Detectable respiratory SARS-CoV-2 RNA is associated with low vitamin D
levels and high social deprivation
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.