Factors associated with Covid-19 deaths in records of 17M adult NHS patients
Here's a link to the paper: <a href="https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1.full.pdf" rel="nofollow">https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v...</a><p>This is interesting data.  I want to see Vitamin D status included in a large population study like this because I've been following two smaller studies covering about a thousand cases total that shows Vitamin D deficiency has a risk ratio of 10 to 20 (more even than being age 80+ in the above study).  The studies:<p>[1] <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3585561" rel="nofollow">https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3585561</a><p>[2] <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484" rel="nofollow">https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484</a><p>Table 1 in each of those papers show Vitamin D status vs Outcomes. The correlation between Vitamin D status, where Normal is >30 ng/ml (or 75 nmol/L), and death rates is stark.<p>From [1] (which had n=780 cases) here is the punchline: "98.9% of Vitamin D deficient cases died while only 1.1% of them were active cases. 87.8% of Vitamin D insufficient cases died while only 12.2% of them were active cases. Only 4.1% of cases with normal Vitamin D levels died while 95.9% of them were active cases."<p>From [2] (which had n=212 cases) here is the punchline: "Of the 212 (100.0%) cases of Covid-2019, 49 (23.1%) were identified mild, 59 (27.8%) were ordinary, 56 (26.4%) were severe, and 48 (22.6%) were critical (Table 1). Mean serum 25(OH)D level was 23.8 ng/ml. Serum 25(OH)D level of cases with mild outcome was 31.2 ng/ml, 27.4 ng/ml for ordinary, 21.2 ng/ml for severe, and 17.1 ng/ml for critical."<p>Note: the classification for outcomes was "(1) mild – mild clinical features without pneumonia diagnosis, (2) ordinary – confirmed pneumonia in chest computer tomography with fever and other respiratory symptoms, (3) severe – hypoxia (at most 93% oxygen saturation) and respiratory distress or abnormal blood gas analysis results (PaCO2 >50 mm Hg or PaO2 < 0 mm Hg), and (4) critical – respiratory failure requiring intensive case monitoring."<p>I want to see a dozen more studies like [1] and [2] to see if this holds up to replication with larger populations.