Abstract
ObjectiveLimited evidence suggests that higher levels of serum vitamin D (25(OH)D) protect against SARS-CoV-2 virus (COVID-19) infection. Black women commonly experience 25(OH)D insufficiency and are overrepresented among COVID-19 cases. We conducted a prospective analysis of serum 25(OH)D levels in relation to COVID-19 infection among participants in the Black Women’s Health Study.MethodsSince 1995, the Black Women’s Health Study has followed 59,000 U.S. Black women through biennial mailed or online questionnaires. Over 13,000 study participants provided a blood sample in 2013–2017. 25(OH)D assays were performed in a certified national laboratory shortly after collection of the samples. In 2020, participants who had completed the online version of the 2019 biennial health questionnaire were invited to complete a supplemental online questionnaire assessing their experiences related to the COVID-19 pandemic, including whether they had been tested for COVID-19 infection and the result of the test. We used logistic regression analysis to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association of 25(OH)D level with COVID-19 positivity, adjusting for age, number of people living in the household, neighborhood socioeconomic status, and other potential confounders.ResultsAmong 5,081 eligible participants whose blood sample had been assayed for 25(OH)D, 1,974 reported having had a COVID-19 test in 2020. Relative to women with 25(OH)D levels of 30 ng/mL (75 nmol/l) or more, multivariable-adjusted ORs for COVID-19 infection in women with levels of 20–29 ng/mL (50–72.5 nmol/l) and <20 ng/mL (<50 nmol/l) were, respectively, 1.48 (95% CI 0.95–2.30) and 1.69 (95% CI 1.04–2.72) (p trend 0.02).ConclusionThe present results suggest that U.S. Black women with lower levels of 25(OH)D are at increased risk of infection with COVID-19. Further work is needed to confirm these findings and determine the optimal level of 25(OH)D for a beneficial effect.
Highlights
The global pandemic caused by SARS-CoV-2 virus (COVID-19) infection has touched people in all walks of life since its emergence in China in December 2019 [1, 2]
In 2020, participants who had completed the online version of the 2019 biennial health questionnaire were invited to complete a supplemental online questionnaire assessing their experiences related to the COVID-19 pandemic, including whether they had been tested for COVID-19 infection and the result of the test
The present results suggest that U.S Black women with lower levels of 25(OH)D are at increased risk of infection with COVID-19
Summary
The global pandemic caused by SARS-CoV-2 virus (COVID-19) infection has touched people in all walks of life since its emergence in China in December 2019 [1, 2]. The spread of COVID-19 infection has been especially high in Black Americans, who tend to live in dense, low-resource communities and work in occupations in which they are more likely to be exposed to the virus [5,6,7,8]. Several recent studies have examined the role of vitamin D levels in relation to COVID-19 infection, with inconsistent results [12,13,14,15,16]. The largest U.S study, based on results from a national laboratory, provides the strongest evidence of an association between lower 25(OH)D level and increased risk of COVID in U.S populations, but was limited by incomplete data on race/ethnicity [12]
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