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Classic case of causation versus correlation. Is COVID-19 more severe because of a Vitamin D deficiency or does severe COVID-19 cause vitamin D deficiency? Or

Classic case of causation versus correlation. Is COVID-19 more severe because of a Vitamin D deficiency or does severe COVID-19 cause vitamin D deficiency? Or perhaps people with Vitamin D deficiencies also not get outside for enough sunlight or eat healthy enough, and poor diet/nutrition results in more severe symptoms of COVID-19?

hirundo 6y ago
It could be that Vitamin D levels are correlated with sun exposure, which improves health via a hormesis response to oxidative stress on the blood in the skin and eyes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122858/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122858/
- SketchySeaBeast 6y ago
  > Vitamin D levels are severely low in the aging population especially in Spain, Italy and Switzerland. This is also the most vulnerable group of population for COVID-19. It could also be that age is the important factor here and that Vitamin D actually isn't relevant at all - as they said Vitamin D is low in all those populations already.
  - vixen99 6y ago
    No, it is relevant because "a cause and effect relationship has been established between the dietary intake of vitamin D and contribution to the normal function of the immune system" & "The (EFSA) Panel considers that the role of vitamin D in the functioning of the immune system applies to all ages, including children." European Food Safety Authority: https://efsa.onlinelibrary.wiley.com/doi/pdf/10.2903/j.efsa.2015.4096 https://efsa.onlinelibrary.wiley.com/doi/pdf/10.2903/j.efsa.... Worth noting that in general and very roughly, at least 85% on average, of old people survive infection with Covid-19 a group which includes those in their 90s.
    - deleted 6y ago
      [deleted]
    - SketchySeaBeast 6y ago
      So if we assume most old people are low in vitamin d, but also most old people survive, does it tell us nothing?
- firethief 6y ago
  Sun also improves health by killing viruses that can cause illness, and by reducing time people spend enclosed in unventilated spaces, where they are prone to respiratory pathogens.
  - AuryGlenz 6y ago
    I’ve never bought the argument that the flu season is caused by people being indoors more (and then contracting or spreading a virus). Most people are still going to their jobs just as much, which is probably where they’d get it anyways. Schools being closed might have an effect, though. Anyways, n=1 but my immune system has seemingly greatly improved from vitamin D supplementation. When I get a cold now there’s at least a chance that I’ll only have major symptoms for a few days, instead of the usual 2 weeks.
GloriousKoji 6y ago
My hypothesis is that COVID-19 is more severe because of a Vitamin D deficiency and old people are more likely to be deficient. The discussion section references a study from 2017 which shows Vitamin D's helps protect against acute respiratory infections, especially those who are D deficient. It mentions the countries with lower levels of vitamin D and higher mortality rates (Spain, Italy, Switzerland) also have an older population. On a different topic: Vitamin D has been touted as this miracle vitamin but studies and trials have shown that it's not effective for improving cardiovascular health or bone density.
hellofunk 6y ago
I’ve been thinking about reports like these for a while, and suppose you had a study that said 100% of all COVID-19 cases in the world are in people who live in areas with less than healthy air pollution. Does that mean the air pollution causes the disease? Because nearly everyone in the world lives in such an area.
KerryJones 6y ago
This is a good point to bring up -- but it was actually proven not to cause Vitamin D deficiency: http://agingbiotech.info/vitamindcovid19/ http://agingbiotech.info/vitamindcovid19/ > Of note, the hospitals tested D levels repeatedly and also had pre-admission levels. The author performed an analysis to determine whether the levels changed much within a patient and found that they did not for 95% of the overall cases examined, which then made up the 212 cases kept for analysis. The vitamin D levels used were pre-admission. Thus, though the data are associative, the reverse causality that the infection caused dropping D levels can be ruled out.
caseysoftware 6y ago
I've been pondering this one too. If there's just correlation, then it makes sense. Odds are older people - especially those in nursing homes - don't get much sunshine and therefore would have lower vitamin D. Alternatively, if there is causation where lower vitamin D levels make you higher risk of infection or a more severe infection, then forcing everyone inside (aka reduced sunshine) via lockdowns is the exactly wrong policy. And if sunshine kills the virus in the first place, then the lockdowns are worse on another front. We should encourage people to hang out in the sun before going inside anywhere. It would be a form of decontamination. Regardless, this is further encouragement to stay away from the NYC subway system!

hirundo 6y ago

It could be that Vitamin D levels are correlated with sun exposure, which improves health via a hormesis response to oxidative stress on the blood in the skin and eyes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122858/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122858/

SketchySeaBeast 6y ago
> Vitamin D levels are severely low in the aging population especially in Spain, Italy and Switzerland. This is also the most vulnerable group of population for COVID-19. It could also be that age is the important factor here and that Vitamin D actually isn't relevant at all - as they said Vitamin D is low in all those populations already.
- vixen99 6y ago
  No, it is relevant because "a cause and effect relationship has been established between the dietary intake of vitamin D and contribution to the normal function of the immune system" & "The (EFSA) Panel considers that the role of vitamin D in the functioning of the immune system applies to all ages, including children." European Food Safety Authority: https://efsa.onlinelibrary.wiley.com/doi/pdf/10.2903/j.efsa.2015.4096 https://efsa.onlinelibrary.wiley.com/doi/pdf/10.2903/j.efsa.... Worth noting that in general and very roughly, at least 85% on average, of old people survive infection with Covid-19 a group which includes those in their 90s.
  - deleted 6y ago
    [deleted]
  - SketchySeaBeast 6y ago
    So if we assume most old people are low in vitamin d, but also most old people survive, does it tell us nothing?
firethief 6y ago
Sun also improves health by killing viruses that can cause illness, and by reducing time people spend enclosed in unventilated spaces, where they are prone to respiratory pathogens.
- AuryGlenz 6y ago
  I’ve never bought the argument that the flu season is caused by people being indoors more (and then contracting or spreading a virus). Most people are still going to their jobs just as much, which is probably where they’d get it anyways. Schools being closed might have an effect, though. Anyways, n=1 but my immune system has seemingly greatly improved from vitamin D supplementation. When I get a cold now there’s at least a chance that I’ll only have major symptoms for a few days, instead of the usual 2 weeks.

GloriousKoji 6y ago

My hypothesis is that COVID-19 is more severe because of a Vitamin D deficiency and old people are more likely to be deficient. The discussion section references a study from 2017 which shows Vitamin D's helps protect against acute respiratory infections, especially those who are D deficient. It mentions the countries with lower levels of vitamin D and higher mortality rates (Spain, Italy, Switzerland) also have an older population. On a different topic: Vitamin D has been touted as this miracle vitamin but studies and trials have shown that it's not effective for improving cardiovascular health or bone density.

hellofunk 6y ago

I’ve been thinking about reports like these for a while, and suppose you had a study that said 100% of all COVID-19 cases in the world are in people who live in areas with less than healthy air pollution. Does that mean the air pollution causes the disease? Because nearly everyone in the world lives in such an area.

KerryJones 6y ago

This is a good point to bring up -- but it was actually proven not to cause Vitamin D deficiency: http://agingbiotech.info/vitamindcovid19/ http://agingbiotech.info/vitamindcovid19/ > Of note, the hospitals tested D levels repeatedly and also had pre-admission levels. The author performed an analysis to determine whether the levels changed much within a patient and found that they did not for 95% of the overall cases examined, which then made up the 212 cases kept for analysis. The vitamin D levels used were pre-admission. Thus, though the data are associative, the reverse causality that the infection caused dropping D levels can be ruled out.

caseysoftware 6y ago

I've been pondering this one too. If there's just correlation, then it makes sense. Odds are older people - especially those in nursing homes - don't get much sunshine and therefore would have lower vitamin D. Alternatively, if there is causation where lower vitamin D levels make you higher risk of infection or a more severe infection, then forcing everyone inside (aka reduced sunshine) via lockdowns is the exactly wrong policy. And if sunshine kills the virus in the first place, then the lockdowns are worse on another front. We should encourage people to hang out in the sun before going inside anywhere. It would be a form of decontamination. Regardless, this is further encouragement to stay away from the NYC subway system!