Vitamin D may Reduce Severity of COVID-19

New research points to vitamin D as a low-cost way to reduce the severity of coronavirus.

As medicine urgently searches for therapies to treat COVID-19, no vaccine or effective anti-viral treatment is yet available. Two new studies, however, highlight the relationship between low vitamin D levels and COVID-19 death rates, and point to an effective treatment to reduce the severity of the pandemic.

Natural food sources of vitamin D include salmon (above), and mushrooms that have been exposed to ultraviolet light. Vitamin D may be a low-cost way to reduce the severity of COVID-19.

In the first study, researchers at Trinity College in Dublin reviewed national health data from 12 European countries. Their work found a strong statistical association between low vitamin D levels and COVID-19 deaths, with data suggesting the vitamin is likely to reduce serious coronavirus complications.

The second study, from Northwestern University, analyzed COVID-19 patient data from 10 countries around the world. The analysis found a correlation between low Vitamin D levels and patients with overactive immune systems causing fatal respiratory failure. The study estimated that if patients have sufficient vitamin D levels, death rates from severe COVID-19 could be cut by 50 percent.

Vitamin D Deficiency: A Major Public Health Problem in Canada

Vitamin D is an essential nutrient to sustain human health. Its primary job is to maintain bone strength and growth by regulating calcium and phosphorus absorption. It also supports the immune system.

Sunlight exposure on the skin produces about 90 percent of vitamin D in the body. In our modern society, however, people spend most of their time indoors. This means vitamin D deficiency is a major public health problem across all age groups around the world.

In Canada, with its low levels of fall and winter sunlight, this is especially true. Vitamin D deficiency is typically worse for Canadian seniors because production of vitamin D in the skin decreases with age. Statistics Canada reports that over a million Canadians are vitamin D deficient. Deficiency is a risk factor for osteoporosis in adults. One third of all Canadians have insufficient vitamin D blood levels, below 50 nmol/L.

In addition to regulating bone health, vitamin D is a key factor in maintaining a strong immune system, fighting infection, and reducing inflammation. For example, severe cases of COVID-19 trigger an immune reaction which produces anti-viral proteins called cytokines. Due to the virus’ rapid replication, the body may produce too many cytokines, which damage its own tissues—especially the lungs.

Vitamin D of a sufficient level—75 to 150 nanomoles per litre of blood (nmol/L)—moderates this cytokine overproduction, and makes “cytokine storms” less likely. As the research at Northwestern University showed, higher vitamin D levels could reduce death rates from severe COVID-19 by an estimated 50 percent.

Vitamin D Tests Restricted

Vitamin D supplements can boost levels when sunshine and food sources are not enough. Although British Columbia recommends vitamin D supplements for health, its Medical Services Plan does not provide free routine vitamin D blood tests. A vitamin D blood test can determine when supplementation is needed.

In the early 2000s, a growing body of research suggested that vitamin D levels above 75 nmol/L reduced the risk of cancer, cardiovascular disease, diabetes, and multiple sclerosis by strengthening the immune system. This led to a dramatic increase in demand for the vitamin D blood test across Canada.

In Ontario, for example, the cost to the province for vitamin D tests rose from $1.7 million dollars in 2004 to $66 million in 2009. Alarmed by the rapid expense increase, Ontario restricted vitamin D test coverage to a few relatively rare conditions.

British Columbia soon followed suit. In 2013, BC began to charge patients for routine vitamin D blood tests (except for those with certain medical conditions). British Columbian adults now pay $61.32 for a vitamin D test. This amount is charged to the patient—effectively acting as a deterrent to routine testing.

Although BC does not cover routine vitamin D tests, the province continues to recommend modest vitamin D supplementation for various age groups. Without yearly assessment, however, patients do not know their actual vitamin D blood status or whether they are reaching healthy levels. Given the low nationwide vitamin D values outlined by Statistics Canada, it is likely that a majority of Canadians do not have optimal levels. At present, a vitamin D level of 75–150 nmol/L is believed necessary for chronic disease prevention and resistance to bacterial and viral infections.

The Value of Vitamin D Testing

Vitamin D tests have proved their value in other parts of the world. In Britain, a nine-year study of 365,000 volunteers found a 17 percent reduction in death from all causes in people with sufficient vitamin D levels.

Canada currently spends about 3 billion dollars a year on cancer treatment. A 17 percent reduction in cancer cases, for example, would save $510 million dollars a year in health care expenses and greatly reduce human suffering from the disease.

Changing public health policy to reach the recommended 75 nmol/L vitamin D baseline level is an achievable goal for all British Columbians. To do this would require the Medical Services Plan (MSP) to provide a free yearly vitamin D test as part of the covered physical exam services. Vitamin D levels should be as well known and useful for monitoring your health as your cholesterol or blood sugar levels.

The pandemic is teaching us many lessons. The value of solving Canada’s vitamin D deficiency is one of the most important. Public policy that offers broad health benefits at an affordable cost should be a priority for provincial lawmakers. Let’s make free vitamin D testing part of a yearly physical assessment in British Columbia, and help stem the impact of COVID-19.

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