Vitamin D and COVID-19 - VitaminD3World - July 2020

Vitamin D3 reduces COVID-19 infections that result in severe illness and significantly decreases the risk of death in at-risk population

It was long ago demonstrated that Vitamin D3 prevents colds and influenza (1). A meta analysis (2) published in 2017 confirmed this finding with the lead investigator, Professor Adrian Martineau from QMUL, concluding that "the reduction in risk of acute respiratory infection induced by Vitamin D was on a par with the protective effect of the flu vaccine."

Given the prevalence of COVID-19 to result in severe respiratory impairment, it is welcome news that Vitamin D3 can have an equally meaningful effect of COVID-19 infections.

Soon after the outbreak of COVID-19 pandemic in 2020, two studies suggested that the severity of the illness and the death rate caused by the virus was related to patients' level of Vitamin D. The first study from Trinity College Dublin (3) showed that countries where the population had higher Vitamin D levels had significantly lower rates of infection and even death. Norway and Finland, which had the highest Vitamin D levels hardly any deaths as compared to 300 deaths per million population in Spain which was found to have the lowest Vitamin D levels.

These findings are the result of Norway, Finland and Sweden, having long ago recognized the dangers of Vitamin D deficiency so supplementation and fortification of foods became widely adapted many years ago.

The correlation between low Vitamin D levels and death from COVID-19 was found to have high statistical significance. A second study conducted by Northwestern University confirmed this finding (4)

Three additional studies have emerged and appear to confirm these important findings. The conclusions that adequate Vitamin D levels could prevent the disease becoming severe in 90% of cases and reduce patients risk of dying from the infection by 96% ( 5, 6, 7)

The first study (5) was conducted in the Philippines in 212 cases with laboratory confirmed infection of COVID-19. Of these 212 cases the majority had good clinical outcomes. But Vitamin D levels were lowest in the most critically ill patients cases and highest in patients with mild symptoms. It was found that 72.8% of patients with Vitamin D levels of less than 50nmol/L had severe or critical conditions as compared to 7.2% of patients with Vitamin D levels of greater than 75nmol/L .(see detailed chart below) The Philippines study concluded that the patient's Vitamin D level was highly significantly associated with the patient's clinical outcome.

In a second study conducted in Indonesia with 780 patients, with laboratory confirmed infection COVID-10 infection. (6) The mortality rate was 98.8% in patients with a Vitamin D level below 50nmol/L, and only 4.1% in patients with Vitamin D levels above 75nmol/L. Univariate analysis revealed that older male patients with pre-existing conditions and below normal Vitamin D levels were associated with an increasing rate of death. This confirms that when controlling for age, sex, and comorbidity, Vitamin D status is strongly associated with COVID -19 mortality outcomes.

Finally, the third study (7) looked at the mortality rate by country as compared to the average vitamin D level. The finding was highly significant. The study found that those countries with the highest vitamin D levels had the lowest mortality rates for COVID -19 infections.

As a result of these ground breaking studies, it is highly recommended that Vitamin D supplementation be aimed at increasing serum 25-hydroxyvitamin D 25(OH)D levels to 75 ng/ml (100-150 nmol/l) This generally would require daily doses of 5000 IU/d vitamin D3.(8)

These data also indicates why so many deaths from COVID-19 infections occur in the Black communities and in those elderly who are institutionalized. These two populations historically have demonstrated the most severe degrees of Vitamin D deficiency. While adults and children would benefit from Vitamin D supplementation it is critical for Black American and the elderly, especially those confined to nursing homes.

References

(1)Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey.

Ginde AA, Mansbach JM, Camargo CA Jr. Arch Intern Med. 2009 Feb 23;169(4):384-90. doi: 10.1001/archinternmed.2008.560. PMID: 19237723

(2)Adrian R Martineau, David A Jolliffe, Richard L Hooper, Lauren Greenberg, John F Aloia, Peter Bergman, Gal Dubnov-Raz, Susanna Esposito, Davaasambuu Ganmaa, Adit A Ginde, Emma C Goodall, Cameron C Grant, Christopher J Griffiths, Wim Janssens, Ilkka Laaksi, Semira Manaseki-Holland, David Mauger, David R Murdoch, Rachel Neale, Judy R Rees, Steve Simpson, Iwona Stelmach, Geeta Trilok Kumar, Mitsuyoshi Urashima, Carlos A Camargo. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ, 2017; i6583 DOI: 10.1136/bmj.i6583

(3)E. Laird, J. Rhodes, R.A. Kenny. Vitamin D and Inflammation: Potential Implications for Severity of Covid-19. Irish Medical Journal, 2020; 113 (5): P81

(4)Ali Daneshkhah, Vasundhara Agrawal, Adam Eshein, Hariharan Subramanian, Hemant Kumar Roy, Vadim Backman. The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. medRxiv, Posted April 30, 2020;

(5)Alipio MM. (2020) Vitamin D supplementation could possibly improve clinical outcomes of patients infected with Coronavirus-2019 (COVID- 2019). Preprint available at SSRN: https://ssrn.com/abstract=3571484

(6)Raharusuna P, Priambada S, Budiarti C et al. (2020) Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study.

(7) Ilie, P., Stefanescu, S., Smith, L. (2020) The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality. Research Square preprint. https://europepmc.org/article/ppr/ppr147305

(8)Grant WB, Lahore H, McDonnell SL, et al., (2020) Vitamin D Supplementation Could Prevent and Treat Influenza, Coronavirus, and Pneumonia Infections" Nutrients preprint, March 14, 2020 https://www.preprints.org/manuscript/202003.0235/v1

Vitamin D3 News

The author of this update, Dr Nigel Rulewski MD established the company Natural Products Corp and the website www.vitaminD3world.com over a decade ago. A physician with experience in multiple specialties, he spent more than 25 years in the pharmaceutical industry as a chief medical officer acquiring an unusually broad drug development experience, ranging from identifying and assessing promising drugs to developing novel clinical positioning, designing and leading clinical trials, achieving FDA approvals, directing regulatory affairs, and supporting successful fundraising initiatives. His interest in the utilization of Vitamin D3 led to the development of a micro-capsule formulation of Vitamin D3, available through www.vitaminD3world.com website.