Temporal Association of Reduced Serum Vitamin D with COVID-19 Infection: Two Single-Institution Case–Control Studies
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Abstract
(1) Background: Vitamin D supplementation has been proposed for the prevention and treatment of COVID-19, but it is not clear if reduced serum vitamin D predisposes individuals to COVID-19 and/or is a secondary consequence of infection. This study assessed the temporal association between serum vitamin D and COVID-19 with two single-institution case–control studies through the University of California San Diego (UCSD) Health System. (2) Methods: This study included patients who tested positive for COVID-19 from 1 January to 30 September 2020 with serum 25-hydroxy-vitamin D (25(OH)D) measured within 180 days of diagnosis. Patients were separated based on whether 25(OH)D was measured before (n = 107 cases, 214 controls) or after (n = 203 cases, 406 controls) COVID-19 diagnosis. COVID-19 infection status was the outcome variable in the pre-diagnosis study, whereas serum 25(OH)D level was the outcome variable in the post-diagnosis study. (3) Results: Serum 25(OH)D levels were not associated with the odds of subsequent COVID-19 infection (OR 1.0, 95% CI: 1.0 to 1.0, p = 0.98). However, COVID-19-positive individuals had serum 25(OH)D measurements that were 2.7 ng/mL lower than the controls (95% CI: −5.2 to −0.2, p = 0.03). (4) Conclusions: In our study population, serum 25(OH)D levels were not associated with the risk of acquiring COVID-19 infection but were reduced in subjects after COVID-19 infection. These results support the possibility that reduced serum 25(OH)D is a consequence and not a cause of COVID-19 infection.
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SciScore for 10.1101/2021.06.03.21258330: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Study Population: The UCSD Institutional Review Board approved this study and approved a waiver for informed consent based on the requirements outlined in the Code of Federal Regulations on the Protection of Human Subjects (45 CFR 46).
Consent: Study Population: The UCSD Institutional Review Board approved this study and approved a waiver for informed consent based on the requirements outlined in the Code of Federal Regulations on the Protection of Human Subjects (45 CFR 46).Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources Data was collected for all subjects … SciScore for 10.1101/2021.06.03.21258330: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: Study Population: The UCSD Institutional Review Board approved this study and approved a waiver for informed consent based on the requirements outlined in the Code of Federal Regulations on the Protection of Human Subjects (45 CFR 46).
Consent: Study Population: The UCSD Institutional Review Board approved this study and approved a waiver for informed consent based on the requirements outlined in the Code of Federal Regulations on the Protection of Human Subjects (45 CFR 46).Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources Data was collected for all subjects tested for COVID-19 through the UCSD Healthcare system from January 1, 2020 to September 30, 2020 (n=6,050), capturing an interval from the onset of local infections to the time prior to initiation of COVID-19 vaccinations. UCSD Healthcaresuggested: NoneAnalyses were performed using RStudio software, version 1.3.959. RStudiosuggested: (RStudio, RRID:SCR_000432)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study also has several limitations. The retrospective design does not allow for determination of causality, and our modest sample size is not powered to detect smaller but potentially significant correlations. Additionally, although we matched baseline characteristics between cases and controls, other unaccounted confounders could have affected the results. In particular, data on the racial identity of our study subjects was incomplete, which did not allow us to include this factor in cohort matching. Racial disparities in COVID-19 illness have been clearly established, with one retrospective study finding that a positive COVID-19 test was significantly associated with lower vitamin D levels in Black individuals, but not with lower vitamin D levels in White individuals38. Our health system’s general catchment area (San Diego county) has a lower Black population (∼5.5%) than the U.S. national average (∼13.4%). Therefore, the results from our analysis may differ from other study populations, and do not argue against the potential utility of Vitamin D supplementation for specific populations. Ultimately, intervention trials will provide the most conclusive insight to the therapeutic value of vitamin D supplementation for COVID-19. Early reports have shown mixed results: A small (n=76) randomized trial indicated that oral calcifediol supplementation reduced the need for intensive care unit admission in COVID-19 infected subjects17, though the trial was not placebo-controlled ...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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