Vitamin D hits the media

Terrifying chart shows how Covid-19 patients who end up in hospital may be almost certain to die if they have a vitamin D deficiency

Indonesian experts analysed hospital records of 780 people who tested positive

98.9% of Covid patients defined as vitamin D deficient — below 20ng/ml — died

Yet this fell to just 4.1% for patients who had enough of the nutrient

SACN will review existing scientific evidence on whether vitamin D lowers risk

Public Health England and NHS regulator NICE are doing a separate review

John, 28th January

John, 9th March

Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study (30th April)

Vitamin D as a Risk Factor

Adjusted for confounds

Vitamin D insufficiency, 7.63 times more likely to die

Vitamin D deficiency, 10.12 times more likely to die

P less than 0.001

Vitamin D supplementation to prevent acute respiratory tract infections (15th Feb)

Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall.

Disparities in the risk and outcomes of COVID-19

No mention of vitamin D

Guardian, Exclusive!!

Scientific Advisory Committee on Nutrition (SACN)

Began work last month (May)

Considering recent evidence on vitamin D and acute respiratory tract infection

Evidence will be considered on specific population groups

National Institute for Health and Care Excellence (Nice)

Conducting a “rapid” evidence review on vitamin D “in the context of Covid-19”

Adrian Martineau,

Professor of respiratory infection and immunity

“Vitamin D could almost be thought of as a designer drug for helping the body to handle viral respiratory infections,”

“It boosts the ability of cells to kill and resist viruses and simultaneously dampens down harmful inflammation, which is one of the big problems with Covid.”

Higher levels of melanin in the skin lead to lower levels of vitamin D creation which are exacerbated in countries which have less sunlight. This can cause immune systems to be weaker

Ethnicity

Vitamin D and health

Annualised mean serum 25(OH)D concentration was higher in white adults, 45.8 nmol/L

Asian, 20.5 nmol/L

Black, 27.7 nmol/L

10 μg/d (400 IU/d) proposed for the general UK population (aged 4y and above)

For serum 25(OH)D concentration less than 25 nmol/L (10ng per ml)

Scottish Government

Vitamin D: advice for all age groups

Published: 3 Jun 2020

Everyone (including children) should consider taking a daily supplement containing 10 micrograms of vitamin D

Specifically recommended that groups at higher risk of vitamin D deficiency take a daily supplement.

All pregnant and breastfeeding women

Infants and children under 5 years old

People who have low or no exposure to the sun, for example those who cover their skin for cultural reasons, are housebound, confined indoors for long periods or live in an institution such as a care home

People from minority ethnic groups with dark skin such as those of African, African-Caribbean and South Asian origin, who require more sun exposure to make as much vitamin D

Guidance from Scottish Government

10–15 minutes of unprotected Scottish sun exposure is safe for all.

Once sunscreen is correctly applied, vitamin D synthesis is blocked. Staying in the sun for prolonged periods without the protection of sunscreen increases the risk of skin cancer.

Too much vitamin D may be harmful

Daily supplements at the recommended amounts will be enough

Avoid daily high dose vitamin D supplements

More than 100 micrograms for adults and children from age 11

More than 50 micrograms for children age 1-10 years

More than 25 micrograms for infants under 12 months.

Indian protocol

60,000 units (1.5 mg) per week for 6 weeks

60,000 units per month for 6 months