Vitamin D status: a U-shaped relationship for SARS-CoV-2 seropositivity in UK healthcare workers
Abstract
Background: There is increasing evidence that vitamin D (VD) deficiency may increase individuals' risk of COVID-19 infection and susceptibility. We aimed to determine the relationship between VD deficiency and sufficiency and COVID-19 seropositivity within healthcare workers.
Methods: The study included an observational cohort of healthcare workers who isolated due to COVID-19 symptoms from 12 May to 22 May 2020, from the University Hospitals Birmingham National Health Service Foundation Trust. Data collected included SARS-CoV-2 seroconversion status, serum 25(OH)D3 levels, age, body mass index (BMI), sex, ethnicity, job role and comorbidities. Participants were grouped into four VD categories: (1) Severe VD deficiency (VD<30 nmol/L); (2) VD deficiency (30 nmol/L ≤VD<50 nmol/L); (3) VD insufficiency (50 nmol/L ≤VD<75 nmol/L); (4) VD sufficiency (VD≥75 nmol/L).
Results: When VD levels were compared against COVID-19 seropositivity rate, a U-shaped curve was identified. This trend repeated when participants were split into subgroups of age, sex, ethnicity, BMI and comorbidity status. Significant difference was identified in the COVID-19 seropositivity rate between VD groups in the total population and between groups of men and women; black, Asian and minority ethnic (BAME) group; BMI<30 (kg/m2); 0 and +1 comorbidities; the majority of which were differences when the severely VD deficient category were compared with the other groups. A larger proportion of those within the BAME group (vs white ethnicity) were severely VD deficient (p<0.00001). A larger proportion of the 0 comorbidity subgroup were VD deficient in comparison to the 1+ comorbidity subgroup (p=0.046).
Conclusions: Our study has shown a U-shaped relationship for COVID-19 seropositivity in UK healthcare workers. Further investigation is required to determine whether high VD levels can have a detrimental effect on susceptibility to COVID-19 infection. Future randomised clinical trials of VD supplementation could potentially identify 'optimal' VD levels, allowing for targeted therapeutic treatment for those at risk.
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Date
2022-09
Type
Article
Subject
Oncology. Pathology., Elderly care., Respiratory medicine, Biochemistry
Collections
Citation
Lugg ST, Mackay WR, Faniyi AA, Faustini SE, Webster C, Duffy JE, Hewison M, Shields AM, Parekh D, Richter AG, Scott A, Thickett DR. Vitamin D status: a U-shaped relationship for SARS-CoV-2 seropositivity in UK healthcare workers. BMJ Open Respir Res. 2022 Sep;9(1):e001258. doi: 10.1136/bmjresp-2022-001258
Journal / Source Title
BMJ Open Respiratory Research
DOI
10.1136/bmjresp-2022-001258
PMID
36167472
Publisher
BMJ Publishing Group
Publisher’s URL
http://bmjopenrespres.bmj.com/