Detectable respiratory SARS‐CoV‐2 RNA is associated with low vitamin D levels and high social deprivation
Mark Livingston, Aiden Plant, Simon Dunmore, Andrew Hartland, Stephen Jones, Ian Laing, Sudarshan Ramachandran
International Journal of Clinical Practice, doi:10.1111/ijcp.14166
Background: Accumulating evidence links COVID-19 incidence and outcomes with vitamin D status. We investigated if an interaction existed between vitamin D levels and social deprivation in those with and without COVID-19 infection.
Methods : Upper or lower respiratory tract samples from 104 patients were tested for SARS-CoV-2 RNA in accordance with Public Health England criteria (January-May 2020) using RT-PCR. The latest serum total 25-hydroxyvitamin D(25-OHD) levels, quantified by LC-MS/MS, was obtained for each patient (September 2019-April 2020). Index of Multiple Deprivation (IMD) was generated for each patient. Univariate and logistic regression analyses examined associations between age, gender, 25-OHD, IMD score and SARS-CoV-2 result in the total cohort and subgroups. Results: In the total cohort, a positive SARS-CoV-2 test was significantly associated with lower 25-OHD levels and higher IMD. A positive test was associated with higher IMD in the male subgroup and with lower 25-OHD levels in those aged >72 years. Low 25-OHD and IMD quintile 5 were separately associated with positive COVID-19 outcome in the cohort. Patients in IMD quintile 5 with vitamin D levels ≤ 34.4 nmol/L were most likely to have a positive COVID-19 outcome, even more so if aged >72 years (OR: 19.07, 95%CI: 1.71-212.25; P = .016).
Conclusions: In this cohort, combined low vitamin D levels and higher social deprivation were most associated with COVID-19 infection. In older age, this combination was even more significant. Our data support the recommendations for normalising vitamin D levels in those with deficient / insufficient levels and in groups at high risk for deficiency.
ACK N OWLED G EM ENTS The authors acknowledge Mr Yusuf Varachia for help with extracting the data from the laboratory database. A preprint of this publication in the Authorea repository: https:// w w w.autho rea.com/users/ 31229 6/ar tic les/45494 0-detec table -respi rator y-sars-cov-2-rna-is-assoc iated -with-low-vitam in-d-level s-and-high-socia l-depri vatio n?commi t=0a10e c6dd5 905a5 d7177 61c9e a66e9 e366c a1f7d
CO N FLI C T O F I NTE R E S T None to declare.
DATA AVA I L A B I L I T Y S TAT E M E N T We used patient level data which was fully anonymised prior to analysis. Any requests for access to this data should be made to the corresponding author, Prof Mark Livingston.
O RCI D
Mark Livingston https://orcid.org/0000-0001-6878-0769
R E FE R E N C E S
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