Safe and effective

Association between vitamin D supplementation and COVID-19 infection and mortality

https://www.nature.com/articles/s41598-022-24053-4

(12th November 2022)

Johns Hopkins
University of Michigan
National Bureau of Economic Research
Department of Medicine, University of Chicago
Department of Veterans Health Affairs
Department of Medicine, University of Chicago, Chicago

Vitamin D deficiency, associated with reduced immune function,

can lead to viral infection

Vitamin D deficiency, associated, increases the risk of COVID-19

But is it a treatment / prognosis improver?

Population of US veterans, we show that Vitamin D2 and D3 fills

Associated with reductions in COVID-19 infection

After applying all restrictions

220,265 supplemented with vitamin D3

34,710 supplemented with vitamin D2

407,860 untreated patients.

Study design

Retrospective cohort

Supplemented (before and during the pandemic),

versus untreated controls

One to one matches

D2, D3, or calcifediol

Veterans Administration Corporate Data Warehouse (CDW) electronic health records.

Vitamin D levels typically respond to treatment following two months of exposure

D3 cohort

COVID-19 rates for the treated
= 2.66%

COVID-19 rates for the untreated = 3.30%

D3 20%, reduction

D2 28% reduction

Mortality within 30-days of COVID-19 infection

Infection ending in mortality within 30 days

D3 group

Treated group death rate after infection = 0.23%

Untreated group death rate after infection = 0.35%

Vitamin D3 33% mortality lower (HR, 67%)

P < 0.001

Vitamin D2 25% lower (HR, 75%) (but not significant)

Veterans receiving higher dosages of Vitamin D obtained greater benefits from supplementation than veterans receiving lower dosages.

Vitamin D blood levels between 0 and 19 ng/ml,

exhibited the largest decrease in COVID-19 infection and mortality following supplementation

(0–19 ng/ml, 20–39 ng/ml, and 40 + ng/ml)

Dosage options, 20 IU, 40 IU, 100 IU, 125 IU, 200 IU, 250 IU, 400 IU, 500 IU, 800 IU, 1000 IU, 2000 IU, 5000 IU, 8000 IU, and 50,000 IU

Black veterans received greater associated COVID-19 risk reductions,

with supplementation than White veterans

As a safe, widely available, and affordable treatment, Vitamin D may help to reduce the severity of the COVID-19 pandemic.

More background

Vitamin D insufficiency and deficiency affect approximately half of the US population,

with increased rates in people with darker skin,

reduced sun exposure,

people living in higher latitudes in the winter,

nursing home residents,

and healthcare workers

Populations with low levels of Vitamin D have also experienced higher rates of COVID-19

New mechanism

Vitamin D is needed to allow T helper cells to control and reduce Interferon gamma (IFN-γ) production

Conclusions

These associated reductions in risk are substantial and justify more significant exploration and confirmation using RCTs.

This is particularly important given the high rates of vitamin D deficiency in the US population and COVID-19.

Extrapolate, D3 supplementation to the entire US population in 2020

4 million fewer COVID-19 cases (19,860,000 actual cases)

116,000 deaths avoided (351,999 actual deaths)

Given our findings,

the absence of severe side effects,

the widespread availability of vitamin D3 at low cost,

vitamin D3 presents a unique opportunity to reduce the spread and severity of the COVID-19 pandemic.

K2, MK-7

Supplement, probably 100 micrograms per day

Nato, 1,000 micrograms per 100 g

Cheese, typically 50 micrograms per 100 g

Safe and effective

UK, GP incentives to vaccinate

Home, £30

Standard reimbursement to Primary Care Networks (which then gets passed to GPs) £15

New contract, £12.58 each