Sars-CoV-2 the virus that causes COVID-19 reached a pandemic level early in 2020. The virus has rapidly spread contributing to over a million deaths worldwide to date. Certain comorbidities have been associated with more severe outcomes, such as advanced age and male gender. Neither of these is modifiable, therefore investigating other modifiable risk factors could reduce the risk of severe outcomes in these patients. In a study published in September of 2020 in the journal Nutrients, the authors “sought to explore possible associations between vitamin D status and disease severity and survival in COVID-19 patients.”1
The study included 185 patients diagnosed with COVID-19. Vitamin D deficiency was defined as “serum total 25-hydroxyvitamin D level < 12ng/mL.” The median observation period was 66 days with a range between 2 and 92 days. Among the patients determined to be vitamin D deficient, it was observed that these patients required oxygen therapy at a higher rate. Additionally, vitamin D patients had higher levels of IL-6 at the time of hospitalization. The authors note, “in the outpatient subgroup, no differences between vitamin D deficient patients and patients with vitamin D levels > 12ng/mL were observed.”
During the observation period, a total of 28 patients required invasive mechanical ventilation, including 16 deaths. A total of 41 patients in the study were vitamin D deficient (22%). The study shows an association between severe COVID-19 and vitamin D deficiency. The authors determined that vitamin D deficiency was associated with a “6-fold higher hazard of severe course of the disease and about 15-fold higher risk of death.”
Multiple limitations were noted by the authors which included the study being a single-center, retrospective and observational study. They call for further studies with larger cohorts and the consideration of other potential confounders. Additionally, the authors state, “without randomized controlled trial evidence, no causal association between vitamin D deficiency and severity/outcome of COVID-19 can be inferred.” Though there are limitations it is well established that micronutrients are essential for physiological functions that help maintain health and support the immune system in fighting disease.
The authors conclude by stating, “this observational study among patients with COVID-19 who have experienced a definite outcome shows an association between vitamin D status and severity of and mortality from COVID-19. Prospective, randomized controlled studies on vitamin D supplementation in SARS-CoV-2 infected individuals are highly warranted.”
Do you currently have your vitamin D levels monitored? Do these findings make you want to have your levels checked? Will you share this information with patients when addressing nutritional counseling?
Radujkovic A, Hippchen T, Tiwari-Heckler S, Dreher S, Boxberger M, Merle U. Vitamin D Deficiency and Outcome of COVID-19 Patients. Nutrients. 2020 Sep 10;12(9):2757. doi: 10.3390/nu12092757. PMID: 32927735; PMCID: PMC7551780.