Vitamin D and Covid-19 – Update II: Further insights into vitamin D and Covid-19.

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There is increasing evidence that vitamin D, or better vitamin D deficiency, may have an impact on the development of Covid-19. In this update we want to continue the already started explanation of recent studies.

June 7, 2020

A publication from Hans Biesalski / Universität Hohenheim

Original text: https://doi.org/10.1016/j.nfs.2020.06.001

This article is not so much a study as it is an attempt to explain the biochemical relationships and why a good vitamin D level can be beneficial.

August 17, 2020

From Great Britain comes a publication that can be viewed here in the original:
https://nutrition.bmj.com/content/early/2020/09/20/bmjnph-2020-000129

The authors address the question of whether dietary supplementation/medication with vitamin D is useful in nursing home residents:

“Conclusion: The medical framing of vitamin D supplements in care homes is a practical barrier to implementation of longstanding nutrition guidelines. A paradigm shift is needed so that vitamin D is understood as a protective nutrient as well as a medicine, and a public health as well as a medical responsibility. Vitamin D is important for musculoskeletal health. Possible links with COVID-19 are still being investigated. The pandemic has drawn attention to conditions in care homes and there is an opportunity to revise current guidance on vitamin D supplementation which will have lasting benefit for this vulnerable group.”

August 28, 2020

An Iranian study that investigated vitamin D levels in patients with Covid-19 (63 patients tested positive) and a control group to find out whether vitamin D influences the severity of the disease. The study offers a very good review of the entire literature on the subject complex, the number of patients is certainly still too small to be able to make generally valid statements.

Click here for the original: https://doi.org/10.1016/j.virusres.2020.198148

“In this study, vitamin D, ACE concentrations, and neutrophil to lymphocyte ratio (NLR) were measured in patients with confirmed COVID-19 in comparison with control group. Results demonstrated significant alterations in vitamin D and ACE levels as well as NLR in the patients’ group. Contribution of those factors with the prognosis and severity of the disease has been shown.”

August 29, 2020

This study comes from Spain. It was investigated in a small group of patients whether administration of vitamin D can prevent intensive care (oxygen, ventilation, etc.) of admitted covid-19 patients.

“CONCLUSION: Our pilot study showed that administration of a high dose of calcifediol or 25-hydroxyvitamin D, a major metabolite of the endocrine vitamin D system, significantly reduced the need for ICU treatment in patients requiring hospitalization for proven COVID-19. Calcifediol appears to be able to reduce disease severity, but larger studies with appropriately matched groups are needed to provide a definitive answer.”

September 1, 2020

From Singapore comes a publication with the (translated) title: Cohort study to evaluate the effect of vitamin D, magnesium and vitamin B 12 in combination on progression to severe disease in elderly patients with coronavirus (COVID-19).

Zur Studie: https://doi.org/10.1016/j.nut.2020.111017

“A vitamin D / magnesium / vitamin B12 combination in older COVID-19 patients was associated with a significant reduction in the proportion of patients with clinical deterioration requiring oxygen support, intensive care support, or both.”

September 17, 2020

American study of 191,779 patient records.

Here PLOS ONE | https://doi.org/10.1371/journal.pone.0239252 the original publication can be viewed.

“In conclusion, SARS-CoV-2 NAAT positivity is strongly and inversely associated with circulating 25(OH)D levels, a relationship that persists across latitudes, races/ethnicities, sexes, and age ranges. Our findings provide further rationale to explore the role of vitamin D supplementation in reducing the risk for SARS-CoV-2 infection and COVID-19 disease. If controlled trials find this relationship to be causative, the implications are vast and would present a cheap, readily-available method for helping prevent infection, especially for those with vitamin D deficiency. This could be of increased importance for the African American and Latinx community, who are disproportionately affected by both COVID-19 and vitamin D deficiency. In the interim, the authors recommend responsible vitamin D supplementation based on personal needs, risk factors, and advice from personal physicians in accordance with existing Endocrine Society Guidelines”

September 25, 2020

Iranian-American investigation

PLOS ONE | https://doi.org/10.1371/journal.pone.0239799 The study can be viewed at this link. For the purpose of further clarification, the editors have placed a cautionary note on the study until some unanswered questions have been resolved.

Nevertheless, here is the conclusion: “Therefore, it is recommended that improving vitamin D status in the general population and in particular hospitalized patients has a potential benefit in reducing the severity of morbidities and mortality associated with acquiring COVID-19.”

October 27, 2020

A publication by Spanish authors examined the vitamin D status of 216 Covid-19 patients who presented to the hospital.

https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgaa733/5934827

“Conclusion: 25OHD levels are lower in hospitalized COVID-19 patients than in population-based controls and these patients had a higher prevalence of deficiency. We did not find any relationship between vitamin D concentrations or vitamin deficiency and the severity of the disease.”

We will keep you informed when there are new results on the topic. In the meantime, let us know on social media what you think of the results so far.

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