Assessment of the Association of Vitamin D Level With SARS-CoV-2 Seropositivity Among Working-Age Adults

Vitamin D study #103 of 131 Meta Analysis

5/19 Analysis of outcomes based on serum levels

Li et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.11634 (Peer Reviewed)
Assessment of the Association of Vitamin D Level With SARS-CoV-2 Seropositivity Among Working-Age Adults

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Cohort study of 18,148 patients in the USA showing low vitamin D associated with COVID-19 PCR+ status before adjustments but not after.

Authors state that "low vitamin D levels were not independently associated with the
risk of seropositivity", however there is significant correlation between some adjustment variables and vitamin D levels in the logistic regression that prevent drawing this conclusion [1]. Details of the logistic regression in the matched sample set are not provided.

Authors analyze only 20ng/mL and 30ng/mL cutoff points, other studies use 10ng/mL (or 12), where more significant differences are typically seen.

Li et al., 5/19/2021, retrospective, USA, North America, peer-reviewed, 4 authors.

risk of COVID-19 case, 8.6% lower, RR 0.91, p = 0.21, high D levels 610 of 13650 (4.5%), low D levels 290 of 4498 (6.4%), adjusted per study, odds ratio converted to relative risk, >20ng/mL, Figure 2.

risk of COVID-19 case, 12.4% lower, RR 0.88, p = 0.06, high D levels 289 of 7272 (4.0%), low D levels 611 of 10876 (5.6%), adjusted per study, odds ratio converted to relative risk, >30ng/mL, Figure 2.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. For an individual study the most serious outcome may have a smaller number of events and lower statistical signficance, however this provides the strongest evidence for the most serious outcomes when combining the results of many trials.

[1] statisticsbyjim.com/regression/multicollinearity-in-regression-analysis/

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