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The authors report data on genetically determined Vitamin D levels and their association with SARS-CoV-2 infection and severe COVID-19 courses. They conclude: "In conclusion, we found no evidence that vitamin D is protective against SARS-CoV-2 infection or COVID-19 severity. "
The main problem of this analysis from GWAS data is, that the observed difference between Vitamin D-levels in quartile 1 (45,6 nmol/l = 18 ng/ml) and quartile 4 (54,0 nmol/l = 21,6 ng/ml) is so small, that no one would it expect to have an effect on the predefined endpoints.
In order to achieve optimum immune responses, a Vitamin D-level of at least 75 nmol/l, preferably >100 nmol/l would be required.
So, as much as this study seems to give an evidence-based conclusion, it is not helpful at all to answer important questions for clinicians:
1) Does Vitamin D-supplementation to achieve OPTIMUM Vitamin D levels reduce the likelihood of SARS-CoV-2 infection?
2) Does a high-dose vitamin D therapy (like 3x 40 000 IU in week 1) in early SARS-CoV-2 infection prevent severe courses of COVID-19, as it was suggested by the randomised intervention study by Castillo et al.
From a clinician’s standpoint, to me it seems clear, that all people should be advised to treat a Vitamin D deficiency of < 75 nmol/l or 30 ng/ml, as there are virtually no risks of Vitamin D supplementation, and possibly many benefits in this Pandemic situation, especially in the immunoc...
From a clinician’s standpoint, to me it seems clear, that all people should be advised to treat a Vitamin D deficiency of < 75 nmol/l or 30 ng/ml, as there are virtually no risks of Vitamin D supplementation, and possibly many benefits in this Pandemic situation, especially in the immunocomprimised elderly patients who frequently will have low Vitamin D levels <25 nmol/l = <10 ng/ml!
Castillo ME, Entrenas Costa LM, Vaquero Barrios JM, Alcalá Díaz
JF, Miranda JL, Bouillon R, Quesada Gomez JM, E¨ ffect of Calcifediol Treatment and best Available Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study. Journal of Steroid Biochemistry and Molecular Biology (2020). doi: https://doi.org/10.1016/j.jsbmb.2020.105751