Wow. If this is confirmed, Coronavirus is almost a disease of Vitamin D deficiency
Missing out on the Sunshine Vitamin?
Hot off the press: A new Indonesian study of 780 people with Coronavirus found that people with a Vitamin D deficiency were much more likely to die. We discussed Vitamin D at length a few weeks ago, so we already knew Vitamin D is associated with a lower rate of respiratory illness, but the results here are quite remarkable.
Of those who died most (85%) had a co-morbidity, the real surprise is that even more than that, 96% had low Vitamin D levels. Of those who survived, most people had normal Vitamin D levels. Only 7% of survivors had low or deficient Vitamin D. That is quite a split.
Vitamin D deficiency was very common among these Indonensian patients. Half of those measured did not have enough Vitamin D in their blood. Of those that did, 96% survived, and only 4% “expired”. Vitamin D looks like a good protector.
After controlling for known risk like being old, or male or having high blood pressure, a Vitamin D level described as deficient (less than 20ng/ml) was associated with a 10 fold greater risk of death. These are quite extraordinary numbers. In most medical studies an OR (odds ratio) as low as 1.3 is notable enough to get published. But these are OR’s of 10.
This doesn’t mean taking a Vit D pill will protect you. It’s possible the severe form of the disease might have caused the low Vitamin D levels, in which case taking a supplement may or may not help. Though I would keep D levels up for all the other reasons anyhow, like a reduction in cancer, flu, asthma, depression, and heart disease. “Not too shabby”. Low risk. Low cost.
UPDATE: Just to make it clear, the caveat in that last paragraph above is very important. This study likely exaggerates the effect of D. If the infection drains D, it could produce a strong association like this. We need prospective studies. Whatever this study shows, the reasons for using D are incredibly strong.
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Just looking at the raw data, without adjusting for risk factors, suggests that when vitamin D levels fall below 30 ng/ml (moderate levels) people were 12 times as likely to die — and when they were even lower, below 20ng/ml, people were 19 times as likely to die. These were higher risks than those from the pre-existing conditions themselves.
The patients were an average age of 54. But it is sobering that the paper notes that even of the under 50s who survived, 80% are still in hospital.
The cost of one night in intensive care would provide vitamin D supplements for a month for 3,000 people.
Grant et al, put out a call for people to supplement with D during this pandemic, pointing out that this will reduce the incidence of the co-morbidities that are hit hardest by Coronavirus. They also point out that D reduces respiratory tract infections, and is actively involved in our own anti-viral defences in at least three different ways. Vitamin D induces cathelicidin and defensins (polypeptides that our immune system uses like surface-to-air missiles against bacteria or enveloped viruses). D also reduces production of proinflammatory cytokines (the messengers that elict the deadly cascade of inflammation).
If the effect of Vitamin D is this strong, it changes everything. It would explain why Coronavirus has hit so hard in the northern colder climates, where wealthier people stay indoors, and cover up, and suffer from Vitamin D deficiencies. The news tonight was full of stories of Remdesivir reducing mortality by a few percent and shortening hospital stays by a day or two. Instead something so much cheaper may be so much more effective.
ABSTRACT
This is a retrospective cohort study which included two cohorts (active and expired) of 780 cases with laboratory-confirmed infection of SARS-CoV-2 in Indonesia. Age, sex, co-morbidity, Vitamin D status, and disease outcome (mortality) were extracted from electronic medical records. The aim was to determine patterns of mortality and associated factors, with a special focus on Vitamin D status. Results revealed that majority of the death cases were male and older and had pre-existing condition and below normal Vitamin D serum level. Univariate analysis revealed that older and male cases with pre-existing condition and below normal Vitamin D levels were associated with increasing odds of death. When controlling for age, sex, and comorbidity, Vitamin D status is strongly associated with COVID-19 mortality outcome of cases.
For Vitamin D status, cases were classified based on their serum 25(OH)D levels:
(1) normal – serum 25(OH)D of > 30 ng/ml,
(2) insufficient – serum 25(OH)D of 21-29 ng/ml, and
(3) deficient – serum 25(OH)D of < 20 ng/ml.
h/t David E
Things worth knowing about Coronavirus:
- Quarantines work: 12 days after lockdowns, quarantines and isolation, Coronavirus slows. This is text book microbiology.
- Coronavirus causes clotting: hold the ventilators, stop blood clots instead
- Coronavirus can affect brains, may increase stroke risk.
- Solve Vitamin D deficiency first to help beat Coronavirus.
- New York is “like mass casualty event”: coronavirus and other deaths are up three-fold
- Coronavirus may be man made. Why did the CCP destroy the evidence?
- Looks like we can extinguish Coronavirus: Australia and NZ tracking to zero.
- Large coronavirus random tests in Austria show only 1% infected
REFERENCE
Raharusun, Prabowo and Priambada, Sadiah and Budiarti, Cahni and Agung, Erdie and Budi, Cipta. (2020) Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study (April 26, 2020). Available at SSRN: https://ssrn.com/abstract=3585561 26th April 2020, Preprint.