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Comment by emdowling | Hacker News Reader

This conclusion (10x higher mortality if deficient in Vitamin D) is rather significant. How trustworthy is this source?

Keep in mind that they aren't saying that their data doesn't say that people not given vitamin D supplements were 10x more likely to die. Instead that people coming in with a deficiency already were 10x more likely to die. Imagine if you had two groups. Group A runs for 1 hour a day outside. The group B is confined to their beds in a nursing home.

Group B is going to have a vitamin D deficiency compared to group A. Group A is also much more likely to survive Covid. However, this wouldn't give you any evidence that vitamin D is the cause of better survival rates. You should assume that it might just be an indicator of better health over all unless you can find some way to control for all the other health factors.

And yet it has been long known D supports the immune system. Being technically-right here is not a good survival strategy.

Borsche and Glauner don't seem very trustworthy, but it is no secret that a vitamin D deficiency is correlated with higher mortality. The comorbidities that are associated with Covid-19 mortality are, pretty much, all correlated with vitamin D deficiency. The real question is, if someone is obese, or has diabetes, or has CKD, or is old, what is it that is making them more likely to die of Covid-19? Is it a vitamin D deficiency or some other related issue? and can supplemental vitamin D help?

My guess is that it helps more than hurts to supplement vitamin D if you are deficient or insufficient. I'd also guess that it is no miracle cure like Borsche and Glauner seem to want people to think.

From a technical writing style perspective, the thing going against this paper is the folksy way of writing. It also includes things called weasel words, such as saying very young doctor, versus young doctor, or even just doctor.

The results are compelling, and I suppose it would not hurt to take a prophylaxis of vitamin D (5,000 units per the article?) as compared to a prophylaxis of something else, such as hydroxychloroquine (or Lysol!)

https://hcqtrial.com/

"...an extensive discussion of the differences between the death rates of New York City and Lagos, Nigeria, which both received infected travelers around the same time. NYC's high rate has been linked to population density, poverty, overcrowding, and ethnicity. Lagos is a crowded urban center of about 22 million people with 30 families often in a single building sharing the same bathroom, and none of the factors mentioned favor reduced death rates in Lagos. Lagos further has lower quality of medical care. Yet NYC had a death rate 600 times higher. The younger population can only account for a small part of this difference. Mitchell concludes that there is a crossover prophylactic effect of antimalarial agents against COVID-19."

The paper that is talked about here doesn't make a very strong case for prophylaxis use of hcq. They may look at population-adjusted death rates, but that's not really enough. You could do the same things between different neighborhoods in NYC and probably see huge difference in death rates that may actually be caused by obesity or so many other factors.

I will grant that prophylaxis use of HCQ is much more interesting than its use in treatment, but I don't think this paper is very strong.

People in my doctor friend's hospital taking HCQ got arrhythmias at a higher rate and often didn't get better. It is not a miracle cure and is quite dangerous in the alleged "treatment ranges".

I am a bit stunned that people are still going on about HCQ after all this time and the many trials. I feel this comment by a virologist is the key to understanding why it got so hyped and is not working:

https://www.sciencedirect.com/science/article/pii/S016635422... (May 2020)

"Highlights

• In vitro data suggest that chloroquine inhibits SARS Cov-2 replication. • In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models. • Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success. • The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data. • Peer review of the results and an independent assessment of the potential benefit for patients are essential."

Based on the downvotes, it appears that I was unclear. It is NOT SAFE to take HCQ as a preventative. (And ingesting Lysol is plain nuts.) It may be okay to take D supplements as a preventative, but based on Deva Boone's advice, that comes with risks over the long haul.

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