjusted odds ratios for the presence of,
Hypertension
Diabetes mellitus
Dyslipidemia
Obesity
Peripheral vascular disease
Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263069
https://www.webmd.com/lung/news/20220208/vitamin-d-deficiency-tied-to-severe-covid
Potential correlation, low vitamin D and increased risk of infection with SARS-CoV-2,
and poorer clinical outcomes
This study examines
Any relationship exists between,
pre-infection serum 25-hydroxyvitamin D (25(OH)D) level,
With disease severity and mortality due to SARS-CoV-2.
April 7th, 2020 and February 4th, 2021
Positive polymerase chain reaction tests for SARS-CoV-2,
searched for historical 25(OH)D levels measured 14 to 730 days prior
Design
Patients admitted were categorized,
disease severity and level of 25(OH)D
Deficient, less than 20 ng/mL (n = 133)
Insufficient, 20 to 30 ng/mL (n = 36)
Adequate, 30 to less than 40 ng/mL (n = 30)
High-normal, 40 ng/mL or greater (n = 40)
Accounted for changes throughout the year
Results
1,176 patients admitted
253 had records of a 25(OH)D level prior to infection
A lower vitamin D status was more common in patients with the severe or critical disease
In patients with severe or critical disease
87.4% had less than 20 ng/mL
In patients with mild or moderate disease
34.3% had Less than 20 ng/mL
P less than 0.001
Patients with vitamin D deficiency (less than 20 ng/mL)
14 times more likely to have severe or critical disease,
Odds ratio 14 (95% confidence interval 4 to 51) p less than 0.001
Mortality, patients with sufficient vitamin D levels
2.3%
Mortality, patients with deficient vitamin D levels
25.6% mortality rate (p less than 0.001)
Conclusions
Among hospitalized COVID-19 patients, pre-infection deficiency of vitamin D was associated with increased disease severity and mortality.
Low vitamin D status has been associated with a range of autoimmune, cardiovascular, and infectious diseases
Essential immunologic mediator
Inhibitory effects on pro-inflammatory cytokines,
TNF-alpha and IL-6
Epidemiological risk factors for vitamin D deficiency
Darker skin pigmentation
Low sun exposure
Skin-covering clothes
Sun creams
Diet low in fish and dairy products
An association between low 25-hydroxyvitamin D (25(OH)D) levels and an increased risk of acquiring influenza and respiratory viruses
Meta-analyses of randomized controlled trials, 2007 and 2020
Vitamin D supplementation reduced the risk of acute respiratory infection as compared with placebos
Factors associated with poorer COVID-19 prognoses
Geographic location in northern countries
Older age
Black and minority ethnic groups
Obesity
Preexisting conditions, diabetes and hypertension
these risk factors are also independently associated with vitamin D deficiency
Difficult to ascertain a definitive causative effect of baseline vitamin D status on a clinical presentation during active COVID-19 infection
A cosinor model, to account for the cycles of serum vitamin D values across the seasons
Vitamin D levels below less than 20 ng/mL
Israeli Arabs 64.3%
Israeli non-Arabs 35.7%
