Coronavirus: Vitamin D deficient ‘at higher risk of death’

By | June 18, 2020

Terrifying chart shows how Covid-19 patients who end up in hospital may be almost certain to die if they have a vitamin D deficiency

  • Indonesian experts analysed hospital records of 780 people who tested positive
  • 98.9% of Covid patients defined as vitamin D deficient — below 20ng/ml — died
  • Yet this fell to just 4.1% for patients who had enough of the nutrient, data showed
  • SACN will review existing scientific evidence on whether vitamin D lowers risk
  • Public Health England and NHS regulator NICE are doing a separate review
  • Here’s how to help people impacted by Covid-19

Nearly 99 per cent of Covid-19 patients who are vitamin D deficient die, according to a terrifying study that adds to mounting evidence that the ‘sunshine’ nutrient could be a coronavirus life-saver. 

Indonesian researchers analysed hospital records of 780 people who tested positive for SARS-CoV-2, the coronavirus that causes Covid-19. 

Results revealed 98.9 per cent of infected patients defined as vitamin D deficient — below 20ng/ml — died. Yet this fell to just 4.1 per cent for patients who had enough of the nutrient.

Researchers warned the study was not definitive, however, because the patients with high vitamin D levels were healthier and younger.

It comes as health chiefs are urgently reviewing the use of vitamin D as a coronavirus lifesaver, with several studies suggesting that Covid-19 patients are far more likely to die if they have a deficiency. 

One investigation – carried out by Anglia Ruskin University in Cambridge – found European countries with lower vitamin D levels have had significantly more pandemic casualties.

The National Institute for Health and Care Excellence is conducting a ‘rapid evidence review’ of the issue – and publication is expected as early as next week. 

A graphic, pictured, shows how the Covid-19 death rate is affected by the level of Vitamin D

A graphic, pictured, shows how the Covid-19 death rate is affected by the level of Vitamin D

The main source of vitamin D for most people is daylight - the body can make its own supply of the nutrient when the skin is exposed to UV rays (stock image)

The main source of vitamin D for most people is daylight – the body can make its own supply of the nutrient when the skin is exposed to UV rays (stock image)

Researchers at the University of East Anglia in May produced a correlation graph showing the relationship between levels of vitamin D (bottom, measured in nmol/l) compared to infection numbers of coronavirus. Countries with low vitamin D levels tend to have the highest case rates per million, they found

Researchers at the University of East Anglia in May produced a correlation graph showing the relationship between levels of vitamin D (bottom, measured in nmol/l) compared to infection numbers of coronavirus. Countries with low vitamin D levels tend to have the highest case rates per million, they found

Data in a Public Health England report showed that the mortality rate - the number of people dying with the coronavirus out of each 100,000 people - was considerably higher for black men than other group. The risk for black women, people of Asian ethnicity, and mixed race people was also higher than for white people of either sex.  People with non-white skin are also at a higher risk of vitamin D deficiency because it takes them longer to make it from sunlight

Data in a Public Health England report showed that the mortality rate – the number of people dying with the coronavirus out of each 100,000 people – was considerably higher for black men than other group. The risk for black women, people of Asian ethnicity, and mixed race people was also higher than for white people of either sex.  People with non-white skin are also at a higher risk of vitamin D deficiency because it takes them longer to make it from sunlight

The Indonesian study was not associated with experts from any university, unlike most Covid-19 research.

All five researchers, led by Prabowo Raharusuna, were listed as ‘independent’. No details of their scientific backgrounds were provided in the paper. 

The research — published in April — has yet to be peer-reviewed by fellow scientists, a process that often uncovers flaws in studies.

The team found vitamin D-deficient patients were 10 times more likely to die when age, gender and co-morbidities were taken into account. 

They wrote in the paper: ‘When controlling for age, sex, and comorbidity, vitamin D status is strongly associated with Covid-19 mortality outcome of cases.’

And they called for randomised controlled trials — considered the gold-standard of scientific research — to prove whether vitamin D can be a life-saver.  

One in five British adults and one in six children is lacking in vitamin D, thanks to poor diets, indoor lifestyles and lack of sunshine.

Experts estimate around 1billion people worldwide are deficient in the vitamin, with the figures having been described as a ‘global public health issue’.

Some scientists fear that the lockdown and months of indoor living have cut levels even further.

Some ethnic groups tend to be at higher risk because their skin is less able to make the vitamin in response to sunlight. 

Older people are also in danger because the body gets less efficient at producing the vitamin with age.

Public Health England is working with NICE on the review and has asked the Scientific Advisory Committee on Nutrition to carry out a separate report. In other developments in the pandemic: 

VITAMIN D DEFICIENCY ‘COULD RAISE COVID-19 DEATH RISK’ FOR BAME PEOPLE 

BAME people may face a higher risk of dying from the coronavirus because they are more likely to have a vitamin D deficiency, scientists claim.

The pandemic is seeing higher rates of people from black, Asian and minority ethnic backgrounds dying if they catch the coronavirus.

The reasons are still unknown and will likely be numerous and complicated. But some experts think a lack of vitamin D may play a role.

People with darker skin need to spend more time in sunlight in order to get the same amount of vitamin D as a person with lighter skin.

For this reason, the NHS suggests people with an African, African-Caribbean or south Asian background could benefit from take a daily supplement throughout the year.

Vitamin D may have a protective effect against severe coronavirus by regulating the immune system, and deficiencies of it have been linked to other respiratory viruses.

However, the largest study to investigate the link between BAME, Covid-19 and vitamin D in a UK population found no proof.   

William Henley, a professor of medical statistics at University of Exeter, told MailOnline the link is worth exploring.

He said: ‘Preliminary research suggests vitamin D levels may also impact on the risk of people suffering from severe COVID-19 infections. 

‘In the UK and northern European latitudes, vitamin D deficiency is a public health concern because ultraviolet B (UVB) radiation is of insufficient intensity for vitamin D synthesis during winter months. 

‘This is a particular concern for people with dark skin, such as those of African, African-Caribbean or south Asian origin, who will need to spend longer in the sun to produce the same amount of vitamin D as someone with lighter skin.’

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Vitamin D tablets are extremely cheap – they cost as little as 3p a day – and Public Health England issued guidance in April advising everyone to take the supplements.

A trial being led by Professor Adrian Martineau of Queen Mary University in London is investigating how certain lifestyle factors – including vitamin D levels – affect susceptibility to the virus.

‘Vitamin D could almost be thought of as a designer drug for helping the body to handle viral respiratory infections,’ he told The Guardian last night.

A review from the University of Surrey, which was published in the British Medical Journal last month, found that vitamin D should be seen as part of a healthy lifestyle but not as a ‘magic bullet’ – because the evidence was not yet clear.

Dr Lee Smith, who led Anglia Ruskin’s study, said: ‘It has been shown to protect against acute respiratory infections, and older adults, the group most deficient in vitamin D, are also the ones most seriously affected by Covid-19. 

A previous study found that 75 per cent of people in institutions, such as hospitals and care homes were severely deficient in vitamin D.’  

A Public Health England spokesman said: ‘NICE is working on a rapid evidence summary on vitamin D in the context of Covid-19 with support from Public Health England. This report will be published in due course.’

The NHS says the general consensus is levels of below 25nmol/L — the equivalent of 10ng/ml — in the blood indicate vitamin D deficiency.  

This is thought to be the equivalent of taking around 10 micrograms of vitamin D a day.

The Institute of Medicine — a US health advisory body — states levels below 20ng/ml (50nmol/L) is a deficiency. 

Large doses of vitamin D can be dangerous, with anything above 100 micrograms to be taken only under medical supervision.

Latest coronavirus video news, views and expert advice at mailplus.co.uk/ coronavirus              

HOW VITAMIN D DEFICIENCY AFFECTS THE BODY

Vitamin D deficiency – when the level of vitamin D in your body is too low – can cause your bones to become thin, brittle or misshapen.

Vitamin D also appears to play a role in insulin resistance, high blood pressure and immune function – and this relates to heart disease and cancer – but this is still being investigated.

Low levels of the vitamin have also long been linked to an increased risk of multiple sclerosis. 

Although the amount of vitamin D adults get from their diets is often less than what’s recommended, exposure to sunlight can make up for the difference. 

For most adults, vitamin D deficiency is not a concern. 

However, some groups – particularly people who are obese, who have dark skin and who are older than age 65 – may have lower levels of vitamin D due to their diets, little sun exposure or other factors.

Source: Mayo Clinic

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