Vitamin D in spotlight for COVID-19 following UK parliamentary comments

02 Oct 2020 --- Vitamin D is in the spotlight as UK’s health minister, Matt Hancock, looks to hear about “all possible scientific advances that might be helpful” in the fight against COVID-19. This comes in light of new evidence pointing to the vitamin’s efficacy, which is in contrast to previous government-backed reviews.

Hancock is set to meet with Dr. Rupa Huq and David Davis, members of parliament (MPs) who have repeatedly called for vitamin D to be investigated as a low-cost and low-risk intervention. 

Davis has previously detailed two potential courses of action for correcting vitamin D deficiency in UK consumers to reduce the risk of serious COVID-19 complications. 

First called for in May, one course of action is encouraging people to use supplements to boost their vitamin D intake, potentially by the NHS providing them for free. According to Davis, this would cost less than a penny a pill – which is “trivial” in comparison to the costs of lockdown.

The second option would be to fortify foods like bread, flour and milk with vitamin D. Davis argues that the best approach would be a combination of fortification, supplementation and a public health education campaign. 

“It’s important that the government takes the potential benefits of vitamin D seriously when it comes to COVID-19. I hope they now investigate the evidence properly,” Liberal Democrat MP Layla Moran tells NutritionInsight. 

Evidence under review
Last week, a study from the Boston University School of Medicine found that in comparison with vitamin D- deficient patients, vitamin D-sufficient hospitalized COVID-19 patients had a significant decreased risk for adverse clinical outcomes, including unconsciousness, hypoxia (body starved for oxygen) and death.

Moreover, the patients had lower blood levels of C-reactive protein, an inflammatory marker, and higher blood levels of lymphocytes, a type of immune cell to help fight infection. The study authors view sufficient vitamin D intake as a cost-effective strategy to reduce the severity of morbidities and mortality associated with acquiring COVID-19. 

In response to the US study, a Department of Health and Social Care spokesperson says: “The latest review from NICE suggests no robust evidence for vitamin D supplements reducing the severity of COVID-19. However, this is a new virus, and we keep all strong evidence on treatments under review.”New investigations have further linked vitamin D with improved COVID-19 outcomes.

Spanish clinical trial
Meanwhile, Davis points to a recent Spanish trial with “clear-cut” results. 

The randomized control trial administered a high dose of calcifediol – a main metabolite of the vitamin D endocrine system – to 50 patients hospitalized with COVID-19 infection. The 26 control patients received the best available therapy and the same standard care, but without calcifediol.

In comparison to half of the untreated patients, only 2 percent of the calcifediol group required admission to the ICU. Of the patients treated with calcifediol, none died and all were discharged without complications. 

The 13 patients not treated with calcifediol, who were not admitted to the ICU, were discharged. Of the 13 patients admitted to the ICU, two died and the remaining 11 were discharged.

“Calcifediol seems to be able to reduce the severity of the disease, but larger trials with groups properly matched will be required to show a definitive answer,” the researchers write. 

In September, another study found that of 489 patients who had a vitamin D level measured in the year before COVID-19 testing, the relative risk of testing positive for COVID-19 was 1.8 times greater for patients with likely deficient vitamin D status than patients with likely sufficient vitamin D status.

However, a consensus paper in the spring warned against taking large doses of vitamin D as a way to address COVID-19. This came as other researchers called for supplementation above the Recommended Dietary Allowance (RDA), albeit within recommended upper safety limits.
The UK’s Department of Health and Social Care will keep “all strong evidence on treatments under review.”

“Reheated leftovers”
This latest conversation surrounding vitamin D for COVID-19 stems from a House of Commons exchange from last week. Dr. Huq asked Hancock whether NHS supplementation or a public information campaign on vitamin D was on the cards.

“Vitamin D is one of the many things that we have looked into, to see whether it reduces the incidence or impact of coronavirus. I have seen reports that it does, so we put it into a trial. Unfortunately, the results were that it does not appear to have any impact. That is the latest clinical advice, which is always kept under review,” Hancock replied. 

A spokesperson for the Department of Health and Social Care tells NutritionInsight that Hancock’s comments about a vitamin D “trial” were in reference to the National Institute for Health and Care Excellence (NICE)’s appraisal of five published studies, as well as a rapid review from the Scientific Advisory Committee on Nutrition (SACN). 

Published in June, NICE concluded that there was no evidence to support taking vitamin D supplements to prevent or treat COVID‑19 specifically. Meanwhile, SACN found that evidence currently does not support vitamin D supplementation to prevent acute respiratory tract infections in the general UK population.

However, some MPs flagged Hancock’s use of the term “trial” may be misleading as the government’s investigations were reviews, rather than clinical trials. 

 “The word ‘trial’ implies fresh evidence, not reheated leftovers,” Dr. Huq later commented in the House of Commons this week.

Hancock responded that what matters is getting the “best and right” clinical advice. “I am enthusiastic to hear about all possible scientific advances that might be helpful.”

“The news that the trials did not occur, despite the Health Secretary telling the Commons otherwise, shows their contempt for parliamentary scrutiny. I hope Hancock will get his facts straight before making such comments. We’re in a crisis, and it’s time for politicians to stop playing science and listen to the experts,” says Moran. 

By Katherine Durrell