6 ms·

> Conclusions: In conclusion, low serum 25 (OH) Vitamin-D level was significantly associated with a higher risk of COVID-19 infection. The limited currently ava

> Conclusions: In conclusion, low serum 25 (OH) Vitamin-D level was significantly associated with a higher risk of COVID-19 infection. The limited currently available data suggest that sufficient Vitamin D level in serum is associated with a significantly decreased risk of COVID-19 infection. This is not as strong a conclusion as it first sounds, for two reasons. 1. This says nothing about Vitamin D as a cure once you got infected. It might work, or it might not, but this study simply does not address the question at all. 2. Correlation (in this case the word used was "association") does not mean causation. A simple example would be something like this: people deficient in Vitamin D are more likely to spend a lot of times indoors, where the transmission of the virus via aerosols is higher. People who spend a lot of time outdoors will get both more Vitamin D and less exposure to the virus. So, if you supplement with Vitamin D but you spend a lot of time indoors, you might, or you might not get higher protection, but this study does not say it.

TheBlight 5y ago
Getting more sun and/or taking vitamin D supplements (in moderation) seem like low risk things to try given the potential benefit.
- yosito 5y ago
  I agree in the short term, but in the long term, sun exposure is a skin cancer risk.
  - NoNotTheDuo 5y ago
    In other news, living is strongly correlated to eventually dying
    - mmazing 5y ago
      Almost everyone who has ever been alive eventually died. It's a dangerous condition.
  - credit_guy 5y ago
    > in the long term, sun exposure is a skin cancer risk. That is not so clear. Moderate, non-burning sun exposure might have benefits that exceed the risks, according to [1]. I'll leave here the relevant quote: The message of sun avoidance must be changed to acceptance of non-burning sun exposure sufficient to achieve serum 25(OH)D concentration of 30 ng/mL or higher in the sunny season and the general benefits of UV exposure beyond those of vitamin D. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129901/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129901/
  - hn8788 5y ago
    Skin cancer also has a very low mortality rate if you detect it early, which is pretty simple because you can see it growing on you.
    - mcswell 5y ago
      Kinda hard to see it growing on your back. (As a kid I got sunburned--mostly on my back--several times, and am therefore at risk.) Also, as one (or at least I) gets older, you get a lot of other skin "things": "age" spots, basal and squamous cell carcinomas (kinds of skin cancer, but not as concerning as melanoma), actinic keratosis (non-cancerous), keloids, freckles, and on and on. There are lots of guides on-line to distinguishing among them, but I've seen spots on myself that looked concerning, only to have my dermatologist (old and very experienced) tell me they're nothing to worry about--and sure enough, ten years later nothing has happened. And on the other hand he found and removed a squamous cell carcinoma that I couldn't even see (yes, even with my glasses on!), confirmed by biopsy. So I would never trust myself to detect a melanoma, or even a basal or squamous cell carcinoma. I visit the dermatologist once or twice a year, and he always reminds me to stay out of the sun (because cancer) and out of the full moon (because werewolf).
  - captaincurrie 5y ago
    I agree, but in the long term, time exposure is a death risk
destitude 5y ago
https://pubmed.ncbi.nlm.nih.gov/34684596/ https://pubmed.ncbi.nlm.nih.gov/34684596/ Conclusions: The datasets provide strong evidence that low D3 is a predictor rather than just a side effect of the infection. Despite ongoing vaccinations, we recommend raising serum 25(OH)D levels to above 50 ng/mL to prevent or mitigate new outbreaks due to escape mutations or decreasing antibody activity.
- jbverschoor 5y ago
  Well. Maybe people exposed to sunlight are on holiday, and therefore less stressed and having a better lifestyle. Remember “half of Italy” died in the beginning. Plent of vitamin d there
  - dukeyukey 5y ago
    Not as much as you'd think; Rome is about the same latitude as Chicago, and they get a similar amount of sunshine (2,500 hours annually, according to a quick Google).
    - polskibus 5y ago
      Most people don’t work outdoors, latitude does not matter much.
      - chithanh 5y ago
        On the contrary. When it comes to skin type vs. vitamin D levels, then people with darker skin who live in the North are more deficient as you would expect. Coincidentally or not, PoC/BAME folks have worse COVID outcomes in these countries, which could be due to vitamin D deficiency. There is of course socio-economic component too.
  - toolz 5y ago
    Italy has very high vitamin d deficiency
  - vibrato2 5y ago
captainmuon 5y ago
Sure, but it would rule out that Vitamin D is harmful wrt. COVID-19, right? And you could look at the subset of data where people have a high vitamin D level due to supplements. If there is still a relationship there, then the argument for a causal relationship would be stronger.
AndrewBissell 5y ago
> This is not as strong a conclusion as it first sounds, for two reasons. 1. This says nothing about Vitamin D as a cure once you got infected. It might work, or it might not, but this study simply does not address the question at all. Huh? Everyone I know who thinks vitamin D might be helpful says you need to supplement with it on a consistent, ongoing basis, not try to take big catch-up doses once you get sick or wind up in the hospital. Given how safe and cheap it is (and that adequate vitamin D levels may be associated with a range of other improved health outcomes as well), even a 25% reduction in those risks would be a big deal.
hn_throwaway_99 5y ago
Your points seem like massive strawmen to me: > This says nothing about Vitamin D as a cure once you got infected. I mean, yeah. There is literally nothing in the study, or literally any of the research I've read, that says anything about vitamin D being a benefit after you get infected, so I'm not sure why one would appear to think that's implied. It's like saying "Hey, this study isn't as strong as you think, because this study says nothing about vitamin D increasing your IQ." The "correlation is not causation!!" bromide, while useful to understand in context, is overused, often given with examples that are more likely to be outlandish, with no backing evidence, than with a more straightforward explanation. As others have commented, there is evidence that vitamin D itself has a protective effect.
- the_mitsuhiko 5y ago
  > The "correlation is not causation!!" bromide, while useful to understand in context, is overused, often given with examples that are more likely to be outlandish I beg to differ. In fact way too many times people fall afoul of the ecological fallacy and it takes a bloody long time to be noticed.
- credit_guy 5y ago
  > The "correlation is not causation!!" bromide, while useful to understand in context, is overused. Maybe then we should take a look at an actual double blind randomized controlled trial. Preferably one with thousands of participants. Luckily, exactly such a trial just ended. It lasted 5 years, it started in 2016 and ended in 2021. It considered acute respiratory infections; Covid was not one at the beginning of the trial, but was by the end of it. Here's the conclusion: Monthly bolus doses of 60 000 IU of vitamin D did not reduce the overall risk of acute respiratory tract infection, but could slightly reduce the duration of symptoms in the general population. These findings suggest that routine vitamin D supplementation of a population that is largely vitamin D replete is unlikely to have a clinically relevant effect on acute respiratory tract infection. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30380-6/fulltext https://www.thelancet.com/journals/landia/article/PIIS2213-8...
  - 5y ago
marcodiego 5y ago
Yes. Correlation does not implies causation. People with any kind of vitamin deficiency are probably less careful with their own health. There are many variables that must be removed before we can finally say anything with confidence about any vitamin and COVID-19.
Syzygies 5y ago
Before my first vaccine dose I asked a former student (who admitted Mt Sinai's first case, and watched countless patients die) about my vitamin D and Clemastine regimen. I didn't want to interfere with the vaccine. "No good deed goes unpunished!" is a bromide, that I was worried about here. "Correlation does not mean causation" is standard statistical caution. She advised me to stop the Clemastine, despite no news whatsoever about its effects after the initial study I'd read, just in case it did work. She advised me that my Vitamin D was irrelevant, that the prevailing consensus was that Vitamin D deficiency identified individuals at risk, but that taking Vitamin D didn't alleviate the correlated risk factors. (On the subject of statistical reasoning, I'm not one for conspiracy theories. Conspiracy fatigue is however just as real as COVID fatigue. Even the LA coroner said RFK was shot point blank from behind, but after JFK... Still, a bat virus lab in Wuhan? I don't know about causality, but that's a pretty choice correlation.)

TheBlight 5y ago

Getting more sun and/or taking vitamin D supplements (in moderation) seem like low risk things to try given the potential benefit.

yosito 5y ago
I agree in the short term, but in the long term, sun exposure is a skin cancer risk.
- NoNotTheDuo 5y ago
  In other news, living is strongly correlated to eventually dying
  - mmazing 5y ago
    Almost everyone who has ever been alive eventually died. It's a dangerous condition.
- credit_guy 5y ago
  > in the long term, sun exposure is a skin cancer risk. That is not so clear. Moderate, non-burning sun exposure might have benefits that exceed the risks, according to [1]. I'll leave here the relevant quote: The message of sun avoidance must be changed to acceptance of non-burning sun exposure sufficient to achieve serum 25(OH)D concentration of 30 ng/mL or higher in the sunny season and the general benefits of UV exposure beyond those of vitamin D. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129901/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5129901/
- hn8788 5y ago
  Skin cancer also has a very low mortality rate if you detect it early, which is pretty simple because you can see it growing on you.
  - mcswell 5y ago
    Kinda hard to see it growing on your back. (As a kid I got sunburned--mostly on my back--several times, and am therefore at risk.) Also, as one (or at least I) gets older, you get a lot of other skin "things": "age" spots, basal and squamous cell carcinomas (kinds of skin cancer, but not as concerning as melanoma), actinic keratosis (non-cancerous), keloids, freckles, and on and on. There are lots of guides on-line to distinguishing among them, but I've seen spots on myself that looked concerning, only to have my dermatologist (old and very experienced) tell me they're nothing to worry about--and sure enough, ten years later nothing has happened. And on the other hand he found and removed a squamous cell carcinoma that I couldn't even see (yes, even with my glasses on!), confirmed by biopsy. So I would never trust myself to detect a melanoma, or even a basal or squamous cell carcinoma. I visit the dermatologist once or twice a year, and he always reminds me to stay out of the sun (because cancer) and out of the full moon (because werewolf).
- captaincurrie 5y ago
  I agree, but in the long term, time exposure is a death risk

destitude 5y ago

https://pubmed.ncbi.nlm.nih.gov/34684596/ https://pubmed.ncbi.nlm.nih.gov/34684596/ Conclusions: The datasets provide strong evidence that low D3 is a predictor rather than just a side effect of the infection. Despite ongoing vaccinations, we recommend raising serum 25(OH)D levels to above 50 ng/mL to prevent or mitigate new outbreaks due to escape mutations or decreasing antibody activity.

jbverschoor 5y ago
Well. Maybe people exposed to sunlight are on holiday, and therefore less stressed and having a better lifestyle. Remember “half of Italy” died in the beginning. Plent of vitamin d there
- dukeyukey 5y ago
  Not as much as you'd think; Rome is about the same latitude as Chicago, and they get a similar amount of sunshine (2,500 hours annually, according to a quick Google).
  - polskibus 5y ago
    Most people don’t work outdoors, latitude does not matter much.
    - chithanh 5y ago
      On the contrary. When it comes to skin type vs. vitamin D levels, then people with darker skin who live in the North are more deficient as you would expect. Coincidentally or not, PoC/BAME folks have worse COVID outcomes in these countries, which could be due to vitamin D deficiency. There is of course socio-economic component too.
- toolz 5y ago
  Italy has very high vitamin d deficiency
- vibrato2 5y ago

captainmuon 5y ago

Sure, but it would rule out that Vitamin D is harmful wrt. COVID-19, right? And you could look at the subset of data where people have a high vitamin D level due to supplements. If there is still a relationship there, then the argument for a causal relationship would be stronger.

AndrewBissell 5y ago

> This is not as strong a conclusion as it first sounds, for two reasons. 1. This says nothing about Vitamin D as a cure once you got infected. It might work, or it might not, but this study simply does not address the question at all. Huh? Everyone I know who thinks vitamin D might be helpful says you need to supplement with it on a consistent, ongoing basis, not try to take big catch-up doses once you get sick or wind up in the hospital. Given how safe and cheap it is (and that adequate vitamin D levels may be associated with a range of other improved health outcomes as well), even a 25% reduction in those risks would be a big deal.

hn_throwaway_99 5y ago

Your points seem like massive strawmen to me: > This says nothing about Vitamin D as a cure once you got infected. I mean, yeah. There is literally nothing in the study, or literally any of the research I've read, that says anything about vitamin D being a benefit after you get infected, so I'm not sure why one would appear to think that's implied. It's like saying "Hey, this study isn't as strong as you think, because this study says nothing about vitamin D increasing your IQ." The "correlation is not causation!!" bromide, while useful to understand in context, is overused, often given with examples that are more likely to be outlandish, with no backing evidence, than with a more straightforward explanation. As others have commented, there is evidence that vitamin D itself has a protective effect.

the_mitsuhiko 5y ago
> The "correlation is not causation!!" bromide, while useful to understand in context, is overused, often given with examples that are more likely to be outlandish I beg to differ. In fact way too many times people fall afoul of the ecological fallacy and it takes a bloody long time to be noticed.
credit_guy 5y ago
> The "correlation is not causation!!" bromide, while useful to understand in context, is overused. Maybe then we should take a look at an actual double blind randomized controlled trial. Preferably one with thousands of participants. Luckily, exactly such a trial just ended. It lasted 5 years, it started in 2016 and ended in 2021. It considered acute respiratory infections; Covid was not one at the beginning of the trial, but was by the end of it. Here's the conclusion: Monthly bolus doses of 60 000 IU of vitamin D did not reduce the overall risk of acute respiratory tract infection, but could slightly reduce the duration of symptoms in the general population. These findings suggest that routine vitamin D supplementation of a population that is largely vitamin D replete is unlikely to have a clinically relevant effect on acute respiratory tract infection. https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30380-6/fulltext https://www.thelancet.com/journals/landia/article/PIIS2213-8...
- 5y ago

marcodiego 5y ago

Yes. Correlation does not implies causation. People with any kind of vitamin deficiency are probably less careful with their own health. There are many variables that must be removed before we can finally say anything with confidence about any vitamin and COVID-19.

Syzygies 5y ago

Before my first vaccine dose I asked a former student (who admitted Mt Sinai's first case, and watched countless patients die) about my vitamin D and Clemastine regimen. I didn't want to interfere with the vaccine. "No good deed goes unpunished!" is a bromide, that I was worried about here. "Correlation does not mean causation" is standard statistical caution. She advised me to stop the Clemastine, despite no news whatsoever about its effects after the initial study I'd read, just in case it did work. She advised me that my Vitamin D was irrelevant, that the prevailing consensus was that Vitamin D deficiency identified individuals at risk, but that taking Vitamin D didn't alleviate the correlated risk factors. (On the subject of statistical reasoning, I'm not one for conspiracy theories. Conspiracy fatigue is however just as real as COVID fatigue. Even the LA coroner said RFK was shot point blank from behind, but after JFK... Still, a bat virus lab in Wuhan? I don't know about causality, but that's a pretty choice correlation.)