COVID-19 Severity and Vitamin D Levels

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In several posts over recent months, we have discussed the many ways that optimal vitamin D levels are necessary to initiate and maintain a healthy immune response, especially within the respiratory system. Our paper, Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths, was published last month, detailing the current research in support of higher vitamin D serum levels and decreased incidence of viral-induced respiratory diseases.

In a preprint letter (not yet peer reviewed), data is presented from 212 COVID-19 patients who had been hospitalized in three separate hospitals in Southern Asia. This is the first published data comparing the severity of symptoms to vitamin D serum levels.

Cases were all confirmed for COVID-19 and were grouped as follows:

  1. Mild – presenting with mild clinical symptoms and no diagnosis of pneumonia
  2. Ordinary – presenting with fever, respiratory symptoms, and a confirmed diagnosis of pneumonia
  3. Severe – cases with hypoxia and respiratory distress
  4. Critical – cases with respiratory failure requiring intensive care

Vitamin D levels were grouped as follows:

  1. Normal – vitamin D level of 30 ng/ml (75 nmol/L) or above. This can be gained with supplementation of 100 mcg/day.
  2. Insufficient – vitamin D level between 21-29 ng/ml (51-74 nmol/L)
  3. Deficient – vitamin D level below 20 ng/ml (50 nmol/L)

What were the findings of this study?  The average vitamin D level of all 212 cases was 24 ng/ml (59 nmol/L).

Of all COVID-19 cases

  • 49 (23%) cases were categorized as mild, with an average vitamin D level of 31 ng/ml (78 nmol/L)
  • 59 (28%) were categorized as ordinary, with an average vitamin D level of 27 ng/ml (68 nmol/L)
  • 56 (26%) were categorized as severe, with an average vitamin D level of 21 ng/ml (53 nmol/L)
  • 48 (23%) were critical, with an average vitamin D level of 17 ng/ml (43 nmol/L)
  • 86% of all cases among patients with normal vitamin D levels were mild, while 73% of cases among patients with vitamin D deficiency were severe or critical
  • For each standard deviation increase in vitamin D level, the odds of having a mild case compared to a severe case were 7.94 times more, and the odds of having a mild case compared to a critical case were 19.61 times more
  • All outcomes were statistically significant