Vitamin D deficiency is strongly associated with increased risk for coronavirus disease 2019 (COVID-19).
The odds ratio for COVID-19 increases with vitamin deficiency in black individuals.
Diabetes, obesity, and periodontal disease are associated with an increased risk for both COVID-19 and vitamin D deficiency.
Patients with vitamin D deficiency were 4.6 times more likely to be positive for COVID-19 (indicated by the ICD-10 diagnostic code COVID19) than patients with no deficiency (P < 0.001). The association decreased slightly after adjusting for sex (odds ratio [OR] = 4.58; P < 0.001) and malabsorption (OR = 4.46; P < 0.001), respectively. The association decreased significantly but remained robust (P < 0.001) after adjusting for race (OR = 3.76; P < 0.001), periodontal disease status (OR = 3.64; P < 0.001), diabetes (OR = 3.28; P < 0.001), and obesity (OR = 2.27; P < 0.001), respectively. In addition, patients with vitamin D deficiency were 5 times more likely to be infected with COVID-19 than patients with no deficiency after adjusting for age groups (OR = 5.155; P < 0.001).
We have had plenty of anecdotes about people failing to be diagnosed with serious diseases during lockdown. This is thanks to either to hospitals cancelling appointments, GP surgeries stopping face-to-face meetings or people picking up the message that they should protect the NHS by trying not to use it.
Our study shows that the COVID-19 pandemic has resulted in a large number of potentially missed or delayed diagnoses of health conditions, which carry high risk if not promptly diagnosed and effectively treated. Primary and secondary care services must proactively prepare to address the large backlog of patients that is likely to follow. Should a public health emergency on the scale of the COVID-19 pandemic occur in the future, or if subsequent surges in COVID-19 cases arise, national communication strategies must be carefully considered to ensure that large numbers of patients with urgent health needs do not disengage with health services.