By: Talking Nutrition Editors
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From the start of the pandemic to the present day, science on vitamin D and COVID-19 has been rapidly evolving, with over 40 patient studies exploring the link between vitamin D levels and diagnosis of the disease.1
Vitamin D is well-known to play several roles in supporting both the innate and adaptive immune systems and reducing the risk of contracting respiratory tract infections.2 For example, it helps to support the growth, maturation and activity of immune cells that are involved in recognizing and killing pathogens , to modulate the production of both proinflammatory and anti-inflammatory cytokines and thus the inflammatory response, as well as promoting cathelicidin synthesis in epithelial and immune cells – an antimicrobial peptide which is believed to help reduce susceptibility to pathogens including in the lungs.3,4,5,6
The research article, titled ‘SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels’ and published in September 2020, has revealed an association between lower test positivity rates and higher circulating vitamin D levels.
Dr. Gombart explained: “The study in US patients by Kaufman et al., (2020) evaluated the association of circulating 25-hydroxyvitamin D [25(OH)D] levels with SARS-CoV-2 positive test results. The researchers used the most recent serum 25(OH)D test during the preceding 12 months available for each patient. After analyzing results from 191,779 patients from all 50 states, the research team found SARS-CoV-2 positivity was strongly and inversely associated with circulating 25(OH)D levels. What’s more, this association persisted across latitudes, races/ethnicities, sexes and age ranges.”
In the study, positive SARS-CoV-2 tests were found in 12.5% of those with deficient vitamin D status (<20 ng/ml), in 8.1% of patients with adequate status (30-34 ng/ml), and only 5.9% of patients with higher vitamin D status (>55 ng/ml). In other words, patients with deficient vitamin D status were shown to have a 54% higher positivity rate than those who had an adequate vitamin D status.
Ultimately, the results highlight an inverse relationship between circulating vitamin D levels and SARS-CoV-2 positivity.
While previous research has shown similar findings around the link between vitamin D and COVID-19 test positivity rates, the study from Kaufman et al. is unique in the size of its research cohort, which – at over 190,000 patients - is significantly larger than previous studies.
Commenting on the implications of the paper, Dr. Gombart said: “The new study shows that low 25(OH)D serum levels are associated with a higher risk of SARS-CoV-2 infection, while increasing levels are associated with a decreasing risk of infection. The study also showed increased risk for SARS-CoV-2 infection in Hispanic and black non-Hispanic communities who suffer from higher rates of vitamin D insufficiency.”
So, what does this mean for the future of vitamin D in relation to SARS-CoV-2 infection? According to Dr. Gombart, “It is important to note that the relationship described in this study is not causative. In other words, it does not demonstrate that vitamin D supplementation reduces risk of infection but provides a strong rationale to address this question with additional research.”
“As we wait for the results of randomized controlled intervention trials to confirm a causative relationship, responsible supplementation for those with deficiency or inadequate serum 25(OH)D levels (<20 ng/ml) to raise their serum levels to >30 ng/ml is recommended. In the paper itself, Kaufman et al. recommend following advice from physicians in accordance with existing Endocrine Society Guidelines.”
“Numerous recently published studies are providing more evidence for a link between higher vitamin D blood levels/status and lower risk of infection and death from COVID-19,” said Dr. Gombart. “From its historical role in treating tuberculosis, ability to induce antimicrobial peptides, regulate other aspects of innate and adaptive immunity, reduce inflammation and increase protection against respiratory tract infections, a strong rationale exists for ensuring adequate vitamin D levels to help reduce the risk of infection.”
Indeed, there is mounting evidence to suggest that vitamin D may be associated with lower risk of infections and critical clinical outcomes from COVID-19. One observational study evaluating the association between vitamin D blood levels with COVID-19 cases and deaths across 20 European countries as of May 2020 found a significant link between the country’s vitamin D status and its COVID-19 cases.7 Another recent study on the mortality rate of COVID-19 and concentrations of vitamin D in national populations found a correlation between lower levels of vitamin D and a higher mortality rate.8
Taking a research-led approach to innovation is key to addressing our world’s most pressing health concerns. At DSM, we take pride in understanding the true potential of our customers’ products and how they can help our planet’s growing population stay healthy. Our broad range of high-quality products, customized solutions, and expert services are designed to power your next innovation in enhancing the health of your consumers.
13 November 2020
7 min read
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