Associations between predicted vitamin D status, vitamin D intake, and risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) severity. Issue 4 (3rd December 2021)

• Record Type: Journal Article
• Authors: Ma, Wenjie; Nguyen, Long H; Yue, Yiyang; Ding, Ming; Drew, David A; Wang, Kai; Merino, Jordi; Rich-Edwards, Janet W; Sun, Qi; Camargo, Carlos A; Giovannucci, Edward; Willett, Walter; Manson, JoAnn E; Song, Mingyang; Bhupathiraju, Shilpa N; Chan, Andrew T
• Is Part Of: American journal of clinical nutrition. Volume 115:Issue 4(2022)
• Page Start: 1123
• Page End: 1133
• Publication Date: 2021-12-03
• Subjects: vitamin D -- SARS-CoV-2 -- COVID-19 -- diet -- supplement -- infection -- severity -- solar UV-B -- UV-A -- Robertson-Berger meter; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqab389
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: Vitamin D may have a role in immune responses to viral infections. However, data on the association between vitamin D and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) severity have been limited and inconsistent. Objective: We examined the associations of predicted vitamin D status and intake with risk of SARS-CoV-2 infection and COVID-19 severity. Methods: We used data from periodic surveys (May 2020 to March 2021) within the Nurses' Health Study II. Among 39, 315 participants, 1768 reported a positive test for SARS-CoV-2 infection. Usual vitamin D intake from foods and supplements were measured using a semiquantitative, pre-pandemic food-frequency questionnaire in 2015. Predicted 25-hydroxyvitamin D [25(OH)D] concentration were calculated based on a previously validated model including dietary and supplementary vitamin D intake, UV-B, and other behavioral predictors of vitamin D status. Results: Higher predicted 25(OH)D concentrations, but not vitamin D intake, were associated with a lower risk of SARS-CoV-2 infection. Comparing participants in the highest quintile of predicted 25(OH)D concentrations with the lowest, the multivariable-adjusted OR was 0.76 (95% CI: 0.58, 0.99; P -trend = 0.04). Participants in the highest quartile of UV-B (OR: 0.76; 95% CI: 0.66, 0.87; P -trend = 0.002) and UV-A (OR: 0.76; 95% CI: 0.66, 0.88; P -trend < 0.001) also had a lower risk of SARS-CoV-2 infection compared with the lowest. High intake of vitamin D from supplements (≥400 IU/d) was associated with a lower risk of hospitalization (OR: 0.51; 95% CI: 0.29, 0.91; P -trend = 0.04). Conclusions: Our study provides suggestive evidence on the association between higher predicted circulating 25(OH)D concentrations and a lower risk of SARS-CoV-2 infection. Greater intake of vitamin D supplements was associated with a lower risk of hospitalization. Our data also support an association between exposure to UV-B or UV-A, independently of vitamin D and SARS-CoV-2 infection, so results for predicted 25(OH)D need to be interpreted cautiously.