An important and easily-modifiable risk factor for COVID-19
severity and death is low vitamin D levels. Vitamin D deficiency
is widespread in Ireland and the UK, and the BAME community is at
even higher risk.
Please see the research from the Philippines (
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484)
and Indonesia (
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3585561).
Both show that these risks are much higher for people whose 25OHD
levels are less than 30ng/ml (75nmol/L) compared to those with
higher levels.
Kawasaki disease has been recognised for 50 years and most doctors
and researchers regard its etiology as being due to a viral or
bacterial trigger combined with other factors which remain
elusive, but which are generally believed to be genetic. Yet they
note its prevalence, in Paris, among dark-skinned children
(
https://www.medrxiv.org/content/medrxiv/early/2020/05/14/2020.05.10.20097394),
its correlation with winter and early spring
(
https://www.cesm-cv.org/wp-content/uploads/2020/04/kwasaki-y-covid19.pdf
,
https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2931103-X)
and the involvement of an exaggerated inflammatory response. Of
the 15 articles I found concerning COVID-19 and Kawasaki disease
http://aminotheory.com/cv19/kd/
9 mentioned inflammation. None of these articles mentioned vitamin
D, despite vitamin D deficiency being a very well known cause of
weak and dysregulated, overly-aggressive, pro-inflammatory immune
responses (
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4070857/).
2016 research from Italy:
Severe vitamin D deficiency in patients with Kawasaki disease: a
potential role in the risk to develop heart vascular
abnormalities?
Stefano Stagi et al. Clinical Rheumatology volume 35, pages
1865–1872 (2016)
https://link.springer.com/article/10.1007/s10067-015-2970-6
https://sci-hub.tw/10.1007/s10067-015-2970-6
shows that children with Kawasaki disease had very low 25OHD
levels: 9.2ng/ml compared to 23.3ng/ml for age-matched healthy
controls. Those children who developed coronary artery
abnormalities averaged 4.9ng/ml. These averages are 20% to 11% of
the 46ng/ml average of African herders and hunter gatherers:
https://www.ncbi.nlm.nih.gov/pubmed/22264449
.
It is easy to understand vitamin D deficiency, combined with
genetic and probably other nutritional factors, causing such
weakened and dysregulated immune response that COVID-19 triggers
Kawasaki disease in children and severe lung inflammation,
followed by a hypercoagulative state in adults:
https://emcrit.org/emcrit/pathophysiology-of-covid19/
and
https://www.nejm.org/doi/full/10.1056/NEJMoa2015432
.
While there may be some parallel causation (unseen factors driving
both disease severity and vitamin D deficiency) and perhaps some
reverse causation (if it could be shown that inflammatory diseases
significantly lower 25OHD levels) these considerations are minor
compared to the surely largely causative relationship between low
vitamin D levels and weakened and excessively inflammatory immune
responses.
It is more difficult to understand why most doctors and
researchers remain unaware this 2016 Italian research. Likewise,
few seem to be aware of the Philippino and Indonesian research.
There has long been a need to raise everyone's 25OHD to at least
30ng/ml - aiming for 40 to 60ng/ml - to ensure strong and
well-regulated immune responses and so to protect against a
plethora of chronic illnesses, including MS, neurodegeneration,
diabetes etc. With COVID-19 threatening to infect most people in
the months to come, there is an urgent need for robust vitamin D
supplementation to prevent the current pattern of harm and death.
This is unlikely to occur until most doctors recognise the need
for this.
Yet, in a widely reported article
https://nutrition.bmj.com/content/early/2020/05/15/bmjnph-2020-000089
Susan Lanham-New and twenty colleagues support the UK standards
for vitamin D3 supplementation (400IU/day for adults) and its aim
for most of the population to have more than 10ng/ml 25OHD. This
is 1/3 of the level reported by Philippino and Indonesian
researchers as an apparent threshold of relative safety.