Covid and D – The Science Oct 2020
Download the handout above for the most recent studies and all of the references.
In my July report, I summarized studies that had shown significant decreases in critical outcomes and death when Covid-19 patients had 25(OH)D levels greater than 30 ng/ml.(1,2), Other studies found a correlation between low mean levels of vitamin D and a high number of cases and mortality per million population due to Covid-19 in 14 – 20 countries.(3,4)
New! Studies Since July 2020
These studies provide more evidence of the protective effect of sufficient vitamin D levels against the incidence of SARS-CoV-2 infection and its severity. Also included is the effective emergency use of Calcifediol [25(OH)D] to raise levels quickly:
- A study of 225 hospitalized Covid-19 patients found that levels of 25(OH)D over 30 ng/ml significantly reduced the severity of illness (p=0.02), hypoxia (p=0.004), unconsciousness (p=0.05), and CRP levels (p=0.01); sufficiency also correlated to an increase in blood lymphocyte percentage (p=0.05), which has been shown to protect against severe illness. In patients over 40 y.o., 9.7% with sufficient levels of D vs 20% of those with insufficient levels died. Furthermore, 6.3% of those with levels greater than 40 ng/ml died. This was less than 1/3 the death rate of those with insufficient D levels and shows the possible benefit of higher blood levels of D.(5)
- Mount Sinai studied 37 hospitalized Covid-19 patients, their 25(OH)D levels and severity of illness. A serum vitamin D level < 20 ng/mL was significantly associated with increased severity of illness as measured using a chest CT (p=0.001). These researchers urge that populations at risk for low serum 25(OH)D be tested and treated for deficiency.(6)
- Out of 76 hospitalized Covid-19 patients, 50 received standard of care plus Calcifediol 0.266 mg orally, on days 3 and 7, then weekly until discharge or ICU admission; the remaining 26 served as a control, receiving only standard of care. Despite a small sample size, results were significant (p<0.001). The Calcifediol group showed a 93% reduction in the ICU admission rate. Only one (2%) in the calcifediol group vs 13 (50%) in the control group required ICU admission. Two in the control group and none in the calcifediol group died. Calcifediol is the hormone derived from vitamin D3. It is better absorbed and faster acting, so more appropriate in emergency situations.(7)
- Vitamin D levels and SARS-CoV-2 test positivity rates were studied in 191,779 patients from all 50 U.S. states. There was 12.5% positivity for the virus in those with <20 ng/ml, 8.1% in those with 30-34 ng/ml, and 5.9% in those with >55 ng/ml. This regression was statistically significant. This again showed that higher 25(OH)D levels protected from contracting the virus.(8)
- Results of vitamin D testing performed between 2010 and 2019 were collected from a health database to assess the relationship between the prevalence of vitamin D deficiency and Covid-19 incidence in 200 localities in Israel. Researchers also matched 52,405 infected patients with 524,050 control individuals of the same sex, age, and region. There was a highly significant correlation between the prevalence of vitamin D deficiency and Covid-19 incidence in localities (p<0.001). In the controls, there was a significant association between vitamin D deficiency and the risk of contracting Covid-19. In a further analysis of those who had acquired vitamin D formulations in the prior 4 months, Covid-19 incidence was significantly lower in those who had purchased vitamin D drops, but not tablets. (9)
References
1 Alipio M. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with Coronavirus-2019. Preprint posted: 9 Apr 2020 Last revised: 7 May 2020. https://papers.ssrn.com/sol3/Papers.cfm?abstract_id=3571484
2 Raharusun P, Sadiah P, Cahni B, Erdie A, Cipta B. Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study (April 26, 2020). Available at SSRN: https://ssrn.com/abstract=3585561 or http://dx.doi.org/10.2139/ssrn.3585561
3 Ilie, PC, Stefanescu S. & Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res (2020). https://doi.org/10.1007/s40520-020-01570-8
4 Laird E, Rhodes J, Kenny RA. Vitamin D and Inflammation: Potential Implications for Severity of Covid-19. Ir Med J; Vol 113; No. 5; P81. http://imj.ie/vitamin-d-and-inflammation-potential-implications-for-severity-of-covid-19/
5 Maghbooli Z, Sahraian MA,Ebrahimi M, Pazoki M, Kafan S, Tabriz HM, Hadadi A, Montazeri M, Nasiri M, Shirvani A, Holick MF. Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection. Sept 25, 2020 PLoS ONE 15(9): e0239799. https://doi.org/10.1371/journal.pone.0239799
6 Pepkowitz SH, Hobel CJ, Mirocha JM, Sobhani K, Huynh CA, Jawanda H, Hasan W. Vitamin D Deciency is Associated with Increased COVID-19 Severity: Prospective Screening of At-Risk Groups is Medically Indicated. https://doi.org/10.21203/rs.3.rs-83262/v1
7 Castillo ME, Costa LME, Barrios JMV, Díaz JFA, Miranda JL, Bouillon R, Gomez JMQ. Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study. The Journal of Steroid Biochemistry and Molecular Biology, Vol 203, October 2020, 105751. https://doi.org/10.1016/j.jsbmb.2020.105751
8 Kaufman HW, Niles JK, Kroll MH, Bi C, Holick MF (2020) SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. Sept 17, 2020. PLoS ONE 15(9): e0239252. https://doi.org/10.1371/journal.pone.0239252
9 Ariel Israel A, Cicurel A, Feldhamer I, Dror Y, Giveon SM, Gillis D, Strich D, Lavie G. The link between vitamin D deficiency and Covid-19 in a large population. Sept 7, 2020. doi: https://doi.org/10.1101/2020.09.04.2018826