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Vitamin D deficiency can increase severity

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A new study adds to the evidence that the severity of COVID-19 may have links to vitamin D deficiency. Lam Luong Dinh/EyeEm/Getty Images
  • Some research suggests that vitamin D insufficiency has links to worse COVID-19 outcomes.
  • A new study that considers vitamin D levels before infection confirms their link to severe COVID-19.
  • The researchers say their findings do not necessarily imply that vitamin D treatment will impact COVID-19 outcomes, although they do suggest it is wise to maintain normal levels.

Having sufficient levels of vitamin D is important for supporting healthy bones and teeth. Too few of them have links to diabetes, autoimmune, cardiovascular and infectious diseases. Among these is COVID-19.

Researchers from Bar Ilan University and Galilee Medical Center in Israel have published a study that examines the links between vitamin D levels and the severity of COVID-19 for 253 people admitted to hospital. with COVID-19 Researchers found records showing their vitamin D levels before they contracted a SARS-CoV-2 infection and went to the hospital.

The study concluded that people with insufficient levels of vitamin D before infection were 14 times more likely to develop severe COVID-19 than those with high levels of vitamin D.

The study appears in PLOS ONE.

The lead author of the study is Dr. Amiel Dror, a researcher at Galilee Medical Center and Bar Ilan. He said Medical News Today why he suspects that previous research on the link between vitamin D insufficiency and COVID-19 has been inconclusive and even contradictory:

“The majority of studies (at least in the early stage of the pandemic) have addressed vitamin D in the setting of acute viral infection. These studies aimed to assess whether low vitamin D at hospital presentation is associated with COVID-19 disease outcome. Vitamin D measurement [during] a patient’s COVID-19 disease represents the vitamin D level at a specific time.

Dr Dror said that when measuring the vitamin D levels of someone already infected with SARS-CoV-2, it is difficult to know if COVID-19 suppresses vitamin D or if its lack worsens the condition. ‘infection.

Dr. Dror explained that “Vitamin D undergoes activation in the liver to become active. Many COVID-19 patients suffer from impaired liver function that abolishes the ability to activate vitamin D during illness.

Dr. Iacopo Chiodini, associate professor of endocrinology at the Università degli Studi di Milano, Italy, said DTM that scientists have yet to establish how vitamin D might help contain COVID-19 even if there is enough of it. Dr. Chiodini was not involved in the study.

Dr. Chiodini suggested that vitamin D could act, for example, as a modulator of cytokine storm which results in lung damage and progression of disease or neutrophil activity, “thereby reducing their excessive activation and recruitment to the inflamed lung.”

He also hypothesized that vitamin D could protect the integrity and repair the pulmonary epithelial barrier or reduce the risk of pulmonary and systemic thrombosis seen in severe cases of COVID-19.

Beyond that, said Dr. Chiodini:

“Vitamin D deficiency may be indicative of a wide range of chronic health conditions or behavioral factors that simultaneously increase COVID-19 disease severity and mortality risk.”

A second area where previous research has proven inconclusive relates to the value of vitamin D supplementation during illness with COVID-19. Dr. Dror quoted a study in which patients received a vitamin D supplement approximately 10 days after the onset of COVID-19 symptoms:

“Obviously, it should come as no surprise that such a late intervention does not change the observed course of the disease so much. When a study aims to determine the effect of vitamin D treatment, [I] would recommend a study design with earlier intervention/treatment rather than 5-10 days after symptom onset when the body has already experienced severe distress.

In the new study, the question remains unanswered. As Dr. Chiodini recalled DTM“An association between vitamin D deficiency before infection and COVID-19 severity does not necessarily imply that vitamin D treatment will impact COVID-19 outcomes.”

After controlling for a variety of other possible factors, Dr. Dror said, “the effect of vitamin D was so strong and identified in every multivariate regression model we tested as the most important independent factor on disease severity and mortality.

Dr Dror noted that his study is observational and added, “I strongly agree that randomized controlled trials are essential to show causation” between vitamin D and COVID-19 results. .

He continued, “That said, there are many good reasons to maintain normal vitamin D levels (bone and skeletal health, etc.) regardless of COVID-19. Therefore, while it may be beneficial in fighting viral respiratory infection, I see no reason to avoid it.

“Overall, I recommend people keep their baseline vitamin D levels normal and definitely avoid the deficiency level of 20 nanograms per milliliter (ng/ml). These recommendations already exist regardless of the COVID-19 pandemic. During this period, I would stick particularly to these recommendations.

– Dr. Dror

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