Wednesday , November 25 2020

Could vitamin D deficiency make COVID-19 worse?



At the beginning of the year, there is a topic that dominates the media, economy and public life like never before. While faced with an entirely new strain of virus at the beginning of the corona pandemic, little was known about its origin, route of distribution, and treatment, no subject has tackled so intensely in recent months. Many questions are still open today, but we already know much more about the SARS-CoV-2 virus. Among other things, research has observed that vitamin D deficiency may be related to the course of COVID-19.

This is the result of a recent study in Spain that observed 216 patients receiving hospital treatment for lung disease caused by “coronavirus”. [1]. The investigation period was extended from March 10 to March 31. At that time, Spain was considered one of the epicenter of the corona epidemic in Europe and the world. 82.2 percent of hospitalized patients were found to have vitamin D deficiency. In contrast, 197 healthy volunteers from the same area were asked to analyze how often a vitamin D deficiency occurred without COVID-19 in this population group. Also observed “only” 47.2 percent of healthy people showed incomplete supply of this vitamin.

Vitamin D Deficiency COVID-19
This study observed that people with a severe course of COVID-19 had low to very low vitamin D levels more often. [1].

Research published in early September showed a correlation between vitamin D deficiency and COVID-19 risk. [2]. This study went a step further and examined other health markers such as inflammatory markers, ferritin, and certain markers for thrombosis formation. These were previously linked to the occurrence of lung disease caused by the coronavirus. [3]. The subjects of the Spanish study also had less positive values ​​here and also had a increased incidence of high blood pressure and cardiovascular diseases.

Comorbidities such as high blood pressure, diabetes or obesity have already been linked to low vitamin D levels regardless of COVID-19. However, with vitamin D deficiency, they can worsen the course of COVID-19. [4]. It is important to note that in the Spanish study, a vitamin D deficiency of less than 20 nanograms per milliliter was converted. 50 Nanomole pro Liter (nmol / L) was identified. The mean value of COVID-19 patients was 13.8 ± 7.2 nanograms per milliliter (34.5 ± 18 nmol / l), while the mean vitamin D level of the comparator was 20.9 ± 7. 4 nanograms per milliliter (52.25 ± 18.5 nmol / l). This difference has a very high statistical significance.

Vitamin D Deficiency COVID-19
The current study observed that 82.2 percent of hospitalized COVID-19 patients were vitamin D deficient, while the incidence in the comparison group was 47.2 percent. [1]. According to RKI’s data, 56.6 percent of German adults had a vitamin D level of less than 50 nanomoles per liter, which was classified as a deficiency in the Spanish study. [5].

According to the Robert Koch Institute (RKI), 56 percent of adults in Germany have a vitamin D value of less than 50 nanomoles per liter. [6]. Because the parathyroid hormone that secretes calcium from the bones reaches a level 75 Nanomole Vitamin D pro Liter decreases in blood plasma in a dose-dependent manner, numerous research projects consider this value to be optimal [6, 7]. Therefore, assuming an under-supply of less than 75 nanomoles per liter, the number of those affected by a deficiency could be much higher.

Two further studies under guidance, among others Michael holick Considered a leading scientist in the field of vitamin D deficiency, he found that vitamin D deficiency reduces the risk of positive COVID-19 testing. 54.5 percent and COVID-19 patients had adequate sources of vitamin D and had a 51.5 percent lower risk of dying from the disease [8, 9].

Could taking vitamin D protect against a serious COVID-19 course?

Researchers are currently unable to give an unequivocal answer to this question. The main reason for this is that for such an analysis, a large number of healthy people with vitamin D deficiency need to take a certain amount and then observe the rate of infection and the frequency of vigorous courses. We are currently counting around 600,000 people who test positive in Germany, which corresponds to around 0.73 percent of the population. To collect enough data for such an analysis, not only is one examining a very large population group, but the study is allowed to continue for several months.

As mentioned, the frequency of vitamin D deficiency is also associated with the occurrence of diseases such as diabetes, obesity, and cardiovascular diseases. These problems are more common among people who currently lead a sedentary and unhealthy lifestyle. This alone can contribute to the weakening of the immune system, resulting in a severe course of COVID-19 infection. After all, people with these diseases are considered a risk group for SARS-CoV-2 infection. [10]. The study by Spanish researchers was unable to determine a causal relationship between vitamin D deficiency and the severity of the COVID-19 course from their data and previously published studies. [1].

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However, the protective effect of vitamin D on infectious diseases is demonstrated by the vitamin’s contribution to normal immune function. This is also confirmed by the European Food Safety Authority (EFSA). [10]. Therefore, it is definitely not a mistake to bring your vitamin D levels to the optimal level with the help of supplements. However, this measure alone is unlikely to be enough to protect yourself from a severe course of COVID-19. Therefore, nutritional supplements should always go hand in hand with an active and healthy lifestyle and a balanced diet.

Conclusion and summary

Several studies over the past weeks and months seem to confirm that vitamin D deficiency is associated with the course of COVID-19 infection. More specifically, people with lower vitamin D levels are more likely to have severe symptoms and have a higher risk of death. However, it is still unclear whether the severity of the course is directly triggered by vitamin D deficiency or concomitant illnesses associated with low vitamin D levels. In any case, targeting the optimum vitamin D levels in the blood as well as adhering to a healthy and active lifestyle will not harm your health.

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Literature sources:

  1. Hernández, José L., et al. “Vitamin D Status in Hospital Patients with SARS-CoV-2 Infection.” Journal of Clinical Endocrinology and Metabolism (2020).
  2. Meltzer, David O., et al. “Vitamin D status and other clinical characteristics in relation to COVID-19 test results.” JAMA network is open 3.9 (2020): e2019722-e2019722.
  3. Huang, Ian, et al. “C-reactive protein, procalcitonin, D-dimer, and ferritin-2019 in severe coronavirus disease: a meta-analysis.” Therapeutic advances in respiratory diseases 14 (2020): 1753466620937175.
  4. Biesalski, Hans K. “Vitamin D deficiency and comorbidities in COVID-19 patients – Fatal relationship?” NFS Magazine (2020).
  5. Robert Koch Institute: “Answers to frequently asked questions about vitamin D from the Robert Koch Institute”, rki.de, as of January 25, 2019
  6. Holick, Michael F. “Vitamin D status: measurement, interpretation and clinical application.” Epidemiology Annals 19.2 (2009): 73-78.
  7. Holick, Michael F., et al. “Evaluation, treatment and prevention of vitamin D deficiency: Endocrine Society clinical practice guideline.” Journal of Clinical Endocrinology and Metabolism 96.7 (2011): 1911-1930
  8. Kaufman, Harvey W., et al. “SARS-CoV-2 positivity rates correlate with circulating 25-hydroxyvitamin D levels.” PloS one 15.9 (2020): e0239252.
  9. Maghbooli, Zhila, et al. “Vitamin D adequacy, a serum 25-hydroxyvitamin D, reduced the risk for adverse clinical outcomes in patients with COVID-19 infection by at least 30 ng / mL.” PloS one 15.9 (2020): e0239799.
  10. Robert Koch Institute (RKI): “Information and assistance for people at high risk of developing severe COVID-19 disease”, https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Risikogruppen .html, 29 October As of 2020
  11. EFSA Dietetic Products, Nutrition and Allergies Panel (NDA). “Scientific Opinion on the verification of a health claim related to vitamin D and contribution to the normal functioning of the immune system in accordance with Article 14 of Regulation (EC) No 1924/2006.” EFSA Magazine 13.5 (2015): 4096.




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