Vitamin D reduces hospital risk

Vitamin D deficiency is associated with higher hospitalisation risk from COVID-19: a retrospective case-control study (June 2021)

Not funded

Large scale, retrospective case-control study

North West of England

Two hospital groups

Lancaster and Tameside and Glossop

Objective

Is hospitalisation with COVID-19 more prevalent with lower vitamin D levels

Individuals with results of serum 25-hydroxyvitamin D (25[OH]D)

1st April 2020 and 29th January 2021

Deficient = less than 25 nmol/L (10 ng/ml)

Insufficient = 25-50 nmol/L (10 to 20 ng/ml)

N = 80,670

1,808 were admitted to hospital with COVID-19

670 died

Primary cohort, n = 58,368

Median vitamin D levels in participants not hospitalised

50 nmol/L (20ng/ml)

(interquartile range, IQR 34.0-66.7 nmol/L)

Median vitamin D levels in participants hospitalised

35.0 nmol/L (14 ng/ml)

(interquartile range, 21.0-57.0nmol/L)

p less than 0.005

Similar findings in a validation cohort, n = 21,234

Non-hospitalised = 47.1 nmol/L (IQR 31.8-64.7 nmol/L)

Hospitalised patients = 33.0 (IQR 19.4-54.1 nmol/L)

p less than 0.005

Adjusted odds ratios

Age, sex, seasonal variation- for hospital admission

OR = 2.3-2.4 times higher, 25(OH)D less than 50 nmol/L

OR for validation cohort, adjusted, = 2.33

No association between low vitamin D levels and in-patient hospital mortality from COVID-

19 in either cohort.

Conclusions

Vitamin D deficiency is associated with higher risk of COVID-19 hospitalisation.

Widespread measurement of serum 25(OH)D and treating any unmasked insufficiency or deficiency through testing may reduce this risk

We have clearly demonstrated that vitamin D insufficiency and deficiency exponentially increase the risk of the disease by a factor of 2.3 to 3.6, even after adjustments for age and sex.

Vitamin D is anti-inflammatory, and it has been shown to modulate the immune system

With its effect on macrophage function and innate immunity, vitamin D may alter the disease manifestations of COVID-19

Vitamin D supplementation should be an important consideration for deficient populations at risk