Ingelheim – The study was conducted at the Galilee Medical Center in Nahariya, Israel and was published in the scientific journal on February 3, 2022 PLOS ONE. The retrospective study examined whether and to what extent there is a connection between the vitamin D level before infection and the severity of the disease and mortality due to SARS-CoV-2.
The health records of 1,176 patients admitted to Galilee Medical Center between April 2020 and February 2021 with positive PCR tests were searched for vitamin D levels measured two weeks to two years prior to infection.
This procedure ensures that the vitamin D values determined were measured before the COVID-19 infection and really reflect the potential influence on the course of the disease. If the vitamin D levels were measured directly upon admission to the hospital, the vitamin D levels would probably already be low due to the viral disease, since an infection has a negative effect on the vitamin D level.
14 times greater risk of severe or critical disease with low vitamin D status
The authors of the study divided the patients who had vitamin D levels (in 253 of the 1176 patients) into 4 categories:
- Deficient (< 20 ng/mL 25(OH)D): 133 (52.5%) patients
- Insufficient (20-29.9 ng/ml 25 (OH) D): 36 (14.2 %) Patients
- Sufficient (30-39.9 ng/mL 25(OH)D): 44 (17.3%) patients
- High-normal (>= 40 ng/mL 25(OH)D): 40 (15.8%) patients
When comparing the vitamin D levels with the course of the disease (mild, moderate, severe, critical), the following came out: Of the 87 patients who had a severe or critical course, 76 (87.4%) patients had vitamin D deficiency -Mirror. A direct comparison between a vitamin D deficiency and high-normal vitamin D levels shows that a deficient vitamin D level before infection is associated with a 14 times higher risk of a severe or critical course. In this multivariable analysis (method to examine several statistical variables), the variables age, gender, BMI and previous illnesses (COPD and diabetes) were taken into account. In addition to age and sometimes also COPD and diabetes, the vitamin D level has been confirmed as an independent risk factor for a severe course of COVID-19.
The mortality rate is similar: the rate of deceased patients with adequate vitamin D levels was 2.3%, while the mortality rate in the vitamin D-deficient group was 25.6%.
In the study, the negative influence of a low vitamin D level was particularly pronounced in people over 50 years of age. In patients younger than 50 years, the severity was still associated with vitamin D deficiency, but to a lesser extent.
To classify the study
The results of this study do not show that vitamin D supplementation (at the time of an existing infection) influences the course of the disease, although this certainly makes sense, as other studies with calcidiol administration show (e.g Loucera and. to, 2021). Rather, the results of the study show that a good vitamin D level before infection can (partly) decide whether someone becomes seriously ill with COVID-19 following a SARS-CoV-2 infection.
Good vitamin D levels are therefore part of the complex puzzle that decides whether someone will develop mild, severe or fatal COVID-19. Age, gender, genetic predispositions, dietary habits, previous illnesses and immunity status are other factors.
Especially with regard to the very poor vitamin D levels in Germany (especially currently towards the end of winter), everyone is advised to test the vitamin D level and adjust it to a good level. Ideally, vitamin D3 should be combined with vitamin K2 when supplementing, since the vitamins complement each other optimally in their effect. Vitamin K2 makes taking vitamin D even safer, especially with higher vitamin D dosages. In a recent study by Visser et al. (2022) was also able to show that a poor vitamin K status is highly significantly associated with increased interleukin-6 levels, which play a key role in the development of severe COVID-19 courses and the associated lung damage.
Vitamin D recommendations of the DGE once more reduced to absurdity
The underlying study clearly shows that only vitamin D levels of 30-50 ng/ml are protective and support the immune system. The most important international institutions like the see it similarly American Geriatrics Society and the Endocrine Society. German authorities and the DGE have been recommending 20 ng/ml for years and are therefore outdated. In addition, the German Society for Nutrition (DGE) recommends 800 IU as an estimated value for an appropriate vitamin D intake in the absence of endogenous synthesis. At this dosage and blood levels of 20 ng/ml, positive effects on bone health can be assumed at best, but not on the immune system. How wrong the DGE was mostly is shown by the fact that until 2012 they recommended 200 IU of vitamin D, which is just enough to prevent rickets, but according to the current state of knowledge was “vitamin D homeopathy”. In order to reach blood levels of 30-50 ng/ml, at least 2000 IU of vitamin D daily are usually necessary, often 4000 IU as well. To remedy a deficiency, even higher doses are temporarily necessary. For detailed dosing recommendations for escalation and maintenance dosing, see www.vitamind.science
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