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Rapid response to:

Editor's Choice

Covid-19: A wake-up call

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2021 (Published 21 May 2020) Cite this as: BMJ 2020;369:m2021

Rapid Response:

Re: Covid-19: A wake-up call

Dear Editor

BAME clinical and support staff are dying in disproportionate numbers, as are those in the general population.

The suggestion from the enclosed literature is that vit D helps the immune system resist viral infections, and that a good supply prevents the covid infection 10th day deterioration, with a 'cytokine storm' inflammation that damages the lungs, often with fatal results, and also the kidneys and other vital organs. A dark skin pre-disposes to vitamin D deficiency in the bleak UK climate.
The final process is of small clots affecting the lung blood vessels, and the kidneys. The last paper suggests that treatment with high doses of a heparin type anti-coagulant can reduce this clotting process, with a lower death rate.

BAME populations are more prone to cardiovascular disease, so that those of South Asian heritage are advised to keep to a lower BMI to prevent this. The risk factors for clotting are very similar to those predicting death in covid patients. There are difficulties in arranging a life-saving organ transplant in BAME populations, as their transplant antigens are different.
At a time of a pandemic, lower standards for the initiation of new treatments may be acceptable. If I were BAME, I would be taking vit D supplements, and would be demanding early treatment with anticoagulants if I were to develop serious complications of covid.

The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients.
.https://www.medrxiv.org/content/10.1101/2020.04.08.20058578v4

E. Laird, J. Rhodes, R.A. Kenny. Vitamin D and Inflammation: Potential Implications for Severity of Covid-19. Irish Medical Journal, 2020; 113 (5): P81

Association of Treatment Dose Anticoagulation with In-Hospital Survival Among Hospitalized Patients with COVID-19. Journal Pre -Proof.
https://www.sciencedirect.com/science/article/pii/S0735109720352189?via%...

Competing interests: No competing interests

31 May 2020
Gareth H. Jones
Tribunal Doctor
Mental Health Review Tribunal for Wales
Caerphilly