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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

#121

Post by tinus_hn »

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.

This review found nothing, so they found ‘no clinical evidence on vitamin D in COVID-19.’ No evidence for and no evidence against.

‘We found no trials of vitamin D in COVID-19 that have reported results.’

‘As our searches returned no relevant results, [...]’

But keep on posting the paper though.

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

#122

Post by goblin89 »

0-_-0 wrote: post #111

Interesting that being an ex-smoker increases the risk, but being a current smoker decreases it. Seems like there is some short term benefit to smoking that outweighs its long term negative health effects.

As someone who relatively freshly started smoking 1.5 years ago, I find it insidious. After stopping for a day or two, I actually feel better as tension goes away and I sleep a lot. Shortly, however, I start randomly getting sneezes, runny nose, and slight ill-like feeling in my head.

Part of what makes me start again is the desire to avoid spooking others with those flu-like symptoms in the middle of an epidemic, since I live in a densely populated area.

I don’t have a clear idea of what mechanism is at work here, my hypothesis is that the withdrawal somehow suppresses my immune system.

Unfortunately, as far as I can tell, nicotine patches aren’t as good (or useful at all) at reducing the respiratory symptoms in short term. I suppose it’s not purely nicotine withdrawal that’s causing this.

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

#123

Post by 0-_-0 »

Nextgrid wrote: post #120
0-_-0 wrote: post #111

Interesting that being an ex-smoker increases the risk, but being a current smoker decreases it. Seems like there is some short term benefit to smoking that outweighs its long term negative health effects.

Could it be a measurement error or that smokers who would’ve died because of covid already did die of something else or get a different condition before, essentially making it survivor bias?

The survivor bias argument doesn't work for the other health problems listed so I don't think it would work for smoking

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

#124

Post by bad_user »

new_realist wrote: post #12

It’s not surprising that historically plague-ridden Europeans would be less susceptible to a new blight then other ethnicities. Disease resistance has been selected for.

These factors aren't causal.

In western countries at least, an obvious confounded for those of asian or black ethnic descent is _poverty_ and thus access to healthcare, malnutrition, sleep deprivation, poor education and everything else that goes with poverty.

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

#125

Post by Filligree »

ashtonkem wrote: post #52
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…

Two takeaways. [2] is pretty scary. As a 30 year old I know that my chance of death is low, but I’d like to avoid a “severe” or “critical” case. There are a large number of unpleasant states between “fine” and “dead” that I’d like to not experience. A 50/50 chance of it being no big deal are worse odds than I’d prefer. [1] is sending me back out onto the patio this weekend for tanning.

Unless you spend literally hours outside every day, it's not likely to be enough.

Get some cod liver oil, drink a tablespoon every day. Does wonders.

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

#126

Post by slg »

gridlockd wrote: post #116
slg wrote: post #106

Earlier quoted context omitted.

You are right that vitamin D is relatively safe compared to other potential treatments that were bandied about like hydroxychloroquine. But while there are fewer health risks from taking it, there are still the same behavioral issues that were present with hydroxychloroquine. The first is causing a run on vitamin D that prevents other people from acquiring if for their proven treatments. However the main issue that I…

> The first is causing a run on vitamin D that prevents other people from acquiring if for their proven treatments. Vitamin D is an easily manufactured supplement, it's not medicine that some people absolutely have to take every day. Also, we're heading into summer and the sun is still rising every day. > However the main issue that I think we want to prevent is luring people into a false sense of security that cause…

Hand sanitizer is also easy to manufacture and I haven't seen it in a local store for over 10 weeks. The ease to manufacture is just one of the steps to getting it on the shelves. Also getting vitamin D from the sun isn't an option for some people, especially those with darker skin.

The difference between masks and vitamin D is that one is proven to work and one might work. If vitamin D doesn't help as much as people here are claiming, there is a real downside if people are behaving as if it works. That applies to my arbitrary example of beach gatherings as well as other behavior the government has no hope of preventing.

Once again, this doesn't necessarily mean that vitamin D doesn't help. We just need better data. The early indication was that hydroxychloroquine helped too and we all know how that turned out.

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

#127

Post by conistonwater »

tinus_hn wrote: post #121
pbowyer wrote: post #79

Earlier quoted context omitted.

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.

This review found nothing, so they found ‘no clinical evidence on vitamin D in COVID-19.’ No evidence for and no evidence against. ‘We found no trials of vitamin D in COVID-19 that have reported results.’ ‘As our searches returned no relevant results, [...]’ But keep on posting the paper though.

I think that's a poor summary of the paper, here's the rest of the abstract:

"There is some evidence that daily vitamin D3 supplementation over weeks to months may prevent other acute respiratory infections, particularly in people with low or very low vitamin D status. This evidence has limitations, including heterogeneity in study populations, interventions, and definitions of respiratory infections that include upper and lower respiratory tract involvement."

"The current advice is that the whole population of the UK should take vitamin D supplements to prevent vitamin D deficiency. This advice applies irrespective of any possible link with respiratory infection."

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

#128

Post by McP »

triplea9 wrote: post #67
dehrmann wrote: post #61

Earlier quoted context omitted.

South Asians and East Asians are pretty different genetically, so the lack of distinction really doesn't help.

In the UK Asian == South Asian

Source? I've never got that impression as an English person. I consider it to be non-specific. However, if you're in a place like Southall or Bradford then the "Asian" people around you are indeed more likely to be south Asian.

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

#129

Post by robinhouston »

goblin89 wrote: post #122
0-_-0 wrote: post #111

Interesting that being an ex-smoker increases the risk, but being a current smoker decreases it. Seems like there is some short term benefit to smoking that outweighs its long term negative health effects.

As someone who relatively freshly started smoking 1.5 years ago, I find it insidious. After stopping for a day or two, I actually feel better as tension goes away and I sleep a lot. Shortly, however, I start randomly getting sneezes, runny nose, and slight ill-like feeling in my head. Part of what makes me start again is the desire to avoid spooking others with those flu-like symptoms in the middle of an epidemic, si…

This is a real effect. Smoking paralyses the cilia; about 4–6 days after cessation, the cilia become active again and start to bring up mucus from the lungs.

The good news is that these symptoms are temporary.

Public health communications on the benefits of cessation don’t usually mention this. I wonder if that’s a mistake. I would have thought it puts a lot of people off quitting, and maybe if they knew what was happening it would be easier to deal with.

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

#130

Post by lrpublic »

martingoodson wrote: post #46
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…

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

Updated NHS advice on vitamin D from [1]

“ Coronavirus update Consider taking 10 micrograms of vitamin D a day to keep your bones and muscles healthy.

This is because you may not be getting enough vitamin D from sunlight if you’re indoors most of the day.

There have been some news reports about vitamin D reducing the risk of coronavirus. However, there is no evidence that this is the case.”

[1] https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-...

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