Further proof that vitamin D could protect people from coronavirus emerged today after another study found adults deficient in the nutrient are more at risk of catching the disease.
Seventy-two per cent of NHS workers who were lacking in the ‘sunshine vitamin’ also tested positive for Covid-19 antibodies — a sign of previous infection. This compared to just 51 per cent for those who had a sufficient amount.
The difference was even greater among those of a Black, Asian or ethnic minority, who may be more likely to have a deficiency because people with darker skin find it harder to obtain it from the sun.
A mountain of studies carried out since the pandemic began have found an people who test positive for Covid-19 do not have enough vitamin D in their bodies, and the sickest of patients are often deficient.
It’s led to calls for doctors to dish out cheap vitamin D supplements — which cost as little as 3p a day and have no dangerous side effects — to fight the disease, rather than waiting for a vaccine which may never be found.
It comes after Matt Hancock wrongly told the House of Commons last week that a Government-funded ‘trial’ investigating vitamin D showed it did not ‘appear to have any impact’.
The Health Secretary was told to ‘get his facts straight’ because there is a wealth of research in favour of the ‘sunshine vitamin’ — nicknamed so because it is made in the body when our skin is exposed to the sun.
Mr Hancock has now agreed to meet experts to to hear the growing case for the vitamin. Scientists have not yet been able to pin down whether the nutrient deficiency is making people more vulnerable to the disease or whether becoming unwell causes vitamin D levels to crash.
Officials estimate one in five Britons are deficient in vitamin D — the equivalent of 13million Britons. But the rate is up to 90 per cent in people with darker skin, such as BAME populations who are known to be at greater risk from Covid-19.
A total of 72 per cent of NHS workers in Birmingham who were lacking in the ‘sunshine vitamin’ (left column) also tested positive for coronavirus antibodies in the blood (seropositive) — a sign of previous infection. This compared to just 51 per cent for those who had a sufficient amount (right column)
What have just some of the DOZENS of studies into vitamin D and Covid-19 shown?
By who? Cordoba University in Spain.
What did scientists study? 50 Covid-19 hospital patients with Covid-19 were given vitamin D. Their health outcomes were compared with 26 volunteers in a control group who were not given the tablets.
What did they find? Only one of the 50 patients needed intensive care and none died. Half of 26 virus sufferers who did not take vitamin D were later admitted to intensive care and two died.
What were the study’s limitations? Small pool of volunteers. Patients’ vitamin D levels were not checked before admission. Comorbidities were not taken into consideration.
By Who? University of Chicago.
What did scientists study? 500 Americans’ vitamin D levels were tested. Researchers then compared volunteers’ levels with how many caught coronavirus.
What did they find? 60 per cent higher rates of Covid-19 among people with low levels of the ‘sunshine vitamin’.
What were the study’s limitations?
Researchers did not check for other compounding factors. Unclear whether or not volunteers were vitamin D deficient at the time of their coronavirus tests. People’s age, job and where they lived – factors which greatly increase the chance of contracting the virus – were not considered.
By Who? Tehran University, in Iran, and Boston University.
What did scientists study? Analysed data from 235 hospitalized patients with Covid-19.
What did they find? Patients who had sufficient vitamin D – of at least 30 ng/mL— were 51.5 per cent less likely to die from the disease. They also had a significantly lower risk of falling seriously ill or needing ventilation. Patients who had plenty of the nutrient also had less inflammation – often a deadly side effect of Covid-19.
What were the study’s limitations? Confounding factors, such as smoking, and social economic status were not recorded for all patients and could have an impact on illness severity.
By Who? Tel Aviv University, Israel.
What did scientists study? 782 people who tested positive for coronavirus had their vitamin d levels prior to infection assessed retrospectively and compared to healthy people.
What did they find? People with vitamin D levels below 30 ng/ml – optimal – were 45 per cent more likely to test positive and 95 per cent more likely to be hospitalised.
What were the study’s limitations? Did not look at underlying health conditions and did not check vitamin D levels at the time of infection.
By Who? Brussels Free University.
What did scientists study? Compared vitamin D levels in almost 200 Covid-19 hospital patients with a control group of more than 2,000 healthy people.
What did they find? Men who were hospitalised with the infection were significantly more likely to have a vitamin D deficiency than healthy men of the same age. Deficiency rates were 67 per cent in the COVID-19 patient group, and 49 per cent in the control group. The same was not found for women.
What were the study’s limitations? Independent scientists say blood vitamin D levels go down when people develop serious illness, which the study did not take into consideration. This suggests that it is the illness that is leading to lower blood vitamin D levels in this study, and not the other way around.
By who? Inha University in Incheon, South Korea.
What did scientists study? 50 hospital patients with Covid-19 were checked for levels of all vital vitamins and compared to a control group.
What did they find? 76 per cent of them were deficient in vitamin D, and a severe vitamin D deficiency (<10 ng/dl) was found in 24 per cent of Covid-19 patients and just 7 per cent in the control group.
What were the study’s limitations?
Small sample size and researchers never accounted for vitamin levels dropping when they fall ill.
By Who?. Independent scientists in Indonesia.
What did scientists study? Checked vitamin D levels in 780 Covid-19 hospital patients.
What did they find? Almost 99% of patients who died had vitamin D deficiency. Of patients with vitamin D levels higher than 30 ng/ml – considered optimal – only per cent died.
What were the study’s limitations? It was not peer-reviewed by fellow scientists, a process that often uncovers flaws in studies.
By Who? University of Glasgow.
What did scientists study? Vitamin D levels in 449 people from the UK Biobank who had confirmed Covid-19 infection.
What did they find? Vitamin D deficiency was associated with an increased risk in infection – but not after adjustment for con-founders such as ethnicity. It led to the team to conclude their ‘findings do not support a potential link between vitamin D concentrations and risk of Covid-19 infection.’
What were the study’s limitations? Vitamin D levels were taken 10 to 14 years beforehand.
By Who? University of East Anglia.
What did scientists study? Average levels of vitamin D in populations of 20 European countries were compared with Covid-19 infection and death rates at the time.
What did they find? The mean level of vitamin D in each country was ‘strongly associated’ with higher levels of Covid-19 cases and deaths. The authors said at the time: ‘The most vulnerable group of population for Covid-19 is also the one that has the most deficit in vitamin D.’
What were the study’s limitations? The number of cases in each country was affected by the number of tests performed, as well as the different measures taken by each country to prevent the spread of infection. And it only looked at correlation, not causation.
By Who? Northwestern University.
What did scientists study? Crunched data from dozens of studies around the world that included vitamin D levels among Covid-19 patients.
What did they find? Patients with a severe deficiency are twice as likely to experience major complications and die.
What were the study’s limitations? Cases and deaths in each country was affected by the number of tests performed.
Scientists have theorised that this could be why BAME groups have higher odds of getting Covid-19 and have been investigating further. But it has yet to be proven.
The latest study adds fuel to the fire. It was conducted by the University of Birmingham on NHS staff at University Hospitals Birmingham NHS Foundation Trust – one of the British hospitals that took the most Covid-19 patients.
Researchers analysed blood samples from 392 healthcare workers in a two-week period in May — towards the end of the first surge of the Covid-19 pandemic.
They included junior doctors and nurses, consultants, physiotherapists, lab workers, secretaries, theatre staff and radiologists.
Samples were first tested for the presence of SARS-CoV-2 antibodies – proteins in the blood which show a person has built an immune response to the infection during previous illness.
They also underwent testing to establish their levels of vitamin D, which is known to help boost the immune system and protect against the common cold.
Adequate levels are usually over 50 ng/mL, with anything below that a concern. In the new study, ‘deficiency’ was defined as a measure below 30 ng/mL.
The NHS says the general consensus is levels of below 25nmol/L — the equivalent of 10ng/ml — in the blood indicate vitamin D deficiency. This is thought to be the equivalent of taking around 10 micrograms of vitamin D a day, the amount found in one small salmon fillet.
The overall average levels of vitamin D in the sample was 55.5 ng/mL. But a total of 61 (or 15.6 per cent) were deficient.
Vitamin D deficiency was more prevalent in those of a BAME ethnic group and in a junior doctor job role. And men, younger workers and those with a higher BMI showed lower Vitamin D levels.
Over half (55 per cent) of the workers had SARS-CoV-2 antibodies, which is significantly high because they work in a hospital in close proximity with Covid-19 patients.
There was an increase in detectable SARS-CoV-2 antibodies in staff with vitamin D deficiency (72 per cent) compared to those without a deficiency (51 per cent), suggesting that lower vitamin D levels could increase susceptibility to the virus.
This was particularly prevalent in BAME men. A whopping 94 per cent who were vitamin D deficient had antibodies, compared to 52 per cent in those who were not.
Results also showed that staff who were vitamin D deficient were more likely to report symptoms of body aches and pains.
Vitamin levels were also lower in staff who reported symptoms of fever — but not for those who had a cough or had suffered from breathlessness.
Professor David Thickett, from the University of Birmingham’s Institute of Inflammation and Ageing, said: ‘Our study has shown that there is an increased risk of Covid-19 infection in healthcare workers who are deficient in vitamin D.
‘Our data adds to the emerging evidence from studies in the UK and globally that individuals with severe Covid-19 are more Vitamin D deficient than those with mild disease.
‘Our results, combined with existing evidence further demonstrates the potential benefits of vitamin D supplementation in individuals at risk of vitamin D deficiency or who are shown to be deficient as a way to potentially alleviate the impact of Covid-19.’
Researchers from Brussels Free University, Belgium, have also claimed giving out vitamin D supplements could be an ‘inexpensive mitigation strategy’.
In June, they found the risk of men being hospitalised with coronavirus was a fifth higher in those who were deficient in the ‘sunshine vitamin’.
Currently the NHS recommends Brits take 10 micrograms of the ‘sunshine’ nutrient each day ‘to keep your bones and muscles healthy’.
Previously it only gave this advise during the winter, because between October and early March there is a lack of sunlight. But it changed its guidance to include all seasons because lockdown was forcing people to spend more time indoors.
But it says on its website that ‘there is currently not enough evidence to support’ claims that the immune system-boosting nutrient reduces the risk of coronavirus.
As well as darker-skinned people, the elderly — the most vulnerable to Covid-19 — are also in danger because the body gets less efficient at producing the vitamin with age.
The findings, published today as a pre-print paper, echo those of at least three other studies which have found a link between infection and vitamin D levels.
The first, published online in July by Tel Aviv University, Israel, looked retrospectively at vitamin D levels in 782 people who tested positive for coronavirus and compared them with healthy people.
People with vitamin D deficiency — below 30 ng/ml — were 45 per cent more likely to test positive and 95 per cent more likely to be hospitalised.
But the study’s reliability was limited by the fact it did not check vitamin D levels at the time of infection. It used blood samples from before infection. It also did not take into consideration underlying health conditions of the patients, which can make the disease more serious.
Another study by the University of Chicago assessed 500 Americans’ vitamin D levels before analysing their risk of catching Covid-19.
They found 60 per cent higher rates of Covid-19 among people with low levels of the ‘sunshine vitamin’, according to the paper published in the journal JAMA in September.
However the researchers did not check for other compounding factors. It is unclear whether or not volunteers were vitamin D deficient at the time of their coronavirus tests. People’s age, job and where they lived — factors which greatly increase the chance of contracting the virus — were also not considered.
University of Glasgow academics refute the theory of vitamin D protection based on their own work, published in May.
They studied vitamin D levels in 449 people from the UK Biobank who had tested positive for Covid-19.
They found vitamin D deficiency was associated with an increased risk in infection — but not after adjustment for ethnicity.
It led to the team to conclude their ‘findings do not support a potential link between vitamin D concentrations and risk of Covid-19 infection’.
It’s important to note that although studies have frequently observed a link between the two conditions — Covid-19 and vitamin D deficiency — it does not prove causation.
Scientists have previously noted that vitamin D levels drop during illness, which may explain why Covid-19 patients studied when they are seriously ill appear to also inadequate levels.
Naveed Sattar, a professor of metabolic medicine at University of Glasgow, previously told MailOnline: ‘Blood vitamin D levels go down when people develop serious illness.
‘The same thing happens to other blood tests such as blood cholesterol, or blood zinc levels, which also fall when someone is sick. These changes are part of what is called the acute phase response. Moreover, the sicker people are, the more exaggerated are these changes.
‘This means that it is likely the occurrence of illness that is leading to lower blood vitamin D levels… and not that low vitamin D levels, are causing Covid-19.’
Vitamin D levels were lower in the BAME ethnic group compared to the white ethnic group
In those with Vitamin D deficiency, levels were lower in BAME ethnicity compared to white ethnicity
As well as in supplements, vitamin D is also available through foods, including oily fish, red meat and eggs (right). A Singaporean study earlier in the year of nearly 800 people found almost 99% of Covid-19 patients who died had vitamin D deficiency (left)
A study by Tehran University, in Iran, and Boston University analysed data from 235 hospitalised patients with Covid-19. Patients who had sufficient vitamin D – of at least 30 ng/mL— were 51.5 per cent less likely to die from the disease. Although no one in the study under age 40 died, fatalities (red) were more common among vitamin D deficient people (under the black line) of all ages
A correlation graph showing the relationship between levels of vitamin D (bottom, measured in nmol/l) compared to infection numbers of coronavirus by the University of East Anglia. Countries with low vitamin D levels tend to have the highest case rates per million – but the graph was from a study in May, when outbreaks looked very different to how they do now and testing was patchy in most countries
University of Chicago researchers studying 500 Americans’ vitamin D levels found 60 per cent higher rates of Covid-19 among people with low levels of the ‘sunshine vitamin’
Matt Hancock told the House of Commons last week he had green-lit a Government-funded ‘trial’ investigating vitamin D and that it did not ‘appear to have any impact’
MATT HANCOCK BLASTS VITAMIN D AS USELESS, CAUSING ANGER AMONG SCIENTISTS
Mr Hancock shot down vitamin D’s potential last week in reply to a question from Dr Rupa Huq, the Labour MP for Ealing and Acton Central.
He said: ‘Vitamin D is one of the many things we have looked into, to see whether it reduces the incidence or impact of coronavirus.
‘And I’ve seen reports that it does, so we therefore put it into a trial, and unfortunately the results were that it doesn’t appear to have any impact. So that is the latest clinical advice, which, of course, is always kept under review.’
Mr Hancock appeared to be referring to a review of evidence conducted by the National Institute for Health and Care Excellence (NICE), an arm of the Department of Health.
NICE conducted a review of a limited number of studies published by June. It noted that a stronger immune system provided greater protection against Covid-19 and admitted that vitamin D boosted immune function.
But it was not convinced there was enough evidence to show that giving doses of the vitamin to already-sick Covid-19 patients provided any benefit.
Officials have since admitted that no clinical trials had taken place and claim it was a slip of the tongue from the health secretary – who was also staunchly opposed to face masks in the spring and claimed they were ‘extremely weak’ in stopping Covid-19’s spread.
Experts said his comments ‘displayed incredible ignorance’, while Liberal Democrat MP Layla Morgan told MailOnline the secretary of state ‘needs to be listening, not dismissing’. She added: ‘I hope Matt Hancock will take a less flippant approach to potential treatments in future and get his facts straight before making such comments. We’re in a crisis, it’s time for politicians to stop playing science and listen to the experts.’
Two leading doctors told MailOnline that politicians and scientists were so hellbent on getting a vaccine – the Government has pumped hundreds of millions into jab development projects – that they had overlooked the potential of vitamin D and boosting people’s immune systems, which they say is a far less glamorous option.
Mr Hancock has now agreed to meet experts to to hear the growing case for the vitamin, which the body produces when exposed to the sun. But his flippant dismissal of vitamin D has sparked fury among scientists and MPs who today said time is running out for ministers to act, as levels of the ‘sunshine vitamin’ drop dramatically in autumn and winter.
Studies linking vitamin D deficiency to poorer health outcomes from Covid-19 have been piling up since the pandemic hit earlier in the year.
A study by Tehran University, in Iran, and Boston University, Massachusetts, found hospitalised Covid-19 patients who had sufficient vitamin D — of at least 30 ng/mL— were 51.5 per cent less likely to die from the disease.
They also had a significantly lower risk of falling seriously ill or needing ventilation, and less inflammation — often a deadly side effect of Covid-19, the study in September revealed.
The University of East Anglia showed in May that average levels of vitamin D in populations of 20 European countries was ‘strongly associated’ with Covid-19 cases and deaths. The authors said at the time: ‘The most vulnerable group of population for Covid-19 is also the one that has the most deficit in vitamin D.
But the most promising study into vitamin D’s effects on Covid-19 was carried out by the University of Cordoba in Spain and published last month.
Researchers gave high doses of calcifediol – a type of vitamin D supplement – to 50 patients hospitalised with the disease.
Scientists compared the participants’ health with 26 volunteers in a control group who were not given the tablets, which are normally prescribed to patients with thyroid or kidney problems.
There were no deaths among volunteers receiving the vitamin and all 50 patients were eventually discharged by the end of the study.
Just one patient given calcifediol fell ill enough to be admitted to intensive care, whereas half of the participants in the control group were taken to ICU and two died.
Independent scientists, including some from NICE, said the findings were promising but there were too many flaws in the study’s methods.
For example, the experts did not measure vitamin D levels before or after administering the drug. And participants’ underlying health conditions were not defined.
Professor Ian Jones, a virologist at the University of Reading, told MailOnline: ‘My general view is that if there is no clear cut view on vitamin D after six months of debate then there is nothing in it.’
Scientists have yet to be able to conclusively say that the sunshine vitamin does help because of a lack of gold-standard trials.
Last week a doctor claimed more research would have been done into the link between vitamin D and Covid-19 if deficiency was a bigger problem for white people.
Dr Aseem Malhotra, one of Britain’s leading anti-obesity campaigners and a former NHS cardiologist, told MailOnline ‘underlying racism’ is clearly to blame for the lack of clinical trials into vitamin D.
He said: ‘Vitamin D plays an essential role in innate and adaptive immunity. Severe deficiency, which has been strongly correlated with adverse outcomes from Covid-19, also has a high prevalence among BAME groups in the UK.
‘The majority of those from South Asian or black backgrounds are either deficient or severely deficient.
‘This has been known for years yet little has been done to act on it, in part because of how endemic racism is in both medical research and practice.’
Dr Malhotra, author of Sunday Times best-seller ‘The 21-Day Immunity Plan’, added that everybody should consider taking vitamin D during the winter months.
He said: ‘There is no significant harm from supplementing the public with vitamin D, and only likely a benefit.’
Dr Malhotra said he suspects ministers are so focused on a vaccine that they may be overlooking more simple treatment options, like promoting a healthy immune system and supplementing vitamin D.
He added: ‘The current narrative of suggesting the best and only solution to beat Covid-19 is waiting for a vaccine plays into the Big Pharma narrative, who have too much influence over politicians.
‘As one very senior politician once said to me, “the Department of Health is too close to industry” — we yet have no idea how effective a vaccine will be.
‘For example the flu vaccine is largely ineffective for over 65s yet most doctors don’t know this let alone patients. The focus needs to be advice and policies that help the population lead healthier lives, which won’t only reduce the burden on the overstretched NHS but will also improve our resilience to infection.’