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Factors associated with Covid-19 deaths in records of 17M adult NHS patients

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Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#81

Post by gridlockd »

pbowyer wrote: post #79
mindviews wrote: post #26

Here's a link to the paper: https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v... 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: [1] https://p…

The Centre for Evidence-Based Medicine at Oxford did a rapid review of the literature on Vitamin D: https://www.cebm.net/covid-19/vitamin-d-a-rapid-review-of-th... Unsurprisingly there's no direct clinical evidence.

> Unsurprisingly there's no direct clinical evidence.

"We searched for trials and didn't find any"

Unsurprisingly, there haven't been any (completed) trials on this particular combination of novel disease and possible prevention/treatment yet.

I'm concerned that people conflate "no evidence for efficacy" with "it doesn't work" instead of "we don't know if it works". You always start out with "no evidence".

There are studies that put serum Vitamin D levels against COVID-19 outcomes and they show a highly significant correlation. That's not "causal evidence", but it should put you on alert, you shouldn't be waiting for 2021 for possible Vitamin-D trials to complete.

As the authors of that review are saying, you should be supplementing anyway, whether there is a causal relationship or not.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#82

Post by rjsw »

elliekelly wrote: post #39
loeg wrote: post #35

Earlier quoted context omitted.

It seems pretty remarkable that men have a hazard factor 2x that of women as well.

There was a post on HN a few days ago about a study that found low testosterone levels were correlated with worse Covid-19 outcomes. I think vitamin D is technically a hormone (or maybe is hormone-like?) so I wonder if it’s absorbed differently by men than women. Or maybe low testosterone is just a side effect of a vitamin D deficiency in men.

One study suggested that progesterone was a factor in reducing viral levels.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#83

Post by ckastner »

supernova87a wrote: post #78
ckastner wrote: post #63

Earlier quoted context omitted.

As far as I understand it, they are comparing the statistics of the 5,683 sample to the 17M in order to determine whether anything stands out. If Covid-19 deaths had no associated factors, then we shouldn't see much of a difference between the two. However, we are seeing differences, for example with diabetes.

Yes that's true, but the 17M figure isn't the interesting / groundbreaking thing. At least it shouldn't be made out to be as if that's the significant thing. 17M just provides the baseline of "normal". Tons more data isn't needed to get that right. 170M wouldn't make a difference. I bet 1.7M wouldn't make a big difference either. What we really need to know right now is how the Covid deaths behave. All that this offe…

I have to admit, the title does sound misleading in this regard, and (to me) even more so the tweets advertising the paper as per the submission.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#84

Post by andor »

phogster wrote: post #68
tom_mellior wrote: post #59

Earlier quoted context omitted.

The thread is good, but a possible link with nicotine has been observed before. This might just be the unlikely case where smoking does indirectly confer some health benefit.

Maybe because it could cause you to go outside, increasing exposure to the sun.

In this specific case, going outside would help reduce exposure to aerosolized saliva.

Imagine people at a bar. The smokers would stand outside in the cold, smoking, while the non-smokers inside are warmer but at higher risk of catching an infection.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#85

Post by gridlockd »

slg wrote: post #55
ip26 wrote: post #41

Earlier quoted context omitted.

The critical question remains though- is vitamin D the causal factor, or instead an indicator of something else?

I agree, we need better evidence on all the vitamin D claims. Comparing rich white people in the suburbs who have lots of open land to get sun and use for exercise versus poorer darker skinned people in dense inner city apartments who spend most of their time inside introduces numerous confound factors that will be highly correlated with vitamin D.

> I agree, we need better evidence on all the vitamin D claims.

Not really. We should be blasting "get your Vitamin D supplements" from the rooftops, because maybe that's a significant factor in COVID-19 and it's safe and people should get them anyway. There's no downside.

If in a few years it then turns out that Vitamin D had nothing to do with it, it doesn't matter. If it turns out that Vitamin D really was a big factor, we'll be sorry for being hesitant with a safe and cheap intervention.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#86

Post by gridlockd »

m463 wrote: post #75
excalibur wrote: post #51

Earlier quoted context omitted.

Sun exposure is far more likely to be the causal factor.

and/or a diet deficient in D (or whatever gets converted to D with sunlight exposure)

There's nothing particular that is required in the diet to synthesize Vitamin D3 from the sun.

Without sun exposure, you'd have to be eating several pounds of fatty fish every day to get to "healthy" levels from diet alone. You need a supplement.

Keep in mind, non-severe Vitamin D deficiency doesn't cause any significant evolutionary pressure, so migrating humans just rolled with it - to this day.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#87

Post by vixen99 »

m463 wrote: post #74
martingoodson wrote: post #46

Earlier quoted context omitted.

In case you weren't aware, controlled trials have shown that vitamin d supplementation protects against respiratory disease [1]. This is evidence that the association you highlight is more than a spurious correlation. It's likely to be causal. [1] https://www.bmj.com/content/356/bmj.i6583

A friend of mine had cancer and they had him taking D3 immediately. also I was out shopping recently and they seemed to sell many varieties of D3, but I didn't see any other D vitamins offered for sale. Is D deficiency really D3 deficiency? or have the other D vitamins sold out?

https://vitamindwiki.com/ is a useful aggregate site for papers (peer-reviewed and others) on vitamin D. The latter is cholecalciferol (https://en.wikipedia.org/wiki/Cholecalciferol).

https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessiona... (excellent series for all vitamins)

Different manufacturers = varieties? It's the same stuff or should be.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#88

Post by MrBuddyCasino »

gridlockd wrote: post #85
slg wrote: post #55

Earlier quoted context omitted.

I agree, we need better evidence on all the vitamin D claims. Comparing rich white people in the suburbs who have lots of open land to get sun and use for exercise versus poorer darker skinned people in dense inner city apartments who spend most of their time inside introduces numerous confound factors that will be highly correlated with vitamin D.

> I agree, we need better evidence on all the vitamin D claims. Not really. We should be blasting "get your Vitamin D supplements" from the rooftops, because maybe that's a significant factor in COVID-19 and it's safe and people should get them anyway. There's no downside. If in a few years it then turns out that Vitamin D had nothing to do with it, it doesn't matter . If it turns out that Vitamin D really was a big…

This. People need to take convexity of risk into account. Taleb has elaborated on this over and over again, its really straightforward.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#89

Post by z3t4 »

gridlockd wrote: post #85
slg wrote: post #55

Earlier quoted context omitted.

I agree, we need better evidence on all the vitamin D claims. Comparing rich white people in the suburbs who have lots of open land to get sun and use for exercise versus poorer darker skinned people in dense inner city apartments who spend most of their time inside introduces numerous confound factors that will be highly correlated with vitamin D.

> I agree, we need better evidence on all the vitamin D claims. Not really. We should be blasting "get your Vitamin D supplements" from the rooftops, because maybe that's a significant factor in COVID-19 and it's safe and people should get them anyway. There's no downside. If in a few years it then turns out that Vitamin D had nothing to do with it, it doesn't matter . If it turns out that Vitamin D really was a big…

Overdosing D can be dangerous as it takes a long time to leave your body.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#90

Post by leto_ii »

m463 wrote: post #74
martingoodson wrote: post #46

Earlier quoted context omitted.

In case you weren't aware, controlled trials have shown that vitamin d supplementation protects against respiratory disease [1]. This is evidence that the association you highlight is more than a spurious correlation. It's likely to be causal. [1] https://www.bmj.com/content/356/bmj.i6583

A friend of mine had cancer and they had him taking D3 immediately. also I was out shopping recently and they seemed to sell many varieties of D3, but I didn't see any other D vitamins offered for sale. Is D deficiency really D3 deficiency? or have the other D vitamins sold out?

The way I understood it, D3 is the easiest one to absorb. Both D2 and D3 do the same thing, but their efficiency is different.
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