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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ COVID-19 severity -32% Improvement Relative Risk Case -8% c19vitamind.com/amin.html Favors vitamin D Favors control
7 January 2021 - Analysis of outcomes based on serum levels
No evidence that vitamin D is able to prevent or affect the severity of COVID-19 in individuals with European ancestry: a Mendelian randomisation study of open data
Amin et al., BMJ Nutrition, Prevention & Health, doi:10.1136/bmjnph-2020-000151 (Peer Reviewed)
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Analysis of vitamin D levels and COVID-19 cases and severity based on genetic predisposition to higher vitamin D levels or lower vitamin D deficiency, finding no significant association.
For some background on Mendelian randomization studies and their limitations see [1].
For reasons why Mendelian randomization may fail in this case, see [2]. Authors suggest that it may come down to the use of 25-OHD concentration in serum as a less than ideal proxy for vitamin D status of cells involved in the immune response. For most other purposes, it may not matter much that unbound (free) 25-OHD is the better predictor of vitamin D deficiency and the resulting unfavourable outcomes. But for the MR analysis, the genetic instrument is strongly dominated by variation in the GC gene which modulates the concentration of vitamin D-binding protein (VDBP) in blood and thereby indirectly the concentrations of 25-OHD and 1,25-dihydroxy vitamin D. Thus, the common GC alleles rs4588A and rs7041T are both associated with much lower than average vitamin D concentrations. In contrast, directly measured unbound (free) vitamin D concentrations are minimally affected by these alleles, if at all.
COVID-19 severity, 32.3% higher, RR 1.32, p = 0.20, high D levels 140,898, low D levels 35,079, odds ratio converted to relative risk, >=50nmol/L vs. <25nmol/L, MR Egger, baseline risk approximated with overall risk.
risk of case, 7.6% higher, RR 1.08, p = 0.14, high D levels 140,898, low D levels 35,079, odds ratio converted to relative risk, >=50nmol/L vs. <25nmol/L, MR Egger, baseline risk approximated with overall risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes.
Amin et al., 1/7/2021, retrospective, population-based cohort, United Kingdom, Europe, peer-reviewed, 2 authors.
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