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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

#71

Post by sterlind »

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.

It could also be low levels of sex hormones in general - having neither estrogen nor testosterone in your body causes osteoporosis, for example. Excess testosterone is metabolized into estrogen, as well.

But the endocrine system is ferociously complex - maybe endocrine abnormalities are a proxy for obesity, or an underlying thyroid issue etc.

According to [0], vitamin D deficiency is associated with higher free testosterone in men and lower estradiol in women. Higher testosterone is associated with cardiovascular problems, which are a big COVID risk factor.

But that doesn't jib well with the study you find, so I dunno what to make of it.

0. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5218632/#__ffn_...

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

#72

Post by meheleventyone »

arethuza wrote: post #57
TuringNYC wrote: post #33

Earlier quoted context omitted.

>> is only partially attributable to pre-existing clinical risk factors or deprivation I'd expect more it is attributable to less access to premium healthcare (remember, in the UK everyone gets healthcare, but not everyone gets privately-sponsored add-on healthcare)

Private healthcare providers in the UK don't seem to be providing hospital treatment for COVID-19 - this is left to the NHS, BUPA says: "As a public health emergency, COVID-19 is being treated through the public health system." https://www.bupa.co.uk/coronavirus/health-insurance Not that private healthcare providers are actually providing resources to the NHS so its possible that you could end up in a private hospita…

This is pretty common in places with dual systems, my wife just had surgery on her shoulder in a private clinic but paid for by the public system.

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

#73

Post by econcon »

JPKab wrote: post #25
lettergram wrote: post #19

I think one of the key takeaways is in the abstract: > People from Asian and black groups are at markedly increased risk of in-hospital death from COVID-19, and contrary to some prior speculation is only partially attributable to pre-existing clinical risk factors or deprivation

Deprivation equals poverty. Asian in Britain will primarily be Indian/Pakistani descent. I wonder if this is vitamin d related? Darker complexion of black and Asian could cause higher risks of vitamin d deficiency in UK.

But Indian/Pakistani aren't dying at much higher rate in their own country or are they? I've no data.

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

#74

Post by m463 »

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

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?

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

#75

Post by m463 »

excalibur wrote: post #51
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?

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)

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

#76

Post by m463 »

loeg wrote: post #35
lettergram wrote: post #19

I think one of the key takeaways is in the abstract: > People from Asian and black groups are at markedly increased risk of in-hospital death from COVID-19, and contrary to some prior speculation is only partially attributable to pre-existing clinical risk factors or deprivation

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

Men also might have other factors compared to women. As an example 2x as many men vs women die in auto accidents.

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

#77

Post by m463 »

tonyedgecombe wrote: post #70
phogster wrote: post #68

Earlier quoted context omitted.

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

Or kill you before you get to a vulnerable age.

it might work like a mask if you always inhale through a filter and an inferno.

It might even purify your second-hand smoke.

but yes, you have a very real point. I remember reading about some drug that seemed to give people heart attacks, but it actually cured what it was supposed to and heart attacks were the next statistically likely thing to get you.

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

#78

Post by supernova87a »

ckastner wrote: post #63
supernova87a wrote: post #53

The title / headline is overstating it a little. The sample only contains 5,683 people who died of the virus. The 17M is the sample of hospital patients in general. I don't know if this is on purpose, but it makes the study sound artificially more significant. Every study could claim the "17M" figure by this practice.

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 offers is the 5,683 sample, but the title inflates it to emphasize the 17M. We need the 5,683 sample to be merged with other samples to reach 56,830, etc. That is the significant thing.

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

#79

Post by pbowyer »

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.

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

#80

Post by rjsw »

tom_mellior wrote: post #59
smt88 wrote: post #56

It seems like a lot of people are interpreting this data as causal. I've already had people tell me they were surprised to learn that smoking protects against Covid! Here's a fantastic explanation of why you should not let your brain tell you that you're learning about things that cause Covid complications and death: https://twitter.com/EpiEllie/status/1258607277357006849

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.

Nicotine must have some evolutionary benefit to the tobacco plant, perhaps it helps it resist the Tobacco mosaic virus.
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