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Zie ook in gerelateerde artikelen

6 oktober 2021: zie ook dit artikel: https://kanker-actueel.nl/vitamine-d-suppletie-geeft-vaak-goede-resultaten-bij-patienten-die-besmet-zijn-met-het-coronavirus-covid-19-en-al-opgenomen-in-het-ziekenhuis-laat-een-grote-meta-analyse-zien-van-alle-studies-wereldwijd.html

30 augustus 2021: zie ook dit artikel: https://kanker-actueel.nl/vitamine-d-suppletie-reguleert-postoperatieve-bloedwaarden-van-pd-l1-bij-patienten-met-spijsverteringskanker-en-verbetert-sterk-de-overall-overleving-van-patienten-met-de-hoogste-pd-l1-waarden.html

28 augustus 2021: zie ook dit artikel: https://kanker-actueel.nl/vitamine-d-tekort-maakt-mensen-kwetsbaar-voor-het-coronavirus-covid-19-voldoende-vitamine-d-in-bloed-geeft-bescherming-tegen-het-coronavirus-concludeert-grote-meta-analyse.html

zie ook dit artikel:

https://kanker-actueel.nl/immuunsysteem-versterken-bij-risicogroepen-en-zorgpersoneel-is-betere-aanpak-dan-wachten-op-vaccin-aldus-immunoloog-dr-carla-peeters.html

14 juli 2021: Twee nieuwe studies bewijzen dat vitamine D kan voorkomen dat mensen ernstig ziek worden van het coronavirus - Covid-19.

Een Engelse studie laat zien dat mensen met een tekort aan vitamine D ruim 2 keer zoveel kans hebben om in het ziekenhuis te belanden. Uit een Italliaanse studie blijkt dat voldoende vitamine D kan leiden tot lagere interleukine-6 waardes (vitamine D onderdrukt de pro-inflammatoire functie van IL-6), waardoor de kans op ernstige ziekte (cytokinenstorm) en overlijden afneemt.

Engelse studie: Vitamin D deficiency is associated with higher hospitalisation risk from COVID-19: a retrospective case-control study

Italiaanse studie: Vitamin D and COVID-19 severity and related mortality: a prospective study in Italy

3 maart 2021: De Gezondheidsraad laat liever mensen doodgaan aan corona dan een advies van heel veel deskundigen opvolgen. Lees dit artikel en ook de reacties onder het artikel in: https://www.nu.nl/coronavirus/6119629/gezondheidsraad-wijzigt-vitamine-d-advies-niet-nut-tegen-covid-19-onbekend.html

De Gezondheidsraad schrijft woensdag dat er nog niet genoeg onderzoek is gedaan om te kunnen zeggen of het slikken van extra vitamine D-pillen COVID-19 kan voorkomen. Ouderen, kinderen tot vier jaar en mensen met een donkere huid wordt nog steeds wel aangeraden om vitamine D te slikken.

Demissionair staatssecretaris Paul Blokhuis (Volksgezondheid, Welzijn en Sport) heeft aan de Gezondheidsraad gevraagd of het zinvol is om vitamine D-pillen te slikken om COVID-19 te voorkomen. De Gezondheidsraad concludeert dat er geen aanleiding is om het huidige vitamine D-advies aan te passen.

Vitamine D kwam in de aandacht, omdat in enkele onderzoeken werd waargenomen dat mensen die met COVID-19 in het ziekenhuis belandden, minder vitamine D in hun lichaam hadden. Een nadeel aan dit soort observaties is volgens de Gezondheidsraad dat risicofactoren voor ernstige COVID-19, zoals een hoge leeftijd, vaak ook risicofactoren zijn voor een tekort aan vitamine D.

De Gezondheidsraad schrijft dat er nu zeker zes goed opgezette onderzoeken lopen naar het nut van vitamine D bij het voorkomen van COVID-19. Als deze onderzoeken uitwijzen dat extra vitamine D-slikken nut heeft tegen COVID-19, dan kan de Gezondheidsraad opnieuw een advies uitbrengen.>>>>>>>lees verder

29 oktober 2020: zie ook dit artikel:

https://kanker-actueel.nl/immuunsysteem-versterken-bij-risicogroepen-en-zorgpersoneel-is-betere-aanpak-dan-wachten-op-vaccin-aldus-immunoloog-dr-carla-peeters.html

18 oktober 2020: Bron: PLOS

Twee nieuwe studies tonen aan dat de waarden van vitamine D in het bloed (bloedspiegel) de kansen op een besmetting met het coronavirus - Covid-19 sterk beïnvloed. Lagere vitamine-D waarden geven grotere kans op ernstige klachten en kans op overlijden wordt hoger. Normale vitamine D waarden geven veel minder kans op een positieve test voor een Covid-19 besmetting.

Het lijkt dus verstandig om uw vitamine D waarden eens te laten meten bij de huisarts en bij lage waarden preventief vitamine D (25-hydroxyvitamine D) te nemen. Advies is een vitamine D inname van 100 mcg (4000 IE) per dag.

Uit een studie gepubliceerd in PLOS (onderzoeksleider vitamine D-expert dr. Michael Holick) bleek uit de analyse van de bloedgegevens van ruim 190.000 proefpersonen dat van al die mensen 9,3% een positieve coronatest had gekregen.
Uit die gegevens bleek ook dat mensen met een vitamine D-tekort (<50 nmol/l) 54% meer kans hebben op een positieve PCR-test in vergelijking met mensen met een normale vitamine D-bloedspiegel (>75 nmol/l).

Ook bleek dat hoe hoger de vitamine D-spiegel, hoe kleiner de kans op een positieve test. Voor iedere toename van de vitamine D-spiegel met 2,5 nmol/l nam het risico op een positieve uitslag met 1,6% af.

Zie voor studierapport:

SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels

Uit een tweede studie bij 489 proefpersonen werd 15% van de deelnemers positief getest op het coronavirus - Covid-19. Ongeveer 25 procent daarvan had een vitamine D-tekort. Zij hadden volgens de onderzoekers 77% meer kans op een positieve PCR-test dan deelnemers met normale vitamine D waarden.
Ook kwam uit die studie naar voren dat mensen met een niet-blanke huid, waarvan bekend is dat die vaker een vitamine D tekort hebben – 2,5 keer meer kans hadden op een positieve PCR-coronatest.

Voor dat studierapport zie:

Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results

Hier de abstracten van bovengenoemde studies:

SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels

Harvey W. Kaufman,
Justin K. Niles,
Martin H. Kroll,
Caixia Bi,
Michael F. Holick

SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels

Harvey W. Kaufman,
Justin K. Niles,
Martin H. Kroll,
Caixia Bi,
Michael F. Holick

Published: September 17, 2020
https://doi.org/10.1371/journal.pone.0239252

Abstract

Until treatment and vaccine for coronavirus disease-2019 (COVID-19) becomes widely available, other methods of reducing infection rates should be explored. This study used a retrospective, observational analysis of deidentified tests performed at a national clinical laboratory to determine if circulating 25-hydroxyvitamin D (25(OH)D) levels are associated with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) positivity rates. Over 190,000 patients from all 50 states with SARS-CoV-2 results performed mid-March through mid-June, 2020 and matching 25(OH)D results from the preceding 12 months were included. Residential zip code data was required to match with US Census data and perform analyses of race/ethnicity proportions and latitude. A total of 191,779 patients were included (median age, 54 years [interquartile range 40.4–64.7]; 68% female. The SARS-CoV-2 positivity rate was 9.3% (95% C.I. 9.2–9.5%) and the mean seasonally adjusted 25(OH)D was 31.7 (SD 11.7). The SARS-CoV-2 positivity rate was higher in the 39,190 patients with “deficient” 25(OH)D values (<20 ng/mL) (12.5%, 95% C.I. 12.2–12.8%) than in the 27,870 patients with “adequate” values (30–34 ng/mL) (8.1%, 95% C.I. 7.8–8.4%) and the 12,321 patients with values ≥55 ng/mL (5.9%, 95% C.I. 5.5–6.4%). The association between 25(OH)D levels and SARS-CoV-2 positivity was best fitted by the weighted second-order polynomial regression, which indicated strong correlation in the total population (R2 = 0.96) and in analyses stratified by all studied demographic factors. The association between lower SARS-CoV-2 positivity rates and higher circulating 25(OH)D levels remained significant in a multivariable logistic model adjusting for all included demographic factors (adjusted odds ratio 0.984 per ng/mL increment, 95% C.I. 0.983–0.986; p<0.001). SARS-CoV-2 positivity is strongly and inversely associated with circulating 25(OH)D levels, a relationship that persists across latitudes, races/ethnicities, both sexes, and age ranges. Our findings provide impetus to explore the role of vitamin D supplementation in reducing the risk for SARS-CoV-2 infection and COVID-19 disease.

Figures

Citation: Kaufman HW, Niles JK, Kroll MH, Bi C, Holick MF (2020) SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PLoS ONE 15(9): e0239252. https://doi.org/10.1371/journal.pone.0239252

Editor: Sakamuri V. Reddy, Charles P. Darby Children's Research Institute, UNITED STATES

Received: July 29, 2020; Accepted: September 3, 2020; Published: September 17, 2020

Copyright: © 2020 Kaufman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Data underlying the study cannot be made publicly available due to ethical concerns about patient confidentiality. Data will be made available to qualified researchers on request to HealthTrends@QuestDiagnostics.com.

Funding: Quest Diagnostics provided support in the form of salaries for authors JKN, BC, MHK, and HWK and consulting fees for MFH but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.

Competing interests: HWK, JKN, MHK, and CB are employees of Quest Diagnostics. HWK, MHK and CB own stock in Quest Diagnostics. MFH is a consultant to Quest Diagnostics and was on the speakers’ bureau for Abbott Inc. and Hyatt Pharmaceutical Industries Company PLC.

Multivariable analysis tested whether vitamin D status before COVID-19 testing was associated with testing positive for COVID-19, controlling for demographic and comorbidity indicators.

Question Is vitamin D status, reflecting vitamin D levels and treatment, associated with test results for coronavirus disease 2019 (COVID-19)?

Findings In this cohort study 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 1.77 times greater for patients with likely deficient vitamin D status compared with patients with likely sufficient vitamin D status, a difference that was statistically significant.

Meaning These findings appear to support a role of vitamin D status in COVID-19 risk; randomized clinical trials are needed to determine whether broad population interventions and interventions among groups at increased risk of vitamin D deficiency and COVID-19 could reduce COVID-19 incidence.

Abstract

Importance Vitamin D treatment has been found to decrease the incidence of viral respiratory tract infection, especially in patients with vitamin D deficiency. Whether vitamin D is associated with coronavirus disease 2019 (COVID-19) incidence is unknown.

Objective To examine whether the last vitamin D status before COVID-19 testing is associated with COVID-19 test results.

Design, Setting, and Participants This retrospective cohort study at an urban academic medical center included patients with a 25-hydroxycholecalciferol or 1,25-dihydroxycholecalciferol level measured within 1 year before being tested for COVID-19 from March 3 to April 10, 2020.

Exposures Vitamin D deficiency was defined by the last measurement of 25-hydroxycholecalciferol less than 20 ng/mL or 1,25-dihydroxycholecalciferol less than 18 pg/mL before COVID-19 testing. Treatment changes were defined by changes in vitamin D type and dose between the date of the last vitamin D level measurement and the date of COVID-19 testing. Vitamin D deficiency and treatment changes were combined to categorize the most recent vitamin D status before COVID-19 testing as likely deficient (last level deficient and treatment not increased), likely sufficient (last level not deficient and treatment not decreased), and 2 groups with uncertain deficiency (last level deficient and treatment increased, and last level not deficient and treatment decreased).

Main Outcomes and Measures The outcome was a positive COVID-19 polymerase chain reaction test result. Multivariable analysis tested whether vitamin D status before COVID-19 testing was associated with testing positive for COVID-19, controlling for demographic and comorbidity indicators.

Results A total of 489 patients (mean age, 49.2 [18.4] years; 366 [75%] women; and 331 [68%] race other than White) had a vitamin D level measured in the year before COVID-19 testing. Vitamin D status before COVID-19 testing was categorized as likely deficient for 124 participants (25%), likely sufficient for 287 (59%), and uncertain for 78 (16%). Overall, 71 participants (15%) tested positive for COVID-19. In multivariate analysis, testing positive for COVID-19 was associated with increasing age up to age 50 years (relative risk, 1.06; 95% CI, 1.01-1.09; P = .02); non-White race (relative risk, 2.54; 95% CI, 1.26-5.12; P = .009), and likely deficient vitamin D status (relative risk, 1.77; 95% CI, 1.12-2.81; P = .02) compared with likely sufficient vitamin D status. Predicted COVID-19 rates in the deficient group were 21.6% (95% CI, 14.0%-29.2%) vs 12.2%(95% CI, 8.9%-15.4%) in the sufficient group.

Conclusions and Relevance In this single-center, retrospective cohort study, likely deficient vitamin D status was associated with increased COVID-19 risk, a finding that suggests that randomized trials may be needed to determine whether vitamin D affects COVID-19 risk.

References

COVID-19 corona virus pandemic. Worldometer. Updated August 12, 2020. Accessed August 12, 2020. https://www.worldometers.info/coronavirus

Grant WB, Lahore H, McDonnell SL, et al. Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients. 2020;12(4):988. doi:10.3390/nu12040988 PubMed Google Scholar Crossref

Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583. doi:10.1136/bmj.i6583 PubMed Google Scholar Crossref

Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011;31(1):48-54. doi:10.1016/j.nutres.2010.12.001 PubMed Google Scholar Crossref

Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019: COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):458-464. doi:10.15585/mmwr.mm6915e3 PubMed Google Scholar Crossref

Umhau JC. Casting sunlight on an epidemic: is vitamin D a critical host factor to prevent COVID-19? MedPage Today. Published March 25, 2020. Accessed April 13, 2020. https://www.medpagetoday.com/infectiousdisease/covid19/85596

NCHS, National Vital Statistics System. Provisional death counts for coronavirus disease (COVID-19). Centers for Disease Control and Prevention. Updated August 12, 2020. Accessed August 12, 2020. https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm

National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. Preparing for COVID-19 in nursing homes. Updated August 12, 2020. Accessed August 12, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html

CDC COVID-19 Response Team. Characteristics of health care personnel with COVID-19 - United States, February 12-April 9, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):477-481. doi:10.15585/mmwr.mm6915e6 PubMed Google Scholar Crossref

10.

Huotari A, Herzig KH. Vitamin D and living in northern latitudes—an endemic risk area for vitamin D deficiency. Int J Circumpolar Health. 2008;67(2-3):164-178. doi:10.3402/ijch.v67i2-3.18258 PubMed Google Scholar Crossref

11.

Elliott ME, Binkley NC, Carnes M, et al. Fracture risks for women in long-term care: high prevalence of calcaneal osteoporosis and hypovitaminosis D. Pharmacotherapy. 2003;23(6):702-710. doi:10.1592/phco.23.6.702.32182 PubMed Google Scholar Crossref

12.

Sowah D, Fan X, Dennett L, Hagtvedt R, Straube S. Vitamin D levels and deficiency with different occupations: a systematic review. BMC Public Health. 2017;17(1):519. doi:10.1186/s12889-017-4436-z PubMed Google Scholar Crossref

13.

Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199-1207. doi:10.1056/NEJMoa2001316 PubMed Google Scholar Crossref

14.

Cumulative number of patients diagnosed with coronavirus disease (COVID-19) in Japan as of August 7, 2020. Statista. Accessed August 12, 2020. https://www.statista.com/statistics/1096478/japan-confirmed-cases-of-coronavirus-by-state-of-health

15.

Ginde AA, Sullivan AF, Mansbach JM, Camargo CA Jr. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. Am J Obstet Gynecol. 2010;202(5):436.e1-436.e8. doi:10.1016/j.ajog.2009.11.036 PubMed Google Scholar Crossref

16.

Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M; Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398-417. doi:10.1542/peds.2007-1894 PubMed Google Scholar Crossref

17.

Nakamura K. Vitamin D insufficiency in Japanese populations: from the viewpoint of the prevention of osteoporosis. J Bone Miner Metab. 2006;24(1):1-6. doi:10.1007/s00774-005-0637-0 PubMed Google Scholar Crossref

18.

Hunt K. Britons urged to take vitamin D while sheltering inside during the pandemic. Published April 23, 2020. Accessed April 27, 2020. https://www.cnn.com/2020/04/23/health/vitamin-d-uk-coronavirus-wellness/index.html

19.

Frieden T. Former CDC Chief Dr. Tom Frieden: coronavirus infection risk may be reduced by vitamin D. Fox News, Opinion. Published March 23, 2020. Accessed April 13, 2020. https://www.foxnews.com/opinion/former-cdc-chief-tom-frieden-coronavirus-risk-may-be-reduced-with-vitamin-d

20.

Medical societies advise on vitamin D in midst of COVID-19. Medscape. Published July 10, 2020. Accessed July 10, 2020. https://www.medscape.com/viewarticle/933715

21.

National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. CDC diagnostic tests for COVID-19. Centers for Disease Control and Prevention. Updated August 5, 2020. Accessed August 12, 2020. https://www.cdc.gov/coronavirus/2019-ncov/lab/testing.html

22.

Viracor. Coronavirus (COVID-19) SARS-CoV-2 PCR. Accessed July 13, 2020. https://www.viracor-eurofins.com/test-menu/8300-coronavirus-covid-19-sars-cov-2-rt-pcr/

23.

Roche Diagnostics. cobas SARS-CoV-2 test (for the COVID-19 coronavirus). Accessed July 13, 2020. https://diagnostics.roche.com/us/en/products/params/cobas-sars-cov-2-test.html

24.

Roche Diagnostics. cobas Elecsys Vitamin D total II assay. Accessed July 15, 2020. https://diagnostics.roche.com/se/sv/products/params/elecsys-vitamin-d-total-ii.html

25.

Mayo Clinic Laboratories. Test ID: DHVD: 1,25-dihydroxyvitamin D, serum. Accessed July 15, 2020. https://www.mayocliniclabs.com/test-catalog/Performance/8822

26.

Del Valle HB, Yaktine AL, Taylor CL, Ross AC, eds. Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press; 2011.

27.

Holick MF, Binkley NC, Bischoff-Ferrari HA, et al; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-1930. doi:10.1210/jc.2011-0385 PubMed Google Scholar Crossref

28.

Healthcare Cost and Utilization Project (HCUP). Elixhauser Comorbidity Software for ICD-10-CM (beta version).Version 2020 v1. Accessed April 8, 2020. https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp

29.

Zhang JX, Iwashyna TJ, Christakis NA. The performance of different lookback periods and sources of information for Charlson comorbidity adjustment in Medicare claims. Med Care. 1999;37(11):1128-1139. doi:10.1097/00005650-199911000-00005 PubMed Google Scholar Crossref

30.

McNutt LA, Wu C, Xue X, Hafner JP. Estimating the relative risk in cohort studies and clinical trials of common outcomes. Am J Epidemiol. 2003;157(10):940-943. doi:10.1093/aje/kwg074 PubMed Google Scholar Crossref

31.

Pregibon D. Data Analytic Methods for Generalized Linear Models. Dissertation. University of Toronto; 1979; 43.

32.

Blizzard L, Hosmer DW. Parameter estimation and goodness-of-fit in log binomial regression. Biom J. 2006;48(1):5-22. doi:10.1002/bimj.200410165 PubMed Google Scholar Crossref

33.

Hastie CE, Mackay DF, Ho F, et al. Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes Metab Syndr. 2020;14(4):561-565. doi:10.1016/j.dsx.2020.04.050 PubMed Google Scholar Crossref

34.

Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. The National Academies Press; 2011.

35.

Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus disease 2019 case surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(24):759-765. doi:10.15585/mmwr.mm6924e2 PubMed Google Scholar Crossref

36.

Gold JAW, Wong KK, Szablewski CM, et al. Characteristics and clinical outcomes of adult patients hospitalized with COVID-19 - Georgia, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(18):545-550. doi:10.15585/mmwr.mm6918e1 PubMed Google Scholar Crossref

37.

Sassi F, Tamone C, D’Amelio P. Vitamin D: nutrient, hormone, and immunomodulator. Nutrients. 2018;10(11):1656. doi:10.3390/nu10111656 PubMed Google Scholar Crossref

38.

Greger JL. Effect of Variations in Dietary Protein, Phosphorus, Electrolytes and Vitamin D on Calcium and Zinc Metabolism: Nutrient Interactions. Marcel Dekker; 1988:205-228.

39.

te Velthuis AJ, van den Worm SH, Sims AC, Baric RS, Snijder EJ, van Hemert MJ. Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog. 2010;6(11):e1001176. doi:10.1371/journal.ppat.1001176 PubMed Google Scholar

40.

Yin K, Agrawal DK. Vitamin D and inflammatory diseases. J Inflamm Res. 2014;7:69-87. doi:10.2147/JIR.S63898 PubMed Google Scholar

41.

Roffe-Vazquez DN, Huerta-Delgado AS, Castillo EC, et al. Correlation of vitamin D with inflammatory cytokines, atherosclerotic parameters, and lifestyle factors in the setting of heart failure: a 12-month follow-up study. Int J Mol Sci. 2019;20(22):5811. doi:10.3390/ijms20225811 PubMed Google Scholar Crossref

42.

Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ; HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-1034. doi:10.1016/S0140-6736(20)30628-0 PubMed Google Scholar Crossref

coronavirus, covid-19, vitamine D tekort, 25-hydroxyvitamine D, risico op overlijden, ernstige klachten