Hasnat A Amin, Fotios Drenos
Journal: BMJ nutrition, prevention & health 2021;4(1):42-48
PMID: 34308111
Vitamin D is commonly discussed in terms of bone health and calcium and phosphate homeostasis, however, evidence has started to emerge that it may also be involved in cancer, the cardiovascular system and inflammation. The aim of this study was to assess whether genetically increased vitamin D levels are associated with SARS-CoV-2 infection risk and COVID-19 severity. This study is based on data from genome-wide association studies for vitamin D levels, vitamin D deficiency and COVID-19 incidence and severity. Results show no evidence that vitamin D is causally related to COVID-19 outcomes and there is no evidence to suggest that current National Institute for Health and Care Excellence guidance should change to support the use of vitamin D supplementation against COVID-19. Authors conclude that their findings support the recent statement by the National Institute for Health and Care Excellence that the use of vitamin D supplementation to mitigate COVID-19 is not supported by the available data.
BACKGROUND
Upper respiratory tract infections are reportedly more frequent and more severe in individuals with lower vitamin D levels. Based on these findings, it has been suggested that vitamin D can prevent or reduce the severity of COVID-19.
METHODS
We used two-sample Mendelian randomisation (MR) to assess the causal effect of vitamin D levels on SARS-CoV-2 infection risk and COVID-19 severity using publicly available data. We also carried out a genome-wide association analysis (GWA) of vitamin D deficiency in the UK Biobank (UKB) and used these results and two-sample MR to assess the causal effect of vitamin D deficiency on SARS-CoV-2 infection risk and COVID-19 severity.
RESULTS
We found no evidence that vitamin D levels causally affect the risk of SARS-CoV-2 infection (ln(OR)=0.17 (95% CI -0.22 to 0.57, p=0.39)) nor did we find evidence that vitamin D levels causally affect COVID-19 severity (ln(OR)=0.36 (95% CI -0.89 to 1.61, p=0.57)). Based on our GWA analysis, we found that 17 independent variants are associated with vitamin D deficiency in the UKB. Using these variants as instruments for our two-sample MR analyses, we found no evidence that vitamin D deficiency causally affects the risk of SARS-CoV-2 infection (ln(OR)=-0.04 (95% CI -0.1 to 0.03, p=0.25)) nor did we find evidence that vitamin D deficiency causally affects COVID-19 severity (ln(OR)=-0.24 (95% CI -0.55 to 0.08, p=0.14)).
CONCLUSIONS
In conclusion, we found no evidence that vitamin D is protective against SARS-CoV-2 infection or COVID-19 severity. Our data support the recent statement by the National Institute for Health and Care Excellence that the use of vitamin D supplementation to mitigate COVID-19 is not supported by the available data.
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
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