BACKGROUND Vitamin D population status may have possible unappreciated consequences to the coronavirus disease 2019(COVID-19)pandemic.Αsignificant association between vitamin D sufficiency and reduction in clinical s...BACKGROUND Vitamin D population status may have possible unappreciated consequences to the coronavirus disease 2019(COVID-19)pandemic.Αsignificant association between vitamin D sufficiency and reduction in clinical severity and inpatient mortality from COVID-19 disease has recently been shown,while a recent study has claimed lower COVID-19 cases in European countries with a better vitamin D status.Low serum 25-hydroxyvitamin-D[25(OH)D]was identified as an independent risk factor for COVID-19 infection and hospitalization,and administration of 0.532 mg(21280 IU)of calcifediol or 25(OH)D,followed by 0.266 mg on days 3 and 7 and then weekly until discharge or intensive care unit admission significantly reduced the need for intensive care unit treatment.AIM To elucidate the role of vitamin D European population status in the COVID-19 pandemic,data from the Worldometer were analyzed.METHODS Linear regression explored the correlation between published representativestandardized population vitamin D concentrations and the number of total cases/million(M),recovered/M,deaths/M and serious-critically ill/M from COVID-19 for 26 European countries populated>4 M(Worldometer).Life expectancy was analyzed with semi-parametric regression.Weighted analysis of variance/analysis of covariance evaluated serious-critical/M and deaths/M by the vitamin D population status:Deficient<50,insufficient:50-62.5,mildly insufficient>62.5-75 and sufficient>75 nmol/L,while controlling for life expectancy for deaths/M.Statistical analyses were performed in XLSTAT LIFE SCIENCE and R(SemiPar Library).RESULTS Linear regression found no correlation between population vitamin D concentrations and the total cases-recovered/M,but negative correlations predicting a reduction of 47%-64%-80%in serious-critical illnesses/M and of 61%-82%-102.4%in deaths/M further enhanced when adapting for life expectancy by 133-177-221%if 25(OH)D concentrations reach 100-125-150 nmol/L,sustained on August 15,2020,indicating a truthful association.Weighted analysis of variance was performed to evaluate serious-critical/M(r2=0.22)by the vitamin D population status and analysis of covariance the deaths/M(r2=0.629)controlling for life expectancy(r2=0.47).Serious-critical showed a decreasing trend(P<0.001)from population status deficient(P<0.001)to insufficient by 9.2%(P<0.001),to mildly insufficient by 47.6%(P<0.044)and to sufficient by 100%(reference,P<0.001).For deaths/M the respective decreasing trend(P<0.001)was 62.9%from deficient(P<0.001)to insufficient(P<0.001),65.15%to mildly insufficient(P<0.001)and 78.8%to sufficient(P=0.041).CONCLUSION Achieving serum 25(OH)D 100-150 nmol/L(40-60 ng/mL)(upper tolerable daily doses followed by maintenance proposed doses not requiring medical supervision,Endocrine Society)may protect from serious-critical illness/death from COVID-19 disease.展开更多
文摘BACKGROUND Vitamin D population status may have possible unappreciated consequences to the coronavirus disease 2019(COVID-19)pandemic.Αsignificant association between vitamin D sufficiency and reduction in clinical severity and inpatient mortality from COVID-19 disease has recently been shown,while a recent study has claimed lower COVID-19 cases in European countries with a better vitamin D status.Low serum 25-hydroxyvitamin-D[25(OH)D]was identified as an independent risk factor for COVID-19 infection and hospitalization,and administration of 0.532 mg(21280 IU)of calcifediol or 25(OH)D,followed by 0.266 mg on days 3 and 7 and then weekly until discharge or intensive care unit admission significantly reduced the need for intensive care unit treatment.AIM To elucidate the role of vitamin D European population status in the COVID-19 pandemic,data from the Worldometer were analyzed.METHODS Linear regression explored the correlation between published representativestandardized population vitamin D concentrations and the number of total cases/million(M),recovered/M,deaths/M and serious-critically ill/M from COVID-19 for 26 European countries populated>4 M(Worldometer).Life expectancy was analyzed with semi-parametric regression.Weighted analysis of variance/analysis of covariance evaluated serious-critical/M and deaths/M by the vitamin D population status:Deficient<50,insufficient:50-62.5,mildly insufficient>62.5-75 and sufficient>75 nmol/L,while controlling for life expectancy for deaths/M.Statistical analyses were performed in XLSTAT LIFE SCIENCE and R(SemiPar Library).RESULTS Linear regression found no correlation between population vitamin D concentrations and the total cases-recovered/M,but negative correlations predicting a reduction of 47%-64%-80%in serious-critical illnesses/M and of 61%-82%-102.4%in deaths/M further enhanced when adapting for life expectancy by 133-177-221%if 25(OH)D concentrations reach 100-125-150 nmol/L,sustained on August 15,2020,indicating a truthful association.Weighted analysis of variance was performed to evaluate serious-critical/M(r2=0.22)by the vitamin D population status and analysis of covariance the deaths/M(r2=0.629)controlling for life expectancy(r2=0.47).Serious-critical showed a decreasing trend(P<0.001)from population status deficient(P<0.001)to insufficient by 9.2%(P<0.001),to mildly insufficient by 47.6%(P<0.044)and to sufficient by 100%(reference,P<0.001).For deaths/M the respective decreasing trend(P<0.001)was 62.9%from deficient(P<0.001)to insufficient(P<0.001),65.15%to mildly insufficient(P<0.001)and 78.8%to sufficient(P=0.041).CONCLUSION Achieving serum 25(OH)D 100-150 nmol/L(40-60 ng/mL)(upper tolerable daily doses followed by maintenance proposed doses not requiring medical supervision,Endocrine Society)may protect from serious-critical illness/death from COVID-19 disease.
