Vitamin D prescribing in care and nursing homes: a prescribing ban contributing to fatalities? P.2

Known Risk Factors and Vitamin D status


Well-known risk factors for Covid-19 have been well publicised to be age, obesity, ethnicity

and socio-economic status. Whilst there are social factors at play that increase risk for some

groups, could Vitamin D also provide a physiological reason these groups are also at risk of

severe Covid-19 infection? A very interesting study conducted in Israel showed that Covid-9

outcomes were worse in communities where traditional dress was worn, and where

individuals had poor vitamin D status. This took into account and adjusted for baseline

characteristics such as age. 14


Table 1: Some better known risk factors for Covid-19 and their known link to Vitamin D deficiency


Risk Factor Linked to low Vitamin D? Linked to Covid 19?


Ethnicity Darker skin less able to BAME communities identified in UK

absorb. If cultural clothing as more susceptible

covers skin, UV light

cannot be absorbed 14


 Obesity  Vitamin D is fat soluble, Obese identified as more likely to

and dilutes into fat cells, require ICU admission for Covid-19

making it less available


Socio- An independent risk factor Thought to be due to social factors such as

economic for Vitamin D deficiency 11 working in hospitality and living in densely status populated areas.



Type II VD protects against T2  NHS trusts reported in spring that

Diabetes diabetes by reducing type II diabetics were more likely to

 parathyroid levels 1,6 require ICU treatment


Older age  Skin is less able to absorb The majority (estimated 74%) of

with age 3,6 Covid-19 deaths have occurred in

over 70s

Death Stats for Nerds


The evidence is increasingly undeniable that Vitamin D is linked to Covid-19. We also know that

Vitamin D is not routinely given to residents in care homes, 5 and in general, the guidance to take

supplements is not widely promoted. Could this be partly to blame of the shockingly large number of deaths this year in England’s care homes?


The following data have been compiled by this author from the published ONS excel spreadsheets on deaths in care homes, 7 and total deaths attributed to Covid-19 in England and Wales 8 with some totals and percentages worked out, so they can be viewed in a context that wouldn’t be seen on the BBC news.


Table 2: Covid-19 Death statistics for care homes in England

Percentage of all Covid-19 deaths (England and Wales) who are

care home residents in England*


36%

(19,726 of 54,678)


Percentage of deaths of all causes (England and Wales) who were

care home residents in England


17%

(84,740 of 494,975)


Percentage of care home Covid-19 deaths that occurred in the care

home and not in hospital (indicative only palliative treatment

offered)


75%

(14,722 of 19,726)


Percentage of all England and Wales Covid-19 fatalities over 80

years of age


61%

(33,352 of 54,678)


Percentage of all England and Wales Covid-19 fatalities over 70

years of age


74%

(40,696 of 54,678)

*This is likely to be an underestimate, as ONS state that deaths recorded early in the pandemic were not attributed to Covid-19. 8








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