Monroy-Iglesias Maria J, Thavarajah Rathesh, Beckmann Kerri, Josephs Debra H, Irshad Sheeba, Karagiannis Sophia N, Van Hemelrijck Mieke, Santaolalla Aida
Transforming Outcomes through Research (TOUR), Centre for Cancer, Society, and Public Health, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom.
Cancer Epidemiology and Population Health Research Group, University of South Australia, Adelaide, Australia.
PLoS One. 2025 Jul 18;20(7):e0328232. doi: 10.1371/journal.pone.0328232. eCollection 2025.
Vitamin D (VitD) plays an important role in immune modulation. VitD deficiency is associated with increased susceptibility to acute respiratory syndrome as observed in COVID-19. We evaluated potential associations between serum VitD levels and risk of COVID-19 infection and hospitalisation, within the overall and cancer populations.
We performed a nested case-control study within the UK biobank cohort, among all individuals with at least one serum VitD level measurement at baseline (2006-2010) and a COVID-19 polymerase chain reaction (PCR) results recorded, and individuals with previous cancer diagnosis. Binary multivariable logistic regression was performed to assess associations between VitD levels and risk of COVID-19 infection (positive PCR), and hospitalisation (COVID-19-positive PCR in hospital), and stratified by ethnicity.
Of 151,543 participants, 21,396 tested positive for COVID-19. Of 24,400 individuals with cancer, 2,608 tested positive. In the total cohort, VitD insufficiency (Adjusted Odds Ratio (aOR) 0.97, 95% Confidence Interval (CI) 0.94-1.00) and deficiency (aOR 0.95, 95%CI 0.90-0.99) were associated with slightly lower odds of COVID-19 infection. In contrast, both VitD insufficiency (aOR 1.19, 95%CI 1.08-1.31) and deficiency (aOR 1.36, 95%CI 1.19-1.56) were associated with higher odds of COVID-19 hospitalisation. Among Asian (aOR 1.50; 95%CI 1.08-2.07) and Black (aOR 1.57; 95%CI 1.14-2.16) participants, VitD deficiency was associated with higher odds of COVID-19 infection. Among White participants, VitD insufficiency was associated with slightly lower odds of COVID-19 infection (aOR 0.97; 95%CI 0.86-0.95), while both VitD insufficiency (aOR 1.19; 95%CI 1.08-1.32) and deficiency (aOR 1.44; 95%CI 1.25-1.66) were associated with increased odds of hospitalisation. In the cancer population, vitamin D deficiency was associated with higher odds of infection only among Black participants (aOR 3.50; 95%CI 1.22-10.01); no other associations were observed.
Low VitD levels were associated with an increased risk of COVID-19 hospitalisation but showed only a weak association with infection risk. Black and Asian populations had higher infection risk associated with VitD deficiency, but this did not translate to increased hospitalisation. In contrast, White populations with low VitD levels exhibited a higher risk of hospitalisation. There was no evidence of an interaction between VitD levels and ethnicity affecting infection or hospitalisation risk. In the cancer cohort, no significant associations were observed for COVID-19 infection or hospitalisation.
维生素D（VitD）在免疫调节中发挥重要作用。正如在2019冠状病毒病（COVID-19）中所观察到的，VitD缺乏与急性呼吸综合征易感性增加有关。我们评估了总体人群和癌症人群中血清VitD水平与COVID-19感染及住院风险之间的潜在关联。
我们在英国生物银行队列中开展了一项巢式病例对照研究，研究对象为所有在基线期（2006 - 2010年）至少有一次血清VitD水平测量记录且有COVID-19聚合酶链反应（PCR）结果记录的个体，以及既往有癌症诊断的个体。采用二元多变量逻辑回归分析评估VitD水平与COVID-19感染风险（PCR阳性）及住院风险（住院期间COVID-19 PCR阳性）之间的关联，并按种族进行分层。
在151,543名参与者中，21,396人COVID-19检测呈阳性。在24,400名癌症患者中，2,608人检测呈阳性。在整个队列中，VitD不足（调整比值比（aOR）0.97，95%置信区间（CI）0.94 - 1.00）和缺乏（aOR 0.95，95%CI 0.90 - 0.99）与COVID-19感染几率略低相关。相比之下，VitD不足（aOR 1.19，95%CI 1.08 - 1.31）和缺乏（aOR 1.36，95%CI 1.19 - 1.56）均与COVID-19住院几率较高相关。在亚洲参与者（aOR 1.50；95%CI 1.08 - 2.07）和黑人参与者（aOR 1.57；95%CI 1.14 - 2.16）中，VitD缺乏与COVID-19感染几率较高相关。在白人参与者中，VitD不足与COVID-19感染几率略低相关（aOR 0.97；95%CI 0.86 - 0.95），而VitD不足（aOR 1.19；95%CI 1.08 - 1.32）和缺乏（aOR 进行1.44；95%CI 1.25 - 1.66）均与住院几率增加相关。在癌症人群中，仅在黑人参与者中维生素D缺乏与感染几率较高相关（aOR 3.50；95%CI 1.22 - 10.01）；未观察到其他关联。
低VitD水平与COVID-19住院风险增加相关，但与感染风险仅呈弱关联。黑人和亚洲人群因VitD缺乏感染风险较高，但这并未转化为住院率增加。相比之下，VitD水平低的白人人群住院风险较高。没有证据表明VitD水平与种族之间存在相互作用影响感染或住院风险。在癌症队列中，未观察到COVID-19感染或住院的显著关联。
