App That Listens to Coughing Developed to Tell if People Have COVID-19

If this app works effectively, it will be very important in allowing people to group up more freely again.

As millions of people worldwide battle the symptoms of COVID-19, a group of “silent patients” may not even know they’re sick and spreading the virus. Asymptomatic people, by definition, have no physical symptoms of the illnesses they carry.

Researchers at the Massachusetts Institute of Technology (MIT) however, say they may be showing symptoms after all — in the sound of their cough. Their study has created an artificial intelligence program that can identify if someone has coronavirus by the way their coughing sounds. Researchers programmed their AI model with thousands of different recorded coughs from both healthy and sick volunteers. When they fed in recordings of new patients, the system accurately detected 98.5 percent of coughs coming from people with a confirmed case of COVID-19. AI also successfully picked out 100 percent of asymptomatic cases from volunteers who reported not having any symptoms but tested positive for the virus.

The team is now working on turning their model into a user-friendly app. If approved by the Food and Drug Administration, the app would give people a non-invasive and quick way to screen themselves during the pandemic daily.

“The effective implementation of this group diagnostic tool could diminish the spread of the pandemic if everyone uses it before going to a classroom, a factory, or a restaurant,” says co-author Brian Subirana in a university release.

The MIT team notes researchers have been working on audio-based medical screenings since before the coronavirus emergency began. Their group in particular originally created this AI model to screen for Alzheimer’s disease.

Although the degenerative neurological condition is mostly associated with memory loss, it also affects the muscles and vocal cords. With this knowledge, researchers trained a general machine-learning algorithm called ResNet50 to detect changes in vocal cord strength. Subirana taught the neural network using an audiobook collection with over 1,000 hours of speech files. The AI model could eventually tell the difference between similar worlds like “them” and “the” or “then.”

The system can also read the emotions of the speaker based on the tone of their voice. The team says this is a key in Alzheimer’s detection because patients tend to display more frustration when they try to get words out. The program learned to assess these moods and put them into categories including neutral, calm, happy, and sad.

Finally, the team turned to coughing. Using recordings of patients coughing, the AI model could analyze the lung and respiratory performance of the cougher. An algorithm to detect muscular degradation was also added to help AI distinguish strong coughs from weaker ones.

With all of this data, study authors discovered that the technology could effectively screen for Alzheimer’s based on a patient’s vocal cord strength, sentiment, lung performance, and muscular degradation.

Once the pandemic began, the team at MIT changed gears and started looking at their model to see if it could detect COVID. Researchers say there is growing evidence coronavirus patients also suffer from neurological symptoms and temporary muscular impairment.

“The sounds of talking and coughing are both influenced by the vocal cords and surrounding organs. This means that when you talk, part of your talking is like coughing, and vice versa. It also means that things we easily derive from fluent speech, AI can pick up simply from coughs, including things like the person’s gender, mother tongue, or even emotional state. There’s in fact sentiment embedded in how you cough,” Subirana explains. “So we thought, why don’t we try these Alzheimer’s biomarkers [to see if they’re relevant] for COVID.”

The team created a website to collect audio samples from volunteers, including many with coronavirus. From nearly 200,000 forced-cough audio samples, the group was able to find 2,500 recordings that came from confirmed COVID-19 patients. Many of these patients were also asymptomatic. After adding more random samples to act as a control, the team chose 4,000 coughing samples to train their AI model to screen for the virus.

Along with amazing accuracy in detecting coronavirus patients, researchers say the tests reveal “a striking similarity between Alzheimer’s and COVID discrimination.” They add that the same four biomarkers for detecting Alzheimer’s effectively screen out the virus as well.

“We think this shows that the way you produce sound, changes when you have Covid, even if you’re asymptomatic,” the research scientist in MIT’s Auto-ID Laboratory adds.

Subirana and his team stress that their AI system is not meant to diagnose what illness you may have; whether it be the flu, asthma, or COVID-19. The tool, instead, works by screening out who is healthy from who is asymptomatic but carrying an illness.

The MIT team is now partnering with several hospitals to collect more coughing samples to refine the system’s accuracy. Their hope is to introduce a free pre-screening app to the public which can cut down on clinical testing delays.

“Pandemics could be a thing of the past if pre-screening tools are always on in the background and constantly improved,” the study authors contend.

The study appears in the IEEE Journal of Engineering in Medicine and Biology.

Will Trump Win Again?

American president Donald Trump will not be victorious in the popular vote — that is certain. He will probably lose the popular vote by an even higher margin than what Hillary Clinton beat him with in 2016. That said, the Electoral College is what determines presidential outcomes, and there are factors that may allow Trump to win the Electoral College again.

A poll credited with predicting Trump’s Electoral College win in 2016 — the IBD/TIPP Poll — shows Trump with a 0.7 point lead among Hispanics and a 3 point lead in the Midwest. The Midwest is particularly important to win due to having swing states such as Michigan, Ohio, Wisconsin, and Pennsylvania. Most polls show that Trump has maintained a multiple percentage point lead in the state of Ohio, a state that seems to have largely been neglected by the national media outlets based in coastal areas such as California and New York. (The people working for those coastal media outlets have been increasingly seen as out of touch with the realities of wage stagnation, drug epidemics, and deindustrialization that has taken place place in much of America.) Whoever wins Ohio has won the presidency every year since 1964 — a record of over half a century that makes it stand out even among the other swing states.

Much of my own family supports Trump, something that continues to disturb and disappoint me in 2020. That being said, something people don’t always realize is that much of the population is struggling to an absurd degree in what has long been world history’s wealthiest nation. A CNBC article from before the pandemic found that 78 percent of people were living paycheck to paycheck, a number that can only have grown worse with what is essentially now an economic depression during the pandemic. Many people are therefore too stressed and too busy to consistently study politics effectively, and the American formal education overall does a terrible job at giving people a decent political education. It doesn’t help that there is so much disinformation now that it takes a fair amount of intelligence to see through it, and too many people in America have suffered cognitive problems for reasons such as growing up in extreme poverty, being subjected to abuse generated in their family members by America’s flawed society, and even — as seen in Flint, Michigan — drinking lead in their water supply. The Flynn Effect is a phenomenon recounting how average IQ scores have gone up as factors such as nutrition have improved. It’s been apparent for all of us since our days in school that high general intelligence is somewhat rare, but many people are not as smart as they would otherwise be growing up in healthier environments. Since democracy is about making choices based on information, democracy suffers when the general capacity of the population to make intelligent decisions is reduced. America would look different if the average IQ was 10 points higher than what it is today.

One of the worst things that Trump has said is encouraging his supporters to vote twice — once by mail and once at the polls. This is encouraging his supporters to commit voter fraud, a felony punishable by up to 5 years in prison. With so many people in my family that support Trump, I have spent a considerable amount of time thinking about and reading the more scientific reasoning about why they support him. One of the reasons is that Trump speaks with short sentences that are easier to understand, at what was once evaluated as a speaking level lower than many other politicians. In association with that, Trump is an accomplished con man, seen through the history of his fraudulent for-profit college and his casino bankruptcies, and he is good at making his supporters feel good. He’s an incredibly charismatic politician — the people who deny this are delusional to what his supporters and many others feel. In getting a bit more anecdotal here, even people who know me and don’t particularly like me (i.e., some people in my family) admit that I am perceptive and by nature feel certain things many others don’t. This doesn’t mean I am a sensitive snowflake — I am not and I hate the amount of our discourse taken up by identity politics rather than focus on people’s material interest. In any case, I always seem to feel when someone is charismatic, no matter how vile that person is. Trump is charismatic. The other main reasons are that Trump is an authoritarian, something much of the population identifies with, and — my biggest takeaway from seeing so much of my family support Trump — is that support of Trump is something for people to come together on. American society has become broken, divisive, run-down, and incredibly politically polarized for much of the population, and support of Trump presents an opportunity for what is arguably one of the few ways for Trump supporters to have meaningful positive interactions with each other. Politics is not like talking about the weather or other small talk subjects — it presents a much greater opportunity than those subjects to have more valuable and fulfilling conversations, even if the people discussing the politics are wrong about what issues to support to benefit the majority of the population. The desire to have these fulfilling social conversations, I posit, is an integral part of human social contact, and one that was increasingly fading in the device-driven world before the pandemic and the term social distancing became a widely used term.

In addressing Trump’s perceived strength, the idea that Trump had a significant positive impact on the economy is a joke. The biggest positive factor on the economy in the last decade was probably the appointment of Janet Yellen and her low interest rate policies at the Federal Reserve, and that allowed the unemployment rate to drop low and it therefore also allowed some of the only minor wage growth for low-wage workers in the last 50 years. To his credit, Trump appointed Jerome Powell, who largely continued the policies of Janet Yellen by not raising interest rates and thus allowing the unemployment rate to remain low before the pandemic hit. Trump also refused to go along with the terrible Trans-Pacific Partnership trade agreement, and the tax cuts mainly for the wealthy and corporations that he pressed for did have a slight boost in demand for the economy. If Trump had done well on other major economic things I would give him credit for them, and it’s clear from these points that he did some decent things for the economy while in office. The decent things he did for the economy are heavily outweighed by the flaws of his governing, such as his illogical trade war and his failure on managing the pandemic. The result of his impact on the economy is a net negative effect, one that may prove to be far more net negative later on as the impacts of those policies are felt for years, but many left-wingers don’t admit the very few things he did that were decent. I consider Trump the worst president by far in modern history, but I consider it important to tell the truth about matters such as these and give credit where it’s due. Trump is stunningly ignorant of most important political issues, and he doesn’t talk about it anymore like he did in 2016, but he does seem to understand that trade deficits in America are bad, and that’s part of why in 2016 he won over so many Rust Belt workers who have been screwed by trade policy. The trade deficit increased under Trump however, despite his having the ability to decrease it through policy, and this was before the pandemic. The reason that trade deficits for the U.S. are bad is that it decreases demand in the economy, and we generally have needed more demand to help workers in the last 50 years. On another note, I read an article by a former Republican governor endorsing Joe Biden, and I read it looking for positive things he had to say about Trump. Essentially the most he said that was good about Trump are some regulatory changes. That was all. In conducting surveys of Americans, I would venture a guess that few are fond of the deregulations that allow more coal debris and pollutants to be deposited in streams near residential water supplies and the deregulation that allows imported meat to claim to be made in America. It is rather incredible that so many continue to support Trump despite him not enacting policies that benefit their material interest. The vast majority of the Trump tax cuts go to the richest people in America, not middle-income or low-wage workers. Trump blocked the Post Office from sending out masks to hundreds of millions of Americans because he “didn’t want to create a panic.” There is audio of Trump with Bob Woodward where Trump back in February acknowledges that COVID-19 is far more deadly than the flu, but then he lies to the public in trying to downplay its severity and holds mass gatherings of people close together where many of them don’t wear masks. Trump’s campaign recently had an event in Nebraska where people caught hypothermia and were left out in the cold due to a lack of transportation provided by the campaign. I scanned social media when this happened and I didn’t find any defense of this from the Trump supporters. Trump is a con man that has successfully deceived millions of people, and that includes many things such as his lies about the pandemic, his lies about stopping the wars overseas and his lies about bringing many manufacturing jobs back. If American society was a more rational place, the CNBC program American Greed that focuses on corporate crime would have had an episode on Trump where they focus on his immoral business dealings and damage to much of the population. There’s a long list of how Trump has negatively impacted the public, but I chose to focus more on the economic conditions since that’s more concrete than focus on controversial issues such as abortion and religion.

All of this said, even as a president with an awful track record, Trump may still win the Electoral College. It looks unlikely by polling and the history of presidents losing when they in power during awful economic conditions, but there are variables present in this pandemic election year that normally haven’t been present in past elections. One is that many more Democrats than Republicans will vote by mail, and a considerable percentage of these mail-in ballots won’t be counted. This isn’t a conspiratorial claim — it’s the state of the voter suppression in American politics. In the 2016 election, Greg Palast — author of the book titled “How Trump Won 2020” — found that 141,000 ballots were thrown out after a challenge due to their signatures. He found that there weren’t any voters arrested for forgery because of this. Additionally, Palast said recently that “Once a year, secretaries of state can literally wipe off the voter rolls those voters they think shouldn’t vote. And not surprisingly, these hacks tend to remove people of color where they can, where Republicans control the state. So for example, in Georgia, as you just heard, the Secretary of State [Raffensperger] removed 198,000 voters illegally on false information. Almost all of them [were] black voters, young voters, including Martin Luther King’s 92-year-old cousin.” Palast also said that “In 2016, 5.8 million ballots were cast and never counted. By the way, that’s an official number from the EAC [Election Assistance Commission], from our federal agency; 5.8 million votes cast not counted.” Most disturbingly, Palast mentioned the study finding that “According to MIT [Massachusetts Institute of Technology], 22%, [i.e.,] one in 5 million mail-in ballots, is never counted.”

If 22 percent of mail-in ballots aren’t counted in 2020, that combined with the voter suppression of other people likely to vote for Joe Biden may hand Trump another Electoral College victory. Again, there is a far higher percentage of Republicans going to the polls to vote for Trump than there is Democrats going to the polls to vote for Biden, and this may culminate in not only Trump eventually winning the Electoral College yet again but it may make Trump have an overall lead today on election day before more mail-in ballots are counted. This may then devolve into a scenario where the contested election is taken to the 6-3 conservative majority on the Supreme Court, where the results of the election that are not favorable to Trump may be thrown out.

America will suffer further harm from another four years of Trump. I dislike Biden and consider him to be a politician with a long record of terrible policies, but after years of Trump, it’s apparent that another four years of Trump will continue to have the sort of vast consequences and immense damage seen during the pandemic. In any case, with either person winning the presidency, I would encourage people to try to make the most of what they have even if it’s not that good. A year from now may be an even worse time than today, and now is already bad for so many of us. That’s just the realistic view of things. Exercise and a healthy diet (including plenty of vitamin D to protect against COVID-19 problems) will help us stay strong, and staying strong will remain important when life is tough.

Scientist’s Plasma Shot That Could Prevent COVID-19 Isn’t Being Considered by The Government

That the use of plasma (shown effective in many other cases) isn’t being considered is another inefficiency by the (U.S. at least) governmental response to the coronavirus pandemic.

It might be the next best thing to a coronavirus vaccine.

Scientists have devised a way to use the antibody-rich blood plasma of COVID-19 survivors for an upper-arm injection that they say could inoculate people against the virus for months.

Using technology that’s been proven effective in preventing other diseases such as hepatitis A, the injections would be administered to high-risk healthcare workers, nursing home patients, or even at public drive-through sites — potentially protecting millions of lives, the doctors and other experts say.

The two scientists who spearheaded the proposal — an 83-year-old shingles researcher and his counterpart, an HIV gene therapy expert — have garnered widespread support from leading blood and immunology specialists, including those at the center of the nation’s COVID-19 plasma research.

But the idea exists only on paper. Federal officials have twice rejected requests to discuss the proposal, and pharmaceutical companies — even acknowledging the likely efficacy of the plan — have declined to design or manufacture the shots, according to a Times investigation. The lack of interest in launching development of immunity shots comes amid heightened scrutiny of the federal government’s sluggish pandemic response.

There is little disagreement that the idea holds promise; the dispute is over the timing. Federal health officials and industry groups say the development of plasma-based therapies should focus on treating people who are already sick, not on preventing infections in those who are still healthy.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said an upper-arm injection that would function like a vaccine “is a very attractive concept.”

However, he said, scientists should first demonstrate that the coronavirus antibodies that are currently delivered to patients intravenously in hospital wards across the country actually work. “Once you show the efficacy, then the obvious next step is to convert it into an intramuscular” shot.

But scientists who question the delay argue that the immunity shots are easy to scale up and should enter clinical trials immediately. They say that until there’s a vaccine, the shots offer the only plausible method for preventing potentially millions of infections at a critical moment in the pandemic.

“Beyond being a lost opportunity, this is a real head-scratcher,” said Dr. Michael Joyner, a Mayo Clinic researcher who leads a program sponsored by the Food and Drug Administration to capitalize on coronavirus antibodies from COVID-19 survivors. “It seems obvious.”

The use of so-called convalescent plasma has already become widespread. More than 28,000 patients have already received the IV treatment, and preliminary data suggest that the method is safe. Researchers are also looking at whether the IV drip products would prevent new infections from taking root.

The antibodies in plasma can be concentrated and delivered to patients through a type of drug called immune globulin, or IG, which can be given through either an IV drip or a shot. IG shots have for decades been used to prevent an array of diseases; the IG shot that prevents hepatitis A was first licensed in 1944. They are available to treat patients who have recently been exposed to hepatitis B, tetanus, varicella and rabies.

[…]

The proposal for an injection approach to coronavirus prevention came from an immunization researcher who drew his inspiration from history.

Dr. Michael Oxman knew that, even during the 1918 flu pandemic, the blood of recovered patients appeared to help treat others. Since then, convalescent plasma has been used to fight measles and severe acute respiratory syndrome, or SARS, among other diseases.

Like other doctors, Oxman surmised that, for a limited time, the blood coursing through the veins of coronavirus survivors probably contains immune-rich antibodies that could prevent — or help treat — an infection.

[…]

Throughout May, researchers and doctors at Yale, Harvard, Johns Hopkins, Duke and four University of California schools sent a barrage of letters to dozens of lawmakers. They held virtual meetings with health policy directors on Capitol Hill, but say they have heard no follow-up to date.

Dr. Arturo Casadevall, the chair of the National COVID-19 Convalescent Plasma Project, said he spoke to FDA officials who told him they do not instruct companies on what to produce. Casadevall told The Times that the leaders of the national project were “very supportive of the need to develop” an IG shot rapidly and that he believed it would be “very helpful in stemming the epidemic.”

Joyner, of the Mayo Clinic, said there are probably 10 million to 20 million people in the U.S. carrying coronavirus antibodies — and the number keeps climbing. If just 2% of them were to donate a standard 800 milliliters of plasma on three separate occasions, their plasma alone could generate millions of IG shots for high-risk Americans.

“At a hot-spot meatpacking plant, or at a mobile unit in the parking lot outside a mall — trust me, you can get the plasma,” Joyner said. “This is not a biological problem nor a technology problem. It’s a back-of-the-envelope intelligence problem.”

The antibody injections, for now, do not appear to be a high priority for the government or the industry.

Grifols, on April 28 — the same day that the U.S. topped 1 million confirmed coronavirus cases — made a major product announcement that would “expand its leadership in disease treatment with immunoglobulins.”

The product was a new vial for IG shots — to treat rabies.

Does Vitamin D Help Protect People from COVID-19? Some Evidence Suggests Yes

A comprehensive global study published in 2017 on respiratory infections would say yes:

A new global collaborative study has confirmed that vitamin D supplementation can help protect against acute respiratory infections. The study, a participant data meta-analysis of 25 randomized controlled trials including more than 11,000 participants, has been published online in The BMJ.

“Most people understand that vitamin D is critical for bone and muscle health,” said Carlos Camargo of the Department of Emergency Medicine at Massachusetts General Hospital (MGH), the study’s senior author. “Our analysis has also found that it helps the body fight acute respiratory infection, which is responsible for millions of deaths globally each year.”

Additionally, a professor of respiratory infection and immunity at Queen Mary University of London had this to say about vitamin D:

“Vitamin D could almost be thought of as a designer drug for helping the body to handle viral respiratory infections,” he said. “It boosts the ability of cells to kill and resist viruses and simultaneously dampens down harmful inflammation, which is one of the big problems with Covid.”

The pharmaceutical industry obviously can’t make enormous profits from vitamin D, and that’s part of why it hasn’t been explored more as a protective mechanism. With all the benefits of vitamin D and the lack of downsides to it however, it is worth getting enough vitamin D (through sufficient sunlight exposure and a good diet) to protect against respiratory infections such as the flu and COVID-19.

Widely Available Drug Dexamethasone Shown to Cut Deaths by a Third in Severely Ill COVID-19 Patients

The coronavirus pandemic remains severe, but dexamethasone (a steroid) is a cheap and relatively common drug that has apparently been shown in a rigorous trial to significantly reduce mortality rates in the most severely ill COVID-19 patients. This drug is not a cure and it wasn’t shown to help patients with moderate COVID-19 symptoms, but the drug has been shown to save lives, and that’s important since presumably more people will eventually be able to recover instead of dying to the coronavirus.

An inexpensive and commonly used steroid can save the lives of people seriously ill with COVID-19, a randomized, controlled clinical trial in the United Kingdom has found. The drug, called dexamethasone, is the first shown to reduce deaths from the coronavirus that has killed more than 430,000 people globally. In the trial, it cut deaths by about one-third in patients who were on ventilators because of coronavirus infection.

“It’s a startling result,” says Kenneth Baillie, an intensive-care physician at the University of Edinburgh, UK, who serves on the steering committee of the trial, called RECOVERY. “It will clearly have a massive global impact.” The RECOVERY study announced the findings in a press release on 16 June, but its researchers say that they are aiming to publish their results quickly and that they are sharing their findings with regulators in the United Kingdom and internationally.

The RECOVERY trial, launched in March, is one of the world’s biggest randomized, controlled trials for coronavirus treatments; it is testing a range of potential therapies. The study enrolled 2,100 participants who received dexamethasone at a low or moderate dose of six milligrams per day for ten days, and compared how they fared against about 4,300 people who received standard care for coronavirus infection.

The effect of dexamethasone was most striking among critically ill patients on ventilators. Those who were receiving oxygen therapy but were not on ventilators also saw improvement: their risk of dying was reduced by 20%. The steroid had no effect on people with mild cases of COVID-19 — those not receiving oxygen or ventilation.

Shortly after the results were released, the UK government announced that it had immediately authorized use of dexamethasone for patients hospitalized with COVID-19 who required oxygen, including those on ventilators.

Rigorous study

“It is a major breakthrough,” says Peter Horby, an infectious-disease specialist at the University of Oxford, UK, and a chief investigator on the trial. Use of steroids to treat viral respiratory infections such as COVID-19 has been controversial, Horby notes. Data from steroid trials during outbreaks of SARS (severe acute respiratory syndrome) and Middle East respiratory syndrome caused by related coronaviruses were inconclusive, he says. Nevertheless, given dexamethasone’s widespread availability, and some promising results from steroid studies in previous outbreaks, Horby says RECOVERY investigators felt it important to test the treatment in a rigorous clinical trial.

Treatment guidelines from the World Health Organization and many countries have cautioned against treating people with coronavirus with steroids, and some investigators were concerned about anecdotal reports of widespread steroid treatment. The drugs suppress the immune system, which could provide some relief from patients whose lungs are ravaged by an over-active immune response that sometimes manifests in severe cases of COVID-19. But such patients may still need a fully functioning immune system to fend off the virus itself.

The RECOVERY trial suggests that at the doses tested, the benefits of steroid treatment may outweigh the potential harm. The study found no outstanding adverse events from the treatment, investigators said. “This treatment can be given to pretty much anyone,” says Horby.

And the pattern of response — with a greater impact on severe COVID-19 and no effect on mild infections — matches the notion that a hyperactive immune response is more likely to be harmful in long-term, serious infections, says Anthony Fauci, head of the US National Institute of Allergy and Infectious Disease. “When you’re so far advanced that you’re on a ventilator, it’s usually that you have an aberrant or hyperactive inflammatory response that contributes as much to the morbidity and mortality as any direct viral effect.”

“Finding effective treatments like this will transform the impact of the COVID-19 pandemic on lives and economies across the world,” said Nick Cammack, head of the COVID-19 Therapeutics Accelerator at Wellcome, a UK biomedical research charity in London, in a statement. “While this study suggests dexamethasone only benefits severe cases, countless lives will be saved globally.”

Easy to administer

So far, the only drug shown to benefit COVID-19 patients in a large, randomized, controlled clinical trial is the antiviral drug remdesivir. Although remdesivir1 was shown to shorten the amount of time that patients may need to spend in the hospital, it did not have a statistically significant effect on deaths.

Remdesivir is also in short supply. Although the drug’s maker — Gilead Sciences of Foster City, California — has taken steps to ramp up production of remdesivir, it is currently available only to a limited number of hospitals around the world. And remdesivir is complex to administer: it must be given by injection over the course of several days.

Dexamethasone, by contrast, is a medical staple found on pharmaceutical shelves worldwide and is available as a pill — a particular benefit as coronavirus infections continue to rise in countries with limited access to healthcare. “For less than £50, you can treat 8 patients and save one life,” said Martin Landray, an epidemiologist at the University of Oxford, and another chief investigator on the RECOVERY trial.

The findings could also have implications for other severe respiratory illnesses, Baillie adds. For example, steroid treatments for a condition called acute respiratory distress syndrome are also controversial. “This really gives us a very good reason to look closely at that, because the mortality benefit is so extraordinarily large,” Baillie says. “I think this will affect patients well beyond COVID-19.”

Low Vitamin D Levels Associated With Higher Coronavirus Mortality Rates

Patients with severe vitamin D deficiencies have been found in research to experience more coronavirus-related complications. Exposure to 20 or 30 minutes of sunlight a day and a healthy diet are good ways to keep high vitamin D levels.

After studying global data from the novel coronavirus (COVID-19) pandemic, researchers have discovered a strong correlation between severe vitamin D deficiency and mortality rates.

Led by Northwestern University, the research team conducted a statistical analysis of data from hospitals and clinics across China, France, Germany, Italy, Iran, South Korea, Spain, Switzerland, the United Kingdom (UK) and the United States.

The researchers noted that patients from countries with high COVID-19 mortality rates, such as Italy, Spain and the UK, had lower levels of vitamin D compared to patients in countries that were not as severely affected.

This does not mean that everyone — especially those without a known deficiency — needs to start hoarding supplements, the researchers caution.

“While I think it is important for people to know that vitamin D deficiency might play a role in mortality, we don’t need to push vitamin D on everybody,” said Northwestern’s Vadim Backman, who led the research. “This needs further study, and I hope our work will stimulate interest in this area. The data also may illuminate the mechanism of mortality, which, if proven, could lead to new therapeutic targets.”

The research is available on medRxiv, a preprint server for health sciences.

Backman is the Walter Dill Scott Professor of Biomedical Engineering at Northwestern’s McCormick School of Engineering. Ali Daneshkhah, a postdoctoral research associate in Backman’s laboratory, is the paper’s first author.

Backman and his team were inspired to examine vitamin D levels after noticing unexplained differences in COVID-19 mortality rates from country to country. Some people hypothesized that differences in healthcare quality, age distributions in population, testing rates or different strains of the coronavirus might be responsible. But Backman remained skeptical.

“None of these factors appears to play a significant role,” Backman said. “The healthcare system in northern Italy is one of the best in the world. Differences in mortality exist even if one looks across the same age group. And, while the restrictions on testing do indeed vary, the disparities in mortality still exist even when we looked at countries or populations for which similar testing rates apply.

“Instead, we saw a significant correlation with vitamin D deficiency,” he said.

By analyzing publicly available patient data from around the globe, Backman and his team discovered a strong correlation between vitamin D levels and cytokine storm — a hyperinflammatory condition caused by an overactive immune system — as well as a correlation between vitamin D deficiency and mortality.

“Cytokine storm can severely damage lungs and lead to acute respiratory distress syndrome and death in patients,” Daneshkhah said. “This is what seems to kill a majority of COVID-19 patients, not the destruction of the lungs by the virus itself. It is the complications from the misdirected fire from the immune system.”

This is exactly where Backman believes vitamin D plays a major role. Not only does vitamin D enhance our innate immune systems, it also prevents our immune systems from becoming dangerously overactive. This means that having healthy levels of vitamin D could protect patients against severe complications, including death, from COVID-19.

“Our analysis shows that it might be as high as cutting the mortality rate in half,” Backman said. “It will not prevent a patient from contracting the virus, but it may reduce complications and prevent death in those who are infected.”

Backman said this correlation might help explain the many mysteries surrounding COVID-19, such as why children are less likely to die. Children do not yet have a fully developed acquired immune system, which is the immune system’s second line of defense and more likely to overreact.

“Children primarily rely on their innate immune system,” Backman said. “This may explain why their mortality rate is lower.”

Backman is careful to note that people should not take excessive doses of vitamin D, which might come with negative side effects. He said the subject needs much more research to know how vitamin D could be used most effectively to protect against COVID-19 complications.

“It is hard to say which dose is most beneficial for COVID-19,” Backman said. “However, it is clear that vitamin D deficiency is harmful, and it can be easily addressed with appropriate supplementation. This might be another key to helping protect vulnerable populations, such as African-American and elderly patients, who have a prevalence of vitamin D deficiency.”

Backman is the director of Northwestern’s Center for Physical Genomics and Engineering and the associate director for Research Technology and Infrastructure at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University.