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Vitamin D and SARS-CoV-2 virus/COVID-19 disease
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  • Published on:
    Existing meta-analysis of serum vitamin D and pulmonary function across nine population-based cohort studies contributes to the evidence base on vitamin D and respiratory health
    • Jiayi Xu, Postdoctoral Fellow Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai
    • Other Contributors:
      • Dana B. Hancock, Senior Genetic Epidemiologist & Director
      • Patricia A. Cassano, Professor & Director

    Lanham-New et al. reviewed current evidence of vitamin D associations with health conditions that are pertinent to SARS-CoV-2 virus/COVID-19 disease. Their review highlighted the importance of a well-balanced diet, including an adequate amount of vitamin D intake, to boost the immune system and to resist viral infection. Lanham-New et al. also noted positive associations reported in a single study between the blood metabolite 25-hydroxyvitamin D (25OHD) and lung function and noted that “formal systematic reviews/meta-analyses of these associations are urgently required.” We would like to draw attention to several published reports of observational cohort studies evaluating the association of serum 25OHD with lung function (1; 2; 3; 4; 5; 6; 7; 8; 9; 10; 11; 12; 13; 14; 15; 16; 17; 18) and to our meta-analysis that investigated this association across nine large population-based cohort studies (total N=27,128) (19).
    Our cross-ancestry meta-analysis included adults (age range: 19-95 yrs) living in northern latitudes (e.g. the Netherlands, Iceland, northern part of U.S.) and adults with darker skin tones (i.e., African ancestry participants), who may be at greater risk of vitamin D deficiency given limited sun exposure or slower production of vitamin D in the skin. Prior to combining association results for meta-analysis, the lung function outcomes, exposure (25OHD), and the covariates were harmonized, and the same statistical models were applied across the nine coh...

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    Conflict of Interest:
    None declared.
  • Published on:
    Avoid vitamin D deficiency
    • Bryndís Eva Birgisdóttir, Professor Unit for Nutrition Research, Faculty of Food Science and Nutrition, University of Iceland and Landspitali-University Hospital

    The article by Lanham-New et al. constitutes a consensus of experts from the UK and other countries. They all agree that avoiding low vitamin D status is important for many health reasons, and possibly also because of the potentially, but not proven lower risk of infection and death from Covid-19, as more studies are needed. They agree that avoiding deficiency can usually be achieved within current national guidelines, highlighting vitamin D-rich foods and moderately dosed vitamin D supplements.

    Because the infection is still new, there is much that needs to be learned and many investigators are making great strides in understanding the role of specific nutrition factors for resisting infection and for the most effective treatment of ongoing disease.

    This Journal strives to apply rigorous scientific standards to all its content. Categorical general statements about the lack of benefit from vitamin D are not supported by any evidence at this time, not least because a growing number of observations and study results that point to an important role. They can even be contradictive as many as many people, especially in northern latitudes have poor vitamin D status, which is one of the overarching messages of the article.

    In the end, it is good to emphasize that the authors all agree, that preventing vitamin D deficiency is important for many health reasons, but for the prevention of deficiency the use of supplements with more than 4000 IU vitamin D is rarel...

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    Conflict of Interest:
    None declared.
  • Published on:
    Vitamin D 25OHD 40ng/ml is required to reduce risk of serious COVID-19 symptoms

    This article contains no arguments or evidence for the adequacy of the UK government recommendations for vitamin D: 400IU (10ug) vitamin D3 (cholecalciferol) for adults or for its aim, which is to ensure the majority of the population attain 25OHD levels above 10ng/ml (25nmol/L). The dosages and 25OHD levels recommended by the US government are only marginally higher.

    The Endocrine Society (1) defines levels below 20ng/ml as deficient, and levels between 21 and 29ng/ml as insufficient. Pastoral Maasai and Hadzabe hunter-gatherers (2) average 46ng/ml 25OHD.

    Of 55 hospitalised COVID-19 patients in the Philippines (3) with 25OHD levels greater than 30ng/ml, 47 had only mild symptoms, without pneumonia, while only two of 157 patients with 25OHD levels below 30ng/ml had mild symptoms. The symptoms of the others were 55: ordinary (CT confirmed pneumonia with fever and respiratory symptoms); 54: severe (hypoxia and respiratory distress) and 46: critical (respiratory failure). These levels are the average of multiple measurements, including well before the patients became ill.

    A similarly sharp dichotomy in outcomes above and below 30ng/ml 25OHD is reported in Indonesian COVID-19 patients (4). The death rate for those with 25OHD levels greater than 30ng/ml was 4.2%; for those with levels 20 to 30ng/ml: 49.1% and for those with less than 20ng/ml: 46.7%.

    In the UK and other countries COVID-19 infection precipitates a potentially deadly condition in...

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    Conflict of Interest:
    None declared.
  • Published on:
    A Position Statement from the COVID-19 Taskforce of the NNEdPro Global Centre for Nutrition and Health, on Vitamin D and high-risk groups in the COVID-19 pandemic
    • Shane McAuliffe, Science Communications Lead NNEdPro Global Centre for Nutrition and Health - Nutrition & Covid-19 Taskforce
    • Other Contributors:
      • Elaine Macaninch, Lead for Patient, Public and Practitioner Outreach
      • James Bradfield, Lead for Education, Awareness, and Implementation
      • Dominic Crocombe, Co-Chair Exec
      • Sumantra Ray, Co-Chair Ex-Officio

    We acknowledge increasing concerns around high-risk groups and COVID-19, about both susceptibility and clinical outcomes. There are many additional factors that are worthy of further research, including the potential role of ethnicity (1-3), inadequate vitamin D status (including both insufficiency and clinical deficiency) (4-6) and inequalities in socio-economic status (7,8). This is not an exhaustive list, and there are many other factors to consider, especially as COVID-19 is a new disease. Our understanding of its interactions, including those with nutrition are continually evolving and with it, so is the evidence base that can inform practice.

    There has been a focus on groups at higher risk during the pandemic, who also tend to be at higher risk of micronutrient deficiencies and poorer overall nutrition, and in such vulnerable groups, diet alone may be insufficient to meet requirements, so micronutrient deficiencies pose a considerable risk to health. In such cases, the immune system may be supported by supplementation, particularly to help correct deficiencies and attenuate the effects of concurrent treatments (9). These observations are particularly prudent in the case of Vitamin D, in which sufficiency is difficult to achieve in the general population at certain times of the year (10) and all year round in vulnerable populations (4,5,11). This is clearly evident for those in residential care, meaning supplementation will be essential to meet requirements....

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    Conflict of Interest:
    None declared.
  • Published on:
    Existing meta-analysis of serum vitamin D and pulmonary function across nine population-based cohort studies contributes to the evidence base on vitamin D and respiratory health
    • Jiayi Xu, Postdoctoral Fellow Pamela Sklar Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai
    • Other Contributors:
      • Dana B. Hancock, Senior Genetic Epidemiologist & Director
      • Patricia A. Cassano, Professor & Director

    Lanham-New et al. reviewed current evidence of vitamin D associations with health conditions that are pertinent to SARS-CoV-2 virus/COVID-19 disease. Their review highlighted the importance of a well-balanced diet, including an adequate amount of vitamin D intake, to boost the immune system and to resist viral infection. Lanham-New et al. also noted positive associations reported in a single study between the blood metabolite 25-hydroxyvitamin D (25OHD) and lung function and noted that “formal systematic reviews/meta-analyses of these associations are urgently required.” We would like to draw attention to several published reports of observational cohort studies evaluating the association of serum 25OHD with lung function (1; 2; 3; 4; 5; 6; 7; 8; 9; 10; 11; 12; 13; 14; 15; 16; 17; 18) and to our meta-analysis that investigated this association across nine large population-based cohort studies (total N=27,128) (19).
    Our cross-ancestry meta-analysis included adults (age range: 19-95 yrs) living in northern latitudes (e.g. the Netherlands, Iceland, northern part of U.S.) and adults with darker skin tones (i.e., African ancestry participants), who may be at greater risk of vitamin D deficiency given limited sun exposure or slower production of vitamin D in the skin. Prior to combining association results for meta-analysis, the lung function outcomes, exposure (25OHD), and the covariates were harmonized, and the same statistical models were applied across the nine coh...

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    Conflict of Interest:
    None declared.
  • Published on:
    POPULATION RESILIENCE We all need optimal back ground immunity, ahead of a second Covid-19 wave
    • Helga M Rhein, retired general practitioner previously Sighthill Health Centre, 380 Calder Road, Edinburgh EH11 4AU

    POPULATION RESILIENCE

    We all need optimal back ground immunity, ahead of a second Covid-19 wave

    In your report (1) you mention the value of sufficient vitamin D for a healthy immune system. You are missing out, however, that the immune function and regulation of appropriate genes and enzymes need a higher vitamin D level (25(OH)D), higher than 25 nmol/l (2-5), as does maximal PTH suppression (6) and is the physiological blood levels in outdoor living people (7). All advocate the optimal blood level to be above 75 nmol/l. An extensive evidence collection is maintained on a specified website (8), and improvements in many conditions have been shown when blood levels were higher (osteomalacia (9), heart disease (10), respiratory tract infections (11), depression (12), COPD (13), cancer survival (14-17) and many more), resulting in the worldwide consensus that levels should be higher than 25 nmol/l. A group of 48 scientists has also published a consensus statement in 2015 that a level of 100 nmol/l should be called sufficient (18). To reach such a level from an average UK level (approx 40 nmol/l) one needs much higher doses of vitamin D than 10 mcg (400 IU).

    But your report says a blood level of 25 nmol/l is sufficient and the majority would only need 10 mcg of a D-supplement.
    However, the Institute of Medicine in the US has declared the level of sufficiency as 50 nmol/l, and they advise also higher D-supplement intake. In contrast to the UK where suf...

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    Conflict of Interest:
    None declared.
  • Published on:
    A call for randomized controlled clinical trial, not dismissal, is warranted

    Multiple lines of strong circumstantial arguments supporting the putative role of Vitamin D as candidate pandemic mitigation agents have been made based on unbiased genomics-guided tracing of SARS-CoV-2 targets in human cells which generated some quite unexpected findings. The title of the paper reporting observations is “Tripartite combination of candidate pandemic mitigation agents: Vitamin D, Quercetin, and Estradiol manifest properties of medicinal agents for targeted mitigation of the COVID-19 pandemic defined by the genomics-guided tracing of SARS-CoV-2 targets in human cells”. One of the end points of this contribution is the identification of the tripartite combination of candidate pandemic mitigation agents comprising of Vitamin D/Quercetin/Estradiol. After the completion of the genomics screens, it was really quite unexpected conclusion to reach. However, after the follow-up analyses of available experimental and clinical observations it seems to make more sense. Please see the link below to the paper

    https://doi.org/10.3390/biomedicines8050129

    One of the main conclusions of the paper is that the randomized controlled clinical trial should be conducted to assess the potential clinical efficacy of the tripartite combination.

    Best regards,

    Dr. Gennadi V. Glinsky, MD, Ph.D.
    Correspondence: gglinskii@ucsd.edu
    Web:...

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    Conflict of Interest:
    None declared.