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R.B. 01-29-2020 02:46 PM

Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Given the recent outbreak of the Corona virus, and that those with weakened immune systems may be at greater risk of more serious outcomes, I post this for general information.

There is significant evidence that low vitamin D is a factor in risk of acquisition and progression of respiratory conditions, as set out in ‘Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials’ https://journals.plos.org/plosone/ar...l.pone.0065835

(Some links to explore - Low vitamin D is associated with increased risk of and poorer outcomes in pneumonia and other conditions involving compromised lung function eg COPD, asthma, bronchitis, influenza etc

https://vitamindwiki.com/Breathing Breathing

https://vitamindwiki.com/tiki-index.php?page_id=1324 Pneumonia Risk, intensity, and mortality

https://vitamindwiki.com/COPD+Overview COPD

https://vitamindwiki.com/Overview+Asthma+and+Vitamin+D Asthma

https://vitamindwiki.com/tiki-index.php?page_id=1304) Overview Influenza and vitamin D



I set out a few lines from studies below. I find the results very thought provoking.

Vitamin D insufficiency is very wide spread globally and particularly in elderly groups. Interestingly a 2019 study titled ‘A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States’ observed:

“We found that the mean 25(OH)D concentration was lower in China than in the US (45.1 vs. 83.5 nmol/L), with Chinese elderly lower than American elderly for every age group. 70.3% in China and 17.4% in the US were considered as vitamin D deficiency (30.6% and 3.4% were considered as severe deficiency)”
https://www.nature.com/articles/s41598-019-56297-y


Association between serum concentration of 25-hydroxyvitamin D and community-acquired pneumonia (CAP): a case-control study

“According to findings, a low level of 25(OH)D is associated with a higher incidence of CAP and more severe disease. It is recommended to pay more attention to vitamin D deficiency in infectious diseases, particularly in CAP patients.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5692194/


Relationship Between Vitamin D Status and Viral Pneumonia in Children
As vitamin D status decreased, the odds ratio (95% confidence interval) for VP showed an increasing trend [sufficiency (0.3; 0.2–0.5), insufficiency (0.9; 0.6–1.3), deficiency (2.0; 1.3–2.9), and severe deficiency (51.7; 7.2–372.2)]. The median (IQR) serum 25(OH)D level in the VP subgroup who accepted mechanical ventilation was significantly lower than that in the nonmechanical ventilation subgroup [12.9(6.5–22.5) ng/mL versus 20.8 (14.2–28.0) ng/mL] (P < 0.001). Poor vitamin D status might be related to the susceptibility and severity of VP in children.”
https://www.liebertpub.com/doi/abs/1...ournalCode=ped


Lots more studies on risk or respiratory illness and Vit D . . . for example

https://vitamindwiki.com/tiki-index.php?page_id=1324

Vitamin D, Innate Immunity and Outcomes in Community Acquired Pneumonia

Results Severe 25-hydroxyvitamin D deficiency (<30nmol/L) was common in this population (15%) and was associated with a higher 30-day mortality compared to patients with sufficient 25-hydroxyvitamin D(>50nmol/L) (OR 12.7, 95%CI 2.2-73.3, p = 0.004).

VitaminDwiki poses the thought “China's Coronavirus can most likely be fought by Vitamin D” ????? (my question marks) – Jan 2020 https://vitamindwiki.com/China%27s+C...80%93+Jan+2020

Suggesting it provides an opportunity for a study – I too had wondered it Vit D supplementation may ameliorate progression, and that study data would be immensely valuable to determine if there was a correlation between vitamin D status and severity of the disease.

And from the WHO site https://www.who.int/elena/titles/vit...a_children/en/
• Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data
Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P et al.
BMJ. 2017;356:i6583.
• Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Bergman P, Lindh AU, Björkhem-Bergman L, Lindh JD.
PLoS One. 2013; 8:e65835.
• Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis
Charan J, Goyal JP, Saxena D, Yadav P.
Journal of Pharmacology and Pharmacotherapeutics. 2012; 3:300-3.

Laurel 01-29-2020 05:49 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Thank you, R.B.! I did not know this and found it very interesting. Copied into an email and sent off to friends.

R.B. 02-02-2020 05:08 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Thank you Laurel :) appreciated.

The implications of the issues raised are arguably very important. Do they help explain the pattern of emergence of serious impacts including fatalities of the corona virus (as seen so far)?

Logically they could - very low vitamin D (due to lack of access to sunshine and or fortified foods), plus long term lung exposure to city smogs (which can also significantly block UVB incidence so further contributing to low Vit D), in a scenario of weakened immune systems due to other factors, greater time spent indoors etc., might be a plausible factor in the restriction of manifestation of disease fatalities to the elderly and frail (as seen to date).

It is important for all globally, that nationally sensitive outcomes for which their are rational explanations do not become the subject of conspiracy theories - and they are circulating. :( https://www.bbc.co.uk/news/blogs-trending-51271037

Clearly our hearts go out to the Chinese families who have been impacted, with respect and gratitude for their self-imposed restrictions on movement to try and mediate the spread of Corona virus

R.B. 02-06-2020 04:26 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Epidemic influenza and vitamin D

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2870528/

Free in full online

Fig 1 is highly thought provoking in terms of seasonality of incidence of influenza globally.

It asks the question is vitamin D a seasonal factor in determining transmission and progression.

Biology certainly points to it as a factor

R.B. 02-06-2020 04:28 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
A number of papers suggests that low vitamin D impacts a number of respiratory condition risks including mortality. As ever things are complex and more research is needed, but there is quite a large body of general evidence and results suggesting a protective factor for vitamin D in respiratory disease, and the results are thought provoking.

Consistent with a role in respiratory conditions Vitamin D appears to have a role in tight cell junction function including in the lung and digestive system.

Regulation of tight cell junction function is also a factor in spread in cancer as discussed elsewhere


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865708/ ‘Vitamin D, vitamin D receptor and tissue barriers’

https://www.ncbi.nlm.nih.gov/pubmed/30409076 ‘Vitamin D Receptor Deletion Leads to the Destruction of Tight and Adherens Junctions in Lungs.’ (suggesting a role for Vit D in tight cell junction function).

R.B. 02-09-2020 01:41 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Selenium has important roles including in the glutathione antioxidant pathways, and has roles in immune function.

Selenium, Selenoproteins, and Immunity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6163284/

It is low in some Chinese populations and high enough to be toxic in others

Wuhan is not listed in the high risk areas


The Changing Selenium Nutritional Status of Chinese Residents
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967180/

R.B. 02-13-2020 04:10 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Some updates on vitaminDwiki


https://vitamindwiki.com/China%27s+C...80%93+Jan+2020

R.B. 03-26-2020 03:01 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Vitamin D deficiency: a factor in COVID-19, progression, severity and mortality? – An urgent call for research https://www.mitofit.org/images/e/ec/...fit_200001.pdf

Start I suggest with Fig 2 page 11 "Graphical representation of; total COVID-19 deaths, and serious / critical cases at 20th March, 2020, plotted against: vitamin serum 25OHD3 levels (nmol/L); % number of persons deficient in vitamin D <25 nmol/L Vitamin 25OHD; across a range of countries; based on data sources and studies as listed in table 1. "

and Fig 1 page 6

The above thread lead me, with assistance from my co-author Amrita, to write a hypothesis paper on the subject of vitamin D and COVID-19.

I am happy to share a preprint with you – a paper will in due course be
submitted to a journal –

Hoping for some media attention at some point.

It is in the public domain so please feel free to circulate – done in just over a week – including reformatting by them as a preprint – worked crazy hours almost every day - so please forgive minor errors and typos – I had problems connecting to the note system Mendely so part was manually noted - and Amrita by then had prior work commitments – - at the end of the day I felt it was important to get this online - and everybody at Mitofit went out of their way to get this online quickly - typological errors are mine - this has not been peer reviewed - and I am not a PhD - have asked be removed twice :)!


The issue is beginning to be looked at in Italy.

Initial unpublished results suggest those recovering form COVID-19 have higher vitamin D


Coronavirus, studio dell'Università di Torino: assumere più vitamina D per ridurre il rischio di contagio

https://torino.repubblica.it/cronaca...gio-252369086/

I primi dati raccolti in questi giorni indicano che i pazienti ricoverati presentano una elevatissima prevalenza di Ipovitaminosi D

StephN 04-04-2020 10:53 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Thanks you ever so much for chiming in with all of this information.

I had read about the possible link to low vitamin D and the virus course, but you have taken it much, much further.

R.B. 04-05-2020 01:52 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Hi StephN - many thanks :)

Trying with others to get studies done

This is the sort of thing I muted as a starter as ideas

• Test all COVID-19 patients in hospital/s at a given point in time for Vit D and follow results
• Take finger prick samples at same time as COVID test – follow through on all positives and an equal number of controls
• A study using Vit D clinically – test for low vit d – where low supplement maybe say 60,000iu followed by 2-4000iu a day – whatever the ethics people would suggest (if successful then various larger boluses could be tried to try and improve but let us go for lowest common denominator) As alternative to above try 1,25 active form based on result in Yang, J,. Zhang, H., Xu, Z. (2016) Effect of Vitamin D on ACE2 and Vitamin D receptor expression in rats with LPS-induced acute lung injury. DOI: 10.3760/cma.j.issn.1671-0282.2016.12.016 (1,25 is used in kidney patients so issues surrounding usage will be well understood by nephrologists and is transferable)

Not expensive - finger-prick based lab based tests - £30 retail on Amazon - patient records already kept etc - do and analyze data 3-4 weeks later

Finding people who want to / can do them - failed so far despite 2 months + of trying - Ted from here https://vitamindwiki.com/ with supporters is also struggling

It makes no sense that getting research into vit D and COVID-19 is so difficult, because the implications are huge.

I have even written to the Vatican and Archbishop of Canterbury because sadly Nuns are being very severely impacted.

I have re-graphed data yesterday including using deaths per million and the possible correlations still hold.

StephN 04-06-2020 10:40 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Thanks, We live in western Washington State, early in the spread in the USA. Have hardly been out since the end of January! Our state was the first to shut down. We are making good progress in beating the predictions by vastly lowering the caseload! There has been so much emphasis on being ready for patient number spikes, getting equipment and protection gear for health workers and looking at how to deal with so many deaths. Now the schools are closed until June 19.

The University of Washington is busy researching on several fronts. Don't know if you could interest anyone in the Vitamin D piece. Anyone in the UK research community remotely interested?

R.B. 04-07-2020 09:23 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Happy to share a letter that was sent to the BMJ and accepted for their Rapid Response section.

'Re: Preventing a covid-19 pandemic - COVID-19: Vitamin D deficiency; and, death rates; are both disproportionately higher in elderly Italians, Spanish, Swedish Somali, and African Americans? A connection? Research urgently required!'

https://www.bmj.com/content/368/bmj.m810/rr-46

Still struggling to get research interest. Is a bit of a catch 22 - possible funding first or defined research projects - cant get one without the other - needs some vision somewhere . . .

No interest from the Gates Foundation - the people handling it do not understand its relevance and appear from a brief response fixated on pharmacological solutions.

Tried Jeff Bezos too but no response.


Needs a big figure with a public presence, and the authority/ access to funding, to say this needs doing and now!

Henry from https://vitamindwiki.com/ who has amazingly brought together vast number of studies in his 'retirement', and a group of others are putting a lot of effort in trying to get some research done as well. We are working as a loose group to try and get some progress.

If Vit D deficiency is a factor, the gains at many levels, for a minor 'investment' in relevant research, could be huge.

IF Vit D is proven in studies to factor in COVID-19 mitigation (and logically why would it not be - but as yet yes no studies so we do not know for sure) then we would know that things should change in summer as Vit D levels rise (if people can get outside if not need to supplement at national level), as happens with other influenzas - yes maybe not just D - but that would be a useful bit of info. in terms of things to think about re social distancing strategies etc going forward etc. etc.

R.B. 04-25-2020 02:48 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
https://www.bmj.com/content/369/bmj.m1548/rr-6

'COVID-19 ’ICU’ risk – 20-fold greater in the Vitamin D Deficient. BAME, African Americans, the Older, Institutionalised and Obese, are at greatest risk. Sun and ‘D’-supplementation – Game-changers? Research urgently required.

Pleased to share another letter to the BMJ (The English equivalent of the NEJM) this time coauthored with 30 others, and structured around a pre-print examining vitamin D levels in hospital COVID-19 patients in relation to seriousness of condition.

Still, with others, trying to get more such studies looking at vitamin D levels in COVID patients and outcomes. Cheap inexpensive and easy and relatively quick to do . . . but requires the will and funding . . .

Acceptance of simple solutions, that may involve a little embarrassment have historically always taken many years

Hopefully in a more connected world we can do better, and take the necessary steps to determine if Vitamin D deficiency is indeed a significant factor in COVID-19.

An example - washing of hands for infection spread control took more than 20 years to gain acceptance and the proposer Semmelweis got put in a mental asylum for his attempts to get the message out :(

E.g. Washing hands before delivery of babies

https://www.upworthy.com/women-were-...igured-out-why
https://en.wikipedia.org/wiki/Ignaz_Semmelweis

"Women were dying from childbirth at hospitals. This 19th-century doctor figured out why. "

Doctors were doing autopsies and then attending births without washing hands or instruments. Semmelweis worked out that this was the problem and order washing with chlorine based disinfection and it worked - mortality was greatly reduced but . . .

"Unfortunately, the Semmelweis' colleagues did not embrace his findings — they were outraged at the suggestion that they were the cause of their patients' deaths. Semmelweis was fired from the hospital and eventually committed to an asylum. He died at the asylum two weeks later. (Several historians believe that he died, after being beaten at the asylum, from sepsis — an infection in the bloodstream caused by germs.)


"It would take about 20 years before his ideas would start to be accepted by the medical community. And even then, it was "germ theory" — and the work of Louis Pasteur in the late-1860s — that really convinced anyone of the importance of hygiene and handwashing."

R.B. 05-12-2020 03:40 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
:) :) :) https://www.medscape.com/viewarticle/930152 :) :) :)

Yeeeeeeeeeeeeeeh - woooooooop - woooooooop



COMMENTARY
Does Vitamin D Protect Against COVID-19?

JoAnn E. Manson, MD, DrPH (Harvard and Brigham)

May 11, 2020


HUGE THANKS Dr Manson

AlaskaAngel 05-14-2020 12:33 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Hi Everybody

Still firmly taking my vitamin D (thanks, RB!)

https://scitechdaily.com/vitamin-d-d...change-advice/

R.B. 05-14-2020 04:16 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
^ if you read my paper from 23rd March you may notice a certain resemblance in terms of content and posit.

https://www.mitofit.org/images/e/ec/...fit_200001.pdf

"The COVID-19 virus emerged in 2019. Mortality rates as at 20th March 2020 are much higher in southern than northern Europe. The elderly, and those with pre-existing conditions, are at greatest risk. It is hypothesised, vitamin D deficiency may significantly compromise, respiratory immune response function, thus greatly increasing risk of COVID-19 hospitalisation, severity and mortality. Winter vitamin D levels: based on; limited data, including; historical measured regional vitamin D deficiency rates (<25nmol/L), intakes, and plasma vitamin D levels; fortification and supplementation policies; and public vitamin D awareness: appear to be significantly lower in southern, than northern Europe. In respiratory system conditions, such as influenza, vitamin D has wide-ranging and fundamental roles, including through: gene transcription via COVID-19 relevant VDR (Vitamin D Receptor) pathways; ACE1 and ACE2 pathways; wider immune function; airway epithelial cell tight-junction function and integrity; and mitochondrial related, energetics, apoptosis and inflammation, management. Studies suggest vitamin D supplementation may be protective against respiratory conditions, in ‘D’ deficient persons. Would vitamin D supplementation of the deficient, mitigate the severity of the current COVID-19 outbreak; and reduce future, likely upcoming, seasonal amplification effects?"

Media Coverage / credit received by my paper = Zero :(

Citation of my paper in the above - nope

Depressing

R.B. 05-22-2020 01:31 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Is ethnicity linked to incidence or outcomes of covid-19?
BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1548 (Published 20 April 2020) Cite this as: BMJ 2020;369:m1548

https://www.bmj.com/content/369/bmj.m1548/rr-19

Rapid Response:
Low vitamin D: high risk COVID-19 mortality? Seven preprints suggest that is case. Does low ‘D’ put BAME and elderly, at particular COVID-19 risk? Testing and Data Required.

Dear Editor

BMJ rapid response letters and supporting references[1, 2] posited vitamin D deficiency disease features in COVID-19 severity and mortality risks.[3] Brown and Sakar,[4] in March, suggested vitamin D plasma deficiency differentials may help account for mortality rate differences between European countries. . , (MORE)

Pleased to report issue did get some brief but appreciated and important coverage in some UK nationals and I featured in a BBC world service daily debate on COVID and Vitamin D.

The Red Cross in one area in India is giving out free vitamin D to the at risk.

I have heard but have no evidence that the importance of vitamin D in relation to COVID is being stressed in China.


VERY DEPRESSINGLY above BMJ item was high on google news tabs on related searches and disappeared over night where I live - on balance of probabilities censored - purely factual - making no representations - simply calling for research - in the real world people are dying and economies being shattered - and just maybe ensuring people are vitamin D sufficient may be able to help - should that option not be explored as a matter of urgency as suggested by this USA Congressman https://www.wisn.com/article/could-v...id-19/32644971, which link no longer works in UK despite showing up on google news.

R.B. 06-15-2020 04:31 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Is ethnicity linked to incidence or outcomes of covid-19?
BAME Children at High Risk of PIMS-TS, a Covid-19 Kawasaki-Like Disease - Vitamin D, a Factor? – Testing and Data Urgently Required

https://www.bmj.com/content/369/bmj.m1548/rr-25

R.B. 06-15-2020 04:36 AM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Re Congressman Grothman asking CDC to look at COVID-19 and vitamin D and recent misinformed media reports suggesting there is no link between COVID-19 and vitamin D deficiency / levels . . . Voice of America fact check


Daily Debunk

Claim: Research illustrates a clear correlation between vitamin D deficiencies and (higher) COVID-19 mortality rates.

Verdict: True

Read the full story at: PolitiFact


Research illustrates a clear correlation between vitamin D deficiencies and (higher) COVID-19 mortality rates.

https://www.voanews.com/covid-19-pan...d-19-mortality

https://www.politifact.com/factcheck...en-vitamin-d-/

and please see Editors note here -

https://nutrition.bmj.com/content/ea...ph-2020-000089

"The article by Lanham-New et al. constitutes a consensus of experts from the UK and other countries. They all agree that avoiding low vitamin D status is important for many health reasons, and possibly also because of the potentially, but not proven lower risk of infection and death from Covid-19, as more studies are needed. They agree that avoiding deficiency can usually be achieved within current national guidelines, highlighting vitamin D-rich foods and moderately dosed vitamin D supplements.

Because the infection is still new, there is much that needs to be learned and many investigators are making great strides in understanding the role of specific nutrition factors for resisting infection and for the most effective treatment of ongoing disease.

This Journal strives to apply rigorous scientific standards to all its content. Categorical general statements about the lack of benefit from vitamin D are not supported by any evidence at this time, not least because a growing number of observations and study results that point to an important role. They can even be contradictive as many people, especially in northern latitudes have poor vitamin D status, which is one of the overarching messages of the article.

In the end, it is good to emphasize that the authors all agree, that preventing vitamin D deficiency is important for many health reasons, but for the prevention of deficiency the use of supplements with more than 4000 IU vitamin D is rarely necessary or justified and is strongly cautioned against.
"

R.B. 06-18-2020 01:14 PM

Re: Coronavirus - is low vitamin D a factor - vitamin D and respiratory conditions
 
Accepted today 😊– had my doubts they would accept - so Delighted

High BAME COVID-19 Mortality - Ethnicity a Factor? – Yet: Cardiovascular Disease – Hypertension – Diabetes - were rare in 1920-60’s in Indigenous Africans – Vitamin D an underrated factor?

https://www.bmj.com/content/369/bmj.m1548/rr-26

And there was some serious media coverage of the issue :)


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