Metabolism. 2020 Jul 23;154322. doi: 10.1016/j.metabol.2020.154322
JoAnn E Manson 1, Shari S Bassuk 2
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Lines of evidence that vitamin D deficiency is an important modifiable risk factor for COVID-19
- Laboratory studies: Vitamin D is important for immune function, modulates the inflammatory response to infection, and regulates the renin-angiotensin system.
- Ecologic studies: Countries with lower average levels of 25(OH)D or lower solar ultraviolet-B radiation exposure have higher COVID-19 mortality.
- Demographic groups known to be at higher risk of vitamin D deficiency—Black individuals, the elderly, nursing-home residents, and those with obesity, vascular comorbidities, or chronic kidney disease—are also those at high risk of COVID-19 hospitalization and/or mortality.
- Observational studies of individuals tested for SARS-CoV-2: Low 25(OH)D levels are associated with a greater likelihood of testing positive for the virus.
- Observational studies of COVID-19 patients: 25(OH)D levels correlate inversely with COVID-19 severity.
- Observational studies (pre-COVID era): Low vitamin D status is associated with increased risk of acute respiratory tract infections.
- Randomized clinical trials (pre-COVID era): Vitamin D supplementation decreases risk of respiratory tract infection, especially in those with low 25(OH)D levels.