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Vitamin D deficiency is associated with higher hospitalisation risk from COVID-19: a retrospective case-control study (June 2021) Not funded https://pubmed.ncbi.nlm.nih.gov/34139758/ https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgab439/6303537 Large scale, retrospective case-control study North West of England Two hospital groups Lancaster and Tameside and Glossop Objective Is hospitalisation with COVID-19 more prevalent with lower vitamin D levels Individuals with results of serum 25-hydroxyvitamin D (25[OH]D) 1st April 2020 and 29th January 2021 Deficient = less than 25 nmol/L (10 ng/ml) Insufficient = 25-50 nmol/L (10 to 20 ng/ml) N = 80,670 1,808 were admitted to hospital with COVID-19 670 died Primary cohort, n = 58,368 Median vitamin D levels in participants not hospitalised 50 nmol/L (20ng/ml) (interquartile range, IQR 34.0-66.7 nmol/L) Median vitamin D levels in participants hospitalised 35.0 nmol/L (14 ng/ml) (interquartile range, 21.0-57.0nmol/L) p less than 0.005 Similar findings in a validation cohort, n = 21,234 Non-hospitalised = 47.1 nmol/L (IQR 31.8-64.7 nmol/L) Hospitalised patients = 33.0 (IQR 19.4-54.1 nmol/L) p less than 0.005 Adjusted odds ratios Age, sex, seasonal variation- for hospital admission OR = 2.3-2.4 times higher, 25(OH)D less than 50 nmol/L OR for validation cohort, adjusted, = 2.33 No association between low vitamin D levels and in-patient hospital mortality from COVID- 19 in either cohort. Conclusions Vitamin D deficiency is associated with higher risk of COVID-19 hospitalisation. Widespread measurement of serum 25(OH)D and treating any unmasked insufficiency or deficiency through testing may reduce this risk We have clearly demonstrated that vitamin D insufficiency and deficiency exponentially increase the risk of the disease by a factor of 2.3 to 3.6, even after adjustments for age and sex. Vitamin D is anti-inflammatory, and it has been shown to modulate the immune system With its effect on macrophage function and innate immunity, vitamin D may alter the disease manifestations of COVID-19 Vitamin D supplementation should be an important consideration for deficient populations at risk

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