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
Aims: 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
... ed 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=0.016). 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 supports the recommendations for normalising vitamin D levels in those with deficient / insufficient levels and in groups at high-risk for deficiency. What's already known about this topic? Vitamin D deficiency and insufficiency are related to a range of adverse health outcomes. Low vitamin D levels appear related to pneumonia, cytokine burst and acute respiratory distress syndrome, all of which are associated with COVID-19. Accumulating evidence links COVID-19 incidence and outcomes with vitamin D status. We investigated to see if an interaction existed between vitamin D levels and social deprivation in those with and without COVID-19 infection.