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Efficacy of Vitamin D in helping with COVID

by df fd1 min read8th Sep 202011 comments

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CoronavirusWorld Modeling
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so a new research found that high dose of Vitamin D significantly improve out comes for COVID patient:

https://www.sciencedirect.com/science/article/pii/S0960076020302764?via%3Dihub

another source on facebook claim that:

- A study in Indonesia found that out of the patients that died from COVID-19, 98.9% of them were deficient in vitamin D, while only 4% of the patients with sufficient vitamin D died.

-A study of patients in New Orleans found that 84.6% of the COVID-19 patients in the ICU were deficient in Vitamin D while only 4% of the patients in the ICU had sufficient levels of Vitamin D.

-A study in the Philippines found that for every standard deviation increase in vitamin D people were 7.94 times more likely to have a mild rather than severe COVID-19 outcome and 19.61 times more likely to have a mild rather than critical outcome.

I couldn't find any mention of this on lesswrong, [granted I haven't look very hard], anyone who have done their reseach on this can help me determine the import of Vitamin D in fighting this pandemic?

and if it's true, anyway we can profit from this? any stock or index fund?

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Vitamin D is out of patent so profit margins are limited. Same issue with hydroxychloroquine.

The study is fairly small, so the reduction in deaths (2/50 to 0/25) was not statistically significant. The dramatic reduction in ICU admissions was s/s though. From my perspective the room for doubt on the benefits of vitamin D3 is now very small since this study which was an RCT (randomized trial). I will certainly look at any large RCT if/when it comes in, I am in no state of suspense about this.

Apart from the studies mentioned above, there are numerous other indirect lines of evidence, e.g.:

1. Severity of the disease in migrant communities with dark skin or social mandates of covered skin e.g. Somalians in Sweden, African Americans in the USA. which inhibits D3 production.

2. Death rates in countries with high incidence of vitamin D deficiency e.g. Belgium, Italy, versus those with low levels (Scandinavia even Sweden, who eat oily fish and supplement/fortify).

3. Low impact in countries and communities (e.g. homeless people) with high sun exposure.

There are also very realistic mechanisms and explanations for why and how vitamin D3 would have this effect, and prior studies on the impact of vitamin D3 on respiratory tract infections including other pneumonias.

When looking at the literature in this space, note (as in virtually all areas of medicine) that bad studies abound. Some things to look for: excessively small studies seemingly designed to produce a not s/s result combined with the belief that a non-s/s result == proof there is no result; large intermittent bolus doses used that generate surfeit of D3 then a deficit; excessively small doses; failure to take the D3 with fat to ensure digestion; failure to take vitamin K2 with D3 for optimal results; failure to take into account accumulated deficits and obesity whereby many months or even years of D3 vanish without trace into fat stores; funding sources with vested interests in a certain outcome (e.g. osteoporosis medication suppliers with an interest in a finding that D3 is not useful in treating osteoporosis and you should use their far more expensive product) ...

1df fd3mo>>> 2. Death rates in countries with high incidence of vitamin D deficiency e.g. Belgium, Italy, versus those with low levels (Scandinavia even Sweden, who eat oily fish and supplement/fortify). if you don't mind expanding on this, Germany however have very low fatality rate, yet for data as of 2015 they have the same level of vit D deficency as Italy
2Rafael Harth3moSince we're comparing the mean of several numbers, and there are many factors other than vitamin D influencing those numbers, I think it's a priori not surprising that there are exceptions.
8 comments, sorted by Highlighting new comments since Today at 7:15 PM

Some of the results are reported in really confusing ways:

A study in Indonesia found that out of the patients that died from COVID-19, 98.9% of them were deficient in vitamin D, while only 4% of the patients with sufficient vitamin D died.

These two numbers don't add up to 100%, which indicates immediately that something sketchy is going on. I think what this is describing is two different measurements:

  • Of patients who died, what percentage had vitamin D deficiency? (98.9% deficient, 1.1% sufficient)
  • Of patients who had deficiency or sufficiency, how many died? (4% of sufficient died, [unknown]% of deficient died)

This doesn't change the results in this case, but it's needlessly confusing to report an apples-and-oranges comparison when you could compare apples to apples.

A study of patients in New Orleans found that 84.6% of the COVID-19 patients in the ICU were deficient in Vitamin D while only 4% of the patients in the ICU had sufficient levels of Vitamin D.

Same thing here except they seem to be reporting the same measurement. What category are the remaining 11% in? Or is this reporting two different categories (COVID-19 patients in ICU vs all patients in ICU)?

LWers have been mentioning this topic since at least Feb 29. LWers on Facebook have been mentioning the new study a fair amount, and discussing how much vitamin D to take.

Anyone who has been paying attention has presumably been ensuring that their vitamin D levels are at least 30 ng/mL.

It's hard to make money off of this, which might be part of why it's not front page news in most places.

Is there a consensus on how much to take if you haven't measured your blood levels?

Is this not the kind of topic where there's a consensus. If you want further arguments I wrote a long post on Vitamin D for LW: https://www.lesswrong.com/s/5CNs9wmHWFQTNjFKo/p/c5aycbSsSc38XWPEc

Thanks, that's helpful.

No consensus, but probably at least 1000 iu per day.

Just in case you, like me, wondered whether this was just a high base rate of vitamin d deficiency: no, vitamin d deficiency is common but not that common.

How high does the base rate need to be in order to explain most COVID deaths?

Note that your reference defines deficiency as less than 20 ng/mL, but correlation studies suggest using 30 ng/mL as the COVID-relevant threshold for deficiency.