New Vitamin D Covid Study with Commentary by Dr. Derrick DeSilva, Jr.
A recent article claimed that a single dose of vitamin D did not have any significant effect on moderate to severe COVID-19 infections. We asked Derrick M. DeSilva, Jr., M.D., an expert on vitamins and other supplements, for his reaction.
Here is the original article:
Vitamin D supplements may offer no Covid benefits, data suggests
Two studies fail to find evidence to support claims supplements protect against coronavirus
March 9, 2021 (The Guardian) – The idea that vitamin D supplements can reduce susceptibility to, and the severity of, Covid-19 is seductive – it offers a simple, elegant solution to a very complex and lethal problem. But analyses encompassing large European datasets suggest the enthusiasm for the sunshine vitamin may be misplaced.Two still to be peer-reviewed papers looked at the link between vitamin D levels and Covid-19 and both reached the same conclusion: evidence for a direct link between vitamin D deficiency and Covid outcomes is lacking.
One set of researchers mined a database of hundreds of thousands of mostly white participants to understand whether giving them vitamin D could decrease their probability of having symptomatic or severe Covid.
Researchers looked at the records of people with certain genetic markers that make them predisposed to vitamin D deficiencies, something that is not influenced by factors such as age and other underlying conditions. They found no evidence for the idea that supplements protect against Covid.
Another study compared the prevalence of vitamin D deficiency in 24 European countries to Covid infections, recovery and mortality data.
Lead author, Dr Michael Chourdakis, from Aristotle University, Greece, said the analysis avoided the methodological limitations of previous studies by only using recent data on vitamin D, and did not only include subsets of the population, for instance, people in nursing homes.
In addition, instead of using mean vitamin D levels, which can be distorted by certain parts of a population having very high or very low concentrations, they specifically looked at levels of deficiency.
“There is an overloading of information about vitamin D benefits … vitamin D has been praised for too many things,” he said, “even though we have very limited data for that.”
He added that the study was methodologically solid and the data showed no significant correlation between vitamin D and Covid infections, recovery or mortality.
Those that traditionally exhibit vitamin D deficiency – older adults and minority ethnic populations – are the same groups that have been disproportionately affected by Covid-19. Protracted lockdowns and subsets of the population shielding has also enhanced time spent indoors away from sunlight. And in general, vitamin D has been implicated in helping the immune response to respiratory infections – so supplements feels like the intuitive answer.
But the evidence on Covid so far – although some of it is positive – is circumstantial. Some researchers argue it is not robust enough to favour a policy of giving the whole population supplements, particularly given the impact that might have on individual behaviour and possible negative physical side-effects from taking too much.
In a recent review, the National Institute for Health and Care Excellence (Nice) agreed, finding evidence for vitamin D supplementation with the aim of preventing or treating Covid was still lacking and that further research was needed.
“We’re scientists – we believe in data. We feel that the data today suggests that vitamin D will not protect against Covid outcomes. We would be happy to entertain any data that suggests otherwise,” Dr Brent Richards, a clinician-scientist from McGill University focused on endocrinology, epidemiology and biostatistics who is one of the authors of the genetic study.
“But it’s important to remember that in the field of vitamin studies there is a familiarity of the general public with vitamins and a high level of trust that we don’t see with other kinds of interventions. So, people very much want this solution to be a vitamin-based solution – and sometimes that’s not always the case.”
A recent case in point is a study from scientists from the University of Barcelona that suggested giving high-dose vitamin D to coronavirus patients when admitted to hospital could cut deaths by a staggering 60%, prompting calls by former Brexit secretary and MP David Davis for the therapy to be rolled out in hospitals.
But some scientists pointed out that while the data is presented as a randomised trial of vitamin D supplementation, it appears individuals were not randomised, wards in the hospital were. Different wards tend to take different patients depending on their level of illness and risk.
Eventually, the study – that had not been peer-reviewed – was removed from the server of the medical journal The Lancet as a result of concerns that kickstarted an investigation into the paper.
Meanwhile randomised controlled trials designed to definitively answer whether vitamin D status plays a direct role in Covid infections and outcomes are ongoing. “What we lack at the moment is really a definitive trial which demonstrates a cause and effect relationship,” said Adrian Martineau, a professor of respiratory infection and immunity at Queen Mary University of London, who is leading such a study.
“You can’t dismiss the circumstantial evidence …[but] it’s not the highest level of evidence. I guess there’s a philosophical question – if you have an intervention that has a good chance of working and is completely safe, why not implement it, while you’re waiting to find out given the public health emergency?”
Here is Dr. DeSilva’s response:
This article is saying there are two studies saying vitamin D has no effect on the Covid virus. But there are 5,000 PubMed studies that point to the fact that Vitamin D has a beneficial effect to help support the health of the immune system in general.
Whether it is viruses or the Covid virus, what we have to look at here is the fact that it’s not just Vitamin D having an effect on viruses; Vitamin D has other beneficial effects also, whether it’s on the cardiovascular system, the nervous system, or the skeletal system. Maybe it has a little less of an effect on the Covid virus, but it does have an effect on viruses in general.
They’re saying it has no effect on the Covid virus. These are just two studies; maybe there needs to be more data. Perhaps they need to take another look at this, because it does have an effect on viruses, and on the immune system.
There really isn’t anything else to say. Every time one of these studies comes out, you wonder where it came from; you wonder who is behind it. You can’t pigeonhole nutrients and supplements into one category. Because vitamins, minerals, supplements and botanicals have various effects—they’re not drugs. Drugs do one thing; supplements and nutrients and botanicals do a myriad of things; that’s the beauty of supplementation, in general. That’s what you have to look at.“
Derrick M. DeSilva, Jr., M.D. is a practicing internist, a senior attending staff member in the Department of Medicine at Raritan Bay Medical Center in Perth Amboy, NJ, and a member of the Teaching Faculty at JFK Medical Center in Edison, NJ. He is past chairman of the conference planning committee of Age Management Medicine Group (AMMG), past president of the American Nutraceutical Association, and a recipient of the Alan P. Mintz, M.D. Award for Clinical Excellence in Age Management Medicine. Dr. DeSilva has received the Best Doctor Award by Castle Connolly for the past 19 consecutive years. He is the host of “Ask the Doctor” on WCTC Radio, NJ, and medical correspondent for Cablevision (News 12 NJ) as well as host of “Health Matters”. Dr. DeSilva is also a published author.