5 ms·

I can't speak for COPD but I'm very familiar with a different chronic pulmonary disease (Cystic Fibrosis), and it seems to _strangely_ not be a huge risk factor

I can't speak for COPD but I'm very familiar with a different chronic pulmonary disease (Cystic Fibrosis), and it seems to _strangely_ not be a huge risk factor for poor COVID outcomes. https://www.sciencedirect.com/science/article/pii/S1569199320301259 https://www.sciencedirect.com/science/article/pii/S156919932... No one really has a good story for why (and it may not hold) but it seems to be consistent with the idea that the most important variable is truly just age.

411111111111111 6y ago
Last study I read put a 99% correlation on vitamin d deficiency and getting a severe case of covid19. Which was significantly more than age correlated on the same dataset.
- rndgermandude 6y ago
  Vitamin-D deficiency may cause severe covid-19, or severe covid-19 may cause vitamin-D deficiency (covid-19 affects the kidneys second worst after lungs it seems, and you need kidneys for vitamin-D processing), or a little bit of both. Which one it is, is not yet known.
  - ComputerGuru 6y ago
    Vitamin D is fat soluble and “buffered” in the body; all of which is to say that no one goes from good vitamin D levels to being vitamin D deficient in the time it takes to get infected and develop serious Covid-19 symptoms.
    - TeMPOraL 6y ago
      Unless the body starts burning vitamin D during the infection for some reason.
    - rndgermandude 6y ago
      What is usually measured is the calcifediol - aka 25(OH)D - in the blood. It is the liver that produces calcifediol from cholecalciferol - aka vitamin-D3. The kidneys (mostly) then turn that in calcitriol, the actual hormon. Vitamin-D2 aka ergocalciferol works similar in that is is eventually converted by liver and kidneys into calcitriol. Ergocalciferol, calcifediol and it's various precursors can indeed be stored in fat tissue. It is unclear however how severe covid-19 can affect the kidney and liver functions relating to this and release of substances from fat tissue. Right now a lot of research seems to point in the direction that vitamin-D deficiency can indeed lead to more severe covid-19. At the same time there is different research suggesting that covid-19 itself messes with vitamin-D levels as well.
  - jsjohnst 6y ago
    As someone who is severely Vitamin D deficient (I take 50,000IU a week via prescription and still have very low blood test results), both my GI doctor and PCP have indicated it as a risk factor if I was to get infected.
    - rndgermandude 6y ago
      That seems very right. It doesn't matter if covid-19 causes/worsens deficiency or deficiency causes severe covid-19, or both. If you're already deficient the outcome will be that it gets even worse for a deficient person. I was more making my initial comment thinking in the opposite direction: that people who are not deficient shouldn't feel overly secure (and take more risks) just because there is a correlation - with unclear causation.
      - jsjohnst 6y ago
        > If you're already deficient the outcome will be that it gets even worse for a deficient person. Exactly! I definitely agree with all points you made in this follow up.
- valesco 6y ago
  Interesting, however I wonder how they accounted for the fact that most everyone is deficient in vitamin d.
  - jusssi 6y ago
    So you made me curious and I googled. Not quite most everyone, it rather seems to be regional: under 20% in Northern Europe, 30-60% in rest of Europe, up to 80% in Middle East. Source: https://eje.bioscientifica.com/view/journals/eje/180/4/EJE-18-0736.xml https://eje.bioscientifica.com/view/journals/eje/180/4/EJE-1...
    - duncanawoods 6y ago
      Huh, weird. I would have assumed deficiency would be inversely proportional to amount of sunshine. Do people in northern europe really experience so much more “sun on skin” time or is it wholly diet driven?
      - indecisive_user 6y ago
        Melanin reduces the amount of vitamin D synthesized in the skin for the same reason it has protective effects against sunburns. Historically this wasn't a problem since people with more melanin live in sunnier, more UV intense regions. In fact, pale skin may have been an adaptation as people moved north from the equator to combat the decrease in sun exposure/intensity. But people spend much less time outdoors today with AC and the internet, so vitamin D deficiency is especially prominent in dark skinned populations.
      - icebraining 6y ago
        From that link: > The generally adequate vitamin D status in the Nordic countries is due to the use of cod liver oil and supplements (46) and vitamin D fortification, leading to a great improvement in Finland during the last decade (47). Doesn't surprise me; here in the South we don't get deficient enough to cause obvious issues, so we don't pay attention to it.
- adrianN 6y ago
  Here is a good article that summarizes what we know about Vitamin D and Covid-19: https://news.ycombinator.com/item?id=23255647 https://news.ycombinator.com/item?id=23255647

411111111111111 6y ago

Last study I read put a 99% correlation on vitamin d deficiency and getting a severe case of covid19. Which was significantly more than age correlated on the same dataset.

rndgermandude 6y ago
Vitamin-D deficiency may cause severe covid-19, or severe covid-19 may cause vitamin-D deficiency (covid-19 affects the kidneys second worst after lungs it seems, and you need kidneys for vitamin-D processing), or a little bit of both. Which one it is, is not yet known.
- ComputerGuru 6y ago
  Vitamin D is fat soluble and “buffered” in the body; all of which is to say that no one goes from good vitamin D levels to being vitamin D deficient in the time it takes to get infected and develop serious Covid-19 symptoms.
  - TeMPOraL 6y ago
    Unless the body starts burning vitamin D during the infection for some reason.
  - rndgermandude 6y ago
    What is usually measured is the calcifediol - aka 25(OH)D - in the blood. It is the liver that produces calcifediol from cholecalciferol - aka vitamin-D3. The kidneys (mostly) then turn that in calcitriol, the actual hormon. Vitamin-D2 aka ergocalciferol works similar in that is is eventually converted by liver and kidneys into calcitriol. Ergocalciferol, calcifediol and it's various precursors can indeed be stored in fat tissue. It is unclear however how severe covid-19 can affect the kidney and liver functions relating to this and release of substances from fat tissue. Right now a lot of research seems to point in the direction that vitamin-D deficiency can indeed lead to more severe covid-19. At the same time there is different research suggesting that covid-19 itself messes with vitamin-D levels as well.
- jsjohnst 6y ago
  As someone who is severely Vitamin D deficient (I take 50,000IU a week via prescription and still have very low blood test results), both my GI doctor and PCP have indicated it as a risk factor if I was to get infected.
  - rndgermandude 6y ago
    That seems very right. It doesn't matter if covid-19 causes/worsens deficiency or deficiency causes severe covid-19, or both. If you're already deficient the outcome will be that it gets even worse for a deficient person. I was more making my initial comment thinking in the opposite direction: that people who are not deficient shouldn't feel overly secure (and take more risks) just because there is a correlation - with unclear causation.
    - jsjohnst 6y ago
      > If you're already deficient the outcome will be that it gets even worse for a deficient person. Exactly! I definitely agree with all points you made in this follow up.
valesco 6y ago
Interesting, however I wonder how they accounted for the fact that most everyone is deficient in vitamin d.
- jusssi 6y ago
  So you made me curious and I googled. Not quite most everyone, it rather seems to be regional: under 20% in Northern Europe, 30-60% in rest of Europe, up to 80% in Middle East. Source: https://eje.bioscientifica.com/view/journals/eje/180/4/EJE-18-0736.xml https://eje.bioscientifica.com/view/journals/eje/180/4/EJE-1...
  - duncanawoods 6y ago
    Huh, weird. I would have assumed deficiency would be inversely proportional to amount of sunshine. Do people in northern europe really experience so much more “sun on skin” time or is it wholly diet driven?
    - indecisive_user 6y ago
      Melanin reduces the amount of vitamin D synthesized in the skin for the same reason it has protective effects against sunburns. Historically this wasn't a problem since people with more melanin live in sunnier, more UV intense regions. In fact, pale skin may have been an adaptation as people moved north from the equator to combat the decrease in sun exposure/intensity. But people spend much less time outdoors today with AC and the internet, so vitamin D deficiency is especially prominent in dark skinned populations.
    - icebraining 6y ago
      From that link: > The generally adequate vitamin D status in the Nordic countries is due to the use of cod liver oil and supplements (46) and vitamin D fortification, leading to a great improvement in Finland during the last decade (47). Doesn't surprise me; here in the South we don't get deficient enough to cause obvious issues, so we don't pay attention to it.
adrianN 6y ago
Here is a good article that summarizes what we know about Vitamin D and Covid-19: https://news.ycombinator.com/item?id=23255647 https://news.ycombinator.com/item?id=23255647