vitamin D deficiency associated with increased risk of severe infection and death from COVID-19

The research is really early, but the preliminary hope is that it might.

A study that has not yet been peer-reviewed wanted to see if severe COVID-19 might be associated with a deficiency in vitamin D. They used data from some of the hardest hit countries, like Germany, South Korea, China, Switzerland, Iran, UK, US, France, Spain and Italy.

Since data for vitamin D and COVID-19 is lacking, the researchers took an indirect route, analyzing the link between vitamin D deficiency and the inflammatory marker C-Reactive Protein (CRP) and the link between CRP and COVID-19. CRP is a surrogate marker for severe COVID-19.

Their research suggests the possibility that the risk of severe COVID-19 climbs from 14.6% to 17.3% when a vitamin D deficiency exists. They suggest that vitamin D may reduce COVID-19 severity by supressing the excessive inflammatory immune response known as a cytokine storm that is responsible for so many COVID-19 deaths. They found that in the US, UK and France, vitamin D deficiency may be associated with higher rates of death. In countries where levels of vitamin D are generally lower, mortality rates from COVID-19 are significantly higher. The researchers hypothesize that, while vitamin D won’t prevent you from getting COVID-19, adequate levels could cut mortality rates in half (medRxiv 2020; doi.org/10.1101/2020.04.08.20058578).

This research is very preliminary, but, interestingly, it is not alone. Another just published study also found an association between low levels of vitamin D and COVID-19. The researchers compared vitamin D levels in 20 European countries with their rates of COVID-19 infection and death. They found a significant correlation between countries with low levels of vitamin D and both the number of cases and the number of deaths.

Vitamin D supports the immune system while helping to prevent the excessive release of inflammatory cytokines. That means it may modulate the immune system in a way that lets it contributes in both ways you would want it to contribute to fighting COVID-19: enhancing the immune response while dampening the cytokine storm (Aging Clin Exp Res 2020;doi.org/10.1007/s40520-020-01570-8).

Having low levels of vitamin D has been associated with susceptibility to acute respiratory tract infections. In 2017, a systematic review and meta-analysis of 25 double-blind studies found that supplementing vitamin D significantly reduces the risk of acute respiratory tract infection by 12%. The protection was even stronger when deficiency of vitamin D was greater (BMJ 2017;356:i6583).

A 2017 study of 107 long-term care residents who were 60 or older found that vitamin D prevents respiratory infections in the elderly. The study compared a monthly 100,000 IU dose of vitamin D to a much lower 12,000 IU dose. The seniors given the higher dose had a significant 40% fewer acute respiratory tract infections (J Am Geriatr Soc 2017;65(3):496-503).


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