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Systematic Review

COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3: Results of a Systematic Review and Meta-Analysis

1
Independent Researcher, D-69117 Heidelberg, Germany
2
Independent Researcher, D-72076 Tübingen, Germany
3
Artificial Intelligence, IU International University of Applied Sciences, D-99084 Erfurt, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: John H. White
Nutrients 2021, 13(10), 3596; https://doi.org/10.3390/nu13103596
Received: 28 September 2021 / Revised: 9 October 2021 / Accepted: 11 October 2021 / Published: 14 October 2021
(This article belongs to the Section Nutrition and Public Health)
Background: Much research shows that blood calcidiol (25(OH)D3) levels correlate strongly with SARS-CoV-2 infection severity. There is open discussion regarding whether low D3 is caused by the infection or if deficiency negatively affects immune defense. The aim of this study was to collect further evidence on this topic. Methods: Systematic literature search was performed to identify retrospective cohort as well as clinical studies on COVID-19 mortality rates versus D3 blood levels. Mortality rates from clinical studies were corrected for age, sex, and diabetes. Data were analyzed using correlation and linear regression. Results: One population study and seven clinical studies were identified, which reported D3 blood levels preinfection or on the day of hospital admission. The two independent datasets showed a negative Pearson correlation of D3 levels and mortality risk (r(17) = −0.4154, p = 0.0770/r(13) = −0.4886, p = 0.0646). For the combined data, median (IQR) D3 levels were 23.2 ng/mL (17.4–26.8), and a significant Pearson correlation was observed (r(32) = −0.3989, p = 0.0194). Regression suggested a theoretical point of zero mortality at approximately 50 ng/mL D3. Conclusions: The datasets provide strong evidence that low D3 is a predictor rather than just a side effect of the infection. Despite ongoing vaccinations, we recommend raising serum 25(OH)D levels to above 50 ng/mL to prevent or mitigate new outbreaks due to escape mutations or decreasing antibody activity. View Full-Text
Keywords: mortality; vitamin D; calcidiol; calcitriol; D3; COVID-19; inflammation; SARS-CoV-2; ARDS; immune status; immunodeficiency; renin; angiotensin; ACE2; virus infection; cytokine release syndrome; CRS mortality; vitamin D; calcidiol; calcitriol; D3; COVID-19; inflammation; SARS-CoV-2; ARDS; immune status; immunodeficiency; renin; angiotensin; ACE2; virus infection; cytokine release syndrome; CRS
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  • Externally hosted supplementary file 1
    Doi: 10.7910/DVN/7FSWNL
    Link: https://doi.org/10.7910/DVN/7FSWNL
    Description: Collected study data and source code used in analysis
MDPI and ACS Style

Borsche, L.; Glauner, B.; von Mendel, J. COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3: Results of a Systematic Review and Meta-Analysis. Nutrients 2021, 13, 3596. https://doi.org/10.3390/nu13103596

AMA Style

Borsche L, Glauner B, von Mendel J. COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3: Results of a Systematic Review and Meta-Analysis. Nutrients. 2021; 13(10):3596. https://doi.org/10.3390/nu13103596

Chicago/Turabian Style

Borsche, Lorenz, Bernd Glauner, and Julian von Mendel. 2021. "COVID-19 Mortality Risk Correlates Inversely with Vitamin D3 Status, and a Mortality Rate Close to Zero Could Theoretically Be Achieved at 50 ng/mL 25(OH)D3: Results of a Systematic Review and Meta-Analysis" Nutrients 13, no. 10: 3596. https://doi.org/10.3390/nu13103596

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