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It would be instructive to know the vitamin d deficiency rate of the typical 2019 hospitalized population. Or the rate of, say, hospitalized patients in taiwan or new zealand (no covid) compared to their general populace’s.

I’m a big proponent of the idea that vitamin d will likely help against covid 19 but this headline is missing some crucial comparative context.

——

Edit: I’m rather wrong in the part below. Patient only refers to people receiving treatment, so this is an accurate use. Keeping it there for posterity. I believe the rest of my comment still stands.

The headline is inaccurate. The study looked at hospitalized patients. That is a group in much worse health. And all manner of health conditions are correlated with low vitamin d.




So can we please run the study to see if this is correlation or causation? I’m getting quite tired of seeing this vitamin D story with no follow up.

It can’t be that hard right? It’s stuff that you can buy over the counter and that you’d have to use crazy amounts of to overdose.


Its not a hard analysis to do but then they wouldn't be able to publish as easily. The scientific process is not about progress, its about publish or perish. D is perfect for this type of non-sense science as it is correlated with so many things and each one can get dozens of papers out of it.


I wrote this whole long comment talking about all the issues in trying to design a good trial to figure this out, but here's one trial I think will give us some more info, it seems better designed than the other ones I've seen (sample size remains a problem):

https://clinicaltrials.gov/ct2/show/NCT04525820


earlier studies relate vitamin D deficiency to risk for Acute Respiratory Distress Syndromes in general.

the "brandykinin hypothsis" links poor COVID-19 outcomes to vitamin D deficiency as vitamin D is a regulator of the Renin Angiotensin System.

https://elifesciences.org/articles/59177#s1


I remember there was a story on HN where there was study related to vitamin D where patients that received vitamin D had higher chance of recovery.



Yes.. what is the base rate of vitamin D deficiency in the general population?


"Vitamin D deficiency was found in 82.2% of COVID-19 cases and 47.2% of population-based controls (p<0.0001)"


Given that the population-based controls were examined in January-March 2020 [(?) the year is slightly obfuscated but a generous reading allows 2020]

and the COVID-19 cases were from March 10-31, the difference could be explained by people being in lockdown and not going outside.


It was March or April when the NIH released a bunch of papers on diseases on either Kaggle or Github (can't exactly remember). I decided to dig into all the data for fun ("fun", it was all in json and you had to manually parse the bitch to read it all). There's a fuckton (in the scientific sense) of studies that show a really good relation to Vit D deficiency and generally being sick as shit (flu, URIs, sinus infections, gastro problems, etc). While Vit C might be good for recovering, D is what you want to focus on in general disease prevention (a wide gamut at that). Outside of that 60k paper release, there are lots of studies on the mental health of folks regarding low and regular Vit D levels (low Vit D levels lead to more, worse and prolonged depression & anxiety).

What I've really taken away from this crazy year, why the hell is there all this research (decades worth, not a handful of years, I'm talking about roughly 40+ years worth) on good levels of Vit D levels leads to a statically healthy life and this fact is being completely shit on/ignored? Perfect? No. But, statistically speaking, you're sickly if your Vit D levels are low, regardless of Covid.


This is unrelated to my parent comment: perhaps I wasn't clear that being outside (in the sun) has a larger impact on your Vitamin D levels than supplementation.

Therefore the study's conclusion is invalid if the two groups studied were measured one before and one after lockdown kept them inside - since we would expect Vitamin D levels to drop, for this reason.


"low Vit D levels lead to more, worse and prolonged depression & anxiety"

This isn't entirely accurate, and I'm going to quibble a bit with it and cite a study, but TLDR exercising outside during the daytime is probably better than just supplements of D.

To be clear I myself take Vitamin D because it may have benefits, including for mental health, so this isn't me trying to say D couldn't help with depression, just that that particular statement is a little misleading in that we don't have the best evidence for it.

There's definitely some evidence that Vitamin D levels are correlated with worse depression scores, but no studies about deficiency causing it to be worse; I suspect few people would choose to sign up for a study to make they depression worse, tbh. Anyway, the closest are studies of supplements to Vitamin D levels in depressed people, and the results there are mixed.

For example a study called "Effect of vitamin D supplement on depression scores in people with low levels of serum 25-hydroxyvitamin D: nested case-control study and randomised clinical trial" in the British Journal of Psychiatry found no statistically significant differences in depression inventories.

I believe there is some meta analysis that shows that Vitamin D supplementation may benefit people with clinically significant depression scores. But if you are badly depressed, you should consider moderate mixed aerobic and anaerobic exercise outside during the day, which gets you sunlight for vitamin D, exercise, and light exposure.

Regardless of whether Vitamin D makes a difference, exercise and light exposure both can help with depression (or in the case of the latter at least Seasonal Affective Disorder, which can cause or exacerbate depression), and the evidence there is more substantial. For the record, light therapy boxes seem to help with SAD even when they generally have low UV so little chance that it's vitamin D that's making the difference.


From p. 18 here shows COViD patients vs controls.

https://watermark.silverchair.com/dgaa733.pdf

Interesting that the controls were twice as likely to be Current Smokers (17% vs 7%).


Do smokers need to go outside to indulge their habit? Where their bodies can manufacture a little vit-D.


Dunno about Spain, but in France, smoking at the dinner table is perfectly acceptable :)


In the USA in 95% of restaurants and households you'd be told to take it outside :)


47 if people complaining about this particular point bothered to skimm linked article.


That would be here: https://academic.oup.com/jcem/advance-article/doi/10.1210/cl...

(I too missed it in the headline-linked article)


A thing I couldn’t find in the article: were the population based controls patients who were hospitalized in 2019, or merely members of the local population?


Even bigger issue than base rate is that this is a retrospective study, so I suspect heavy measurement bias. Patients that are likely to have a Vitamin D level checked are different than hospitalized patients. Vitamin D levels are not checked routinely in hospitalized patients. I know this because I'm a hospitalist, but also because during the height of the local pandemic this 900+ bed hospital only had 216 patients with a vitamin D level checked. Presumably at least 1000 COVID patients moved through that hospital during this time, more likely several thousand.


It says 'patients', feeling a bit squiffy and calling in sick doesn't make you a patient (not even an out-patient), medical treatment or attention does.


You’re quite right, I hadn’t properly thought through what patient means precisely. I edited my comment, thanks!


The study has a demographic breakdown table that has some details about other conditions the covid and the control population had. One thing that stood out to me was: 'Immunosuppression'. The COVID population had this condition at 8x the rate the control group had and this condition may be induced deliberately. That seems like it could be an alternative explanation to low vitamin D.


What is a non-hospitalised patient?


"outpatient"


someone who is currently diagnosed with/ treated for covid, but does not require hospitalisation?


A patient that is no longer hospitalized

> 216 patients aged ≥18 years, with confirmed COVID-19 [admitted] from March 10 to March 31, 2020, and

> 197 sex-matched population-based controls recruited from the Camargo Cohort during their last follow-up visit on January-March of the past year


[flagged]


Please don't be a jerk when correcting people, no matter how annoying another comment is or you feel it is. It's great to provide correct information, and also enough.

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