10 ms·
Here's a link to the paper: https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v.
by mindviews 6y ago
Here's a link to the paper: https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v...
This is interesting data. I want to see Vitamin D status included in a large population study like this because I've been following two smaller studies covering about a thousand cases total that shows Vitamin D deficiency has a risk ratio of 10 to 20 (more even than being age 80+ in the above study). The studies:
[1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3585561 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3585561
[2] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484
Table 1 in each of those papers show Vitamin D status vs Outcomes. The correlation between Vitamin D status, where Normal is >30 ng/ml (or 75 nmol/L), and death rates is stark.
From [1] (which had n=780 cases) here is the punchline: "98.9% of Vitamin D deficient cases died while only 1.1% of them were active cases. 87.8% of Vitamin D insufficient cases died while only 12.2% of them were active cases. Only 4.1% of cases with normal Vitamin D levels died while 95.9% of them were active cases."
From [2] (which had n=212 cases) here is the punchline: "Of the 212 (100.0%) cases of Covid-2019, 49 (23.1%) were identified mild, 59 (27.8%) were ordinary, 56 (26.4%) were severe, and 48 (22.6%) were critical (Table 1). Mean serum 25(OH)D level was 23.8 ng/ml. Serum 25(OH)D level of cases with mild outcome was 31.2 ng/ml, 27.4 ng/ml for ordinary, 21.2 ng/ml for severe, and 17.1 ng/ml for critical."
Note: the classification for outcomes was "(1) mild – mild clinical features without pneumonia diagnosis, (2) ordinary – confirmed pneumonia in chest computer tomography with fever and other respiratory symptoms, (3) severe – hypoxia (at most 93% oxygen saturation) and respiratory distress or abnormal blood gas analysis results (PaCO2 >50 mm Hg or PaO2 < 0 mm Hg), and (4) critical – respiratory failure requiring intensive case monitoring."
I want to see a dozen more studies like [1] and [2] to see if this holds up to replication with larger populations.
- melvinroest 6y ago"98.9% of Vitamin D deficient cases died while only 1.1% of them were active cases. 87.8% of Vitamin D insufficient cases died while only 12.2% of them were active cases. Only 4.1% of cases with normal Vitamin D levels died while 95.9% of them were active cases." Wait, only 13.3% (1.1 + 12.2) of all the active cases in total were vitamin D insufficient or worse? I thought the majority of people had insufficient vitamin D. This data doesn't fully make sense to me. How come that so few people with a vitamin D insufficiency were active cases? I get that most of them died. But I don't get that so few, less than 15 percent, got to become an active case. Edit: ah, it's an Indonesian study. Nevermind, I wouldn't know the numbers from there.
- ip26 6y agoThe critical question remains though- is vitamin D the causal factor, or instead an indicator of something else?
- deleted 6y ago[deleted]
- excalibur 6y agoSun exposure is far more likely to be the causal factor.
- m463 6y agoand/or a diet deficient in D (or whatever gets converted to D with sunlight exposure)
- gridlockd 6y agoThere's nothing particular that is required in the diet to synthesize Vitamin D3 from the sun. Without sun exposure, you'd have to be eating several pounds of fatty fish every day to get to "healthy" levels from diet alone. You need a supplement. Keep in mind, non-severe Vitamin D deficiency doesn't cause any significant evolutionary pressure, so migrating humans just rolled with it - to this day.
- ip26 6y agoThat, or perhaps a lack of sun exposure is linked to having preexisting conditions. Diabetics, COPD, asthmatics, etc as a group probably tend to spend less time outside.
- slg 6y agoI agree, we need better evidence on all the vitamin D claims. Comparing rich white people in the suburbs who have lots of open land to get sun and use for exercise versus poorer darker skinned people in dense inner city apartments who spend most of their time inside introduces numerous confound factors that will be highly correlated with vitamin D.
- martingoodson 6y agoIn case you weren't aware, controlled trials have shown that vitamin d supplementation protects against respiratory disease [1]. This is evidence that the association you highlight is more than a spurious correlation. It's likely to be causal. [1] https://www.bmj.com/content/356/bmj.i6583 https://www.bmj.com/content/356/bmj.i6583
- m463 6y agoA friend of mine had cancer and they had him taking D3 immediately. also I was out shopping recently and they seemed to sell many varieties of D3, but I didn't see any other D vitamins offered for sale. Is D deficiency really D3 deficiency? or have the other D vitamins sold out?
- vixen99 6y agohttps://vitamindwiki.com/ https://vitamindwiki.com/ is a useful aggregate site for papers (peer-reviewed and others) on vitamin D. The latter is cholecalciferol (https://en.wikipedia.org/wiki/Cholecalciferol https://en.wikipedia.org/wiki/Cholecalciferol). https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona... (excellent series for all vitamins) Different manufacturers = varieties? It's the same stuff or should be.
- leto_ii 6y agoThe way I understood it, D3 is the easiest one to absorb. Both D2 and D3 do the same thing, but their efficiency is different.
- odrekf 6y agoAs a vegan, I learned that there's D2 (comes from plants) and D3 (comes from animals), and they are the same as far as I know. Not sure about using them for treatments.
- irishcoffee 6y agoAs a carnivore I’ve learned the same.
- ashtonkem 6y agoTwo takeaways. [2] is pretty scary. As a 30 year old I know that my chance of death is low, but I’d like to avoid a “severe” or “critical” case. There are a large number of unpleasant states between “fine” and “dead” that I’d like to not experience. A 50/50 chance of it being no big deal are worse odds than I’d prefer. [1] is sending me back out onto the patio this weekend for tanning.
- Filligree 6y agoUnless you spend literally hours outside every day, it's not likely to be enough. Get some cod liver oil, drink a tablespoon every day. Does wonders.
- hanoz 6y agoI heard British prof Steve Jones on the radio recently say that 15 minutes in the middle of the day was enough at this time of year.
- xkapastel 6y agoPosts like this really need to specify what type of person they are talking about. 15 minutes is very clearly not enough for someone with dark skin.
- pbowyer 6y agoThe Centre for Evidence-Based Medicine at Oxford did a rapid review of the literature on Vitamin D: https://www.cebm.net/covid-19/vitamin-d-a-rapid-review-of-the-evidence-for-treatment-or-prevention-in-covid-19/ https://www.cebm.net/covid-19/vitamin-d-a-rapid-review-of-th... Unsurprisingly there's no direct clinical evidence.
- gridlockd 6y ago> Unsurprisingly there's no direct clinical evidence. "We searched for trials and didn't find any" Unsurprisingly, there haven't been any (completed) trials on this particular combination of novel disease and possible prevention/treatment yet. I'm concerned that people conflate "no evidence for efficacy" with "it doesn't work" instead of "we don't know if it works". You always start out with "no evidence". There are studies that put serum Vitamin D levels against COVID-19 outcomes and they show a highly significant correlation. That's not "causal evidence", but it should put you on alert, you shouldn't be waiting for 2021 for possible Vitamin-D trials to complete. As the authors of that review are saying, you should be supplementing anyway, whether there is a causal relationship or not.
- jansan 6y agoYou would see tons of research going on if there was more money to be made with Vitamin D.
- trekrich 6y agovery true.
- emmelaich 6y agoNot so sure. Vitamin D is cheap to make.
- 0-_-0 6y agoI don't see why, since vitamin D is not patentable. If you spend the money on research others can make money from it making you lose out. Same reason why herbs are not researched even though they've been used for medicinal purposes for thousands of years: you can't patent a plant.
- 0-_-0 6y ago> I want to see Vitamin D status included in a large population study like this Although vitamin D is not mentioned in this study, it does show that black people have a hazard ratio of about 2 compared to whites. In the UK black people would be more vitamin D deficient than white people. Now that I think about it, isn't the potential for vitamin D deficiency the reason there are white people in the first place?
- lrpublic 6y agoFrom NHS advice on vitamin D referenced in my previous comment “Some people will not get enough vitamin D from sunlight because they have very little or no sunshine exposure.” .. “ If you have dark skin – for example you have an African, African-Caribbean or south Asian background – you may also not get enough vitamin D from sunlight.”
- wongarsu 6y ago> Now that I think about it, isn't the potential for vitamin D deficiency the reason there are white people in the first place? Yes. Pale skin has better vitamin D production in low light, while black skin avoids skin damage even in extreme sunlight. Skin color is just evolution finding the right trade-off for the local climate.
- Zach_the_Lizard 6y agoSickle cell disease is also more common in people of African origin, so that could be another reason for a higher hazard ratio.
- russfink 6y agoIs there any data showing which patients took D supplements (or daily multivitamin) vs having naturally normal/high levels? Medical people, does the answer matter?
- wolfi1 6y agoI'm a little bit hesitant about vitamin deficiency. this sounds like orthomolecular medicine and I wouldn't trust that. I'm especially hesitant if that vitamin is fat-soluble because it can accumulate in your body fat and eventually be poisonous.
- dassafina 6y agoI am curious, what does it take to innovate in vitamin level testing space? Being able to know vitamin level in your body at any given day just like you can measure your heart rate. Not via mailing in blood sample, but something simpler. is it too far fetched to think that we can have something like a watch to be able to measure our vitamin levels regularly?
- myself248 6y agoI'd picture something like a finger-prick blood sampler akin to a glucose meter. Might not be something I'd do every day forever, but I could see doing daily samples for a week to get a feel for aboroption, then occasionally to check how my supplements and sun exposure are working. If you could build a thing that can measure several different parameters depending on which test strips you load into it, I'd buy a pack of vitamin D strips, a pack of vitamin B, a pack of testosterone, and pack that looks for markers of inflammation. Heck yeah. My doctor would eat that data right up.
- dominotw 6y agoI've been thinking about vitamin D all last week after listening to Dr. Rhona patrick on joe rogan podcast( dont' hate). I haven't found and answer to this, if Vitamin D is such big factor then why aren't vitamin D deficient populations in the subcontinent ( india/pakistan ..) being hit hard.
- iddiid 6y agoSince aging reduces vitamin D production in skin, we have that vitamin D level is correlated with age that is correlated with worse response to COVID-19. Aging reduces vitamin D production in skin. There is a decrease in the concentration of 7-dehydrocholesterol in the epidermis in old compared with young individuals and a reduced response to UV light, resulting in a 50% decrease in the formation of previtamin D3