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Detectable respiratory SARS-CoV-2 RNA is associated with low vitamin D levels and high social deprivation
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  • Mark Livingston,
  • Aiden Plant,
  • Simon Dunmore,
  • Andrew Hartland,
  • Stephen Jones,
  • Ian Laing,
  • Sudarshan Ramachandran
Mark Livingston
Walsall Manor Hospital
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Aiden Plant
Walsall Manor Hospital
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Simon Dunmore
University of Wolverhampton
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Andrew Hartland
Walsall Manor Hospital
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Stephen Jones
Walsall Manor Hospital
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Ian Laing
Royal Preston Hospital
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Sudarshan Ramachandran
University Hospitals Birmingham NHS Foundation Trust
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Abstract

Aims: Accumulating evidence links COVID-19 incidence and outcomes with vitamin D status. We investigated if an interaction existed between vitamin D levels and social deprivation in those with and without COVID-19 infection. Methods: Upper- or lower-respiratory tract samples from 104 patients were tested for SARS-CoV-2 RNA in accordance with Public Health England criteria (January–May 2020) using RT-PCR. The latest serum total 25-hydroxyvitamin D(25-OHD) levels, quantified by LC-MS/MS, was obtained for each patient (September 2019–April 2020). Index of Multiple Deprivation (IMD) was generated for each patient. Univariate and logistic regression analyses examined associations between age, gender, 25-OHD, IMD score and SARS-CoV-2 result in the total cohort and subgroups. Results: In the total cohort, a positive SARS-CoV-2 test was significantly associated with lower 25-OHD levels and higher IMD. A positive test was associated with higher IMD in the male subgroup and with lower 25-OHD levels in those aged >72 years. Low 25-OHD and IMD quintile 5 were separately associated with positive COVID-19 outcome in the cohort. Patients in IMD quintile 5 with vitamin D levels ≤34.4 nmol/L were most likely to have a positive COVID-19 outcome, even more so if aged >72 years (OR: 19.07, 95%CI: 1.71–212.25; p=0.016). Conclusions: In this cohort, combined low vitamin D levels and higher social deprivation were most associated with COVID-19 infection. In older age, this combination was even more significant. Our data supports the recommendations for normalising vitamin D levels in those with deficient / insufficient levels and in groups at high-risk for deficiency.

Peer review status:UNDER REVIEW

27 May 2020Submitted to International Journal of Clinical Practice
28 May 2020Assigned to Editor
28 May 2020Submission Checks Completed
28 May 2020Reviewer(s) Assigned