Addendum to vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis

Damascena, Alialdo Dantas; Azevêdo, Laylla Mirella Galvão; Oliveira, Tarcio de Almeida; Santana, Jerusa da Mota; Pereira, Marcos

doi:10.1080/10408398.2021.1951652

Cited by 10 publications

(1 citation statement)

References 29 publications

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“…Several small meta-analyses showed that lower 25OHD levels are associated with increased patient susceptibility to infection, higher rates of hospital admissions, longer hospital stays, increased need for mechanical ventilation or intensive care unit admission, and higher COVID-19 mortality [75][76][77][78][79][80][81][82][83] A larger meta-analysis included 54 clinical studies, representing a total of 1,403,715 patients concluded that low 25OHD levels are associated with increased risk of SARS-CoV-2 infection, severity (hospitalization and ICU admission), and mortality from COVID-19, regardless of the cut-off point chosen in the assessment (severe deficiency (<10 ng/mL), deficiency (<20 ng/mL), and insufficiency (<30 ng/mL)) [83]. The most recent meta-analysis evaluated studies with more than 2 million subjects and concluded that serum 25OHD levels below 20 ng/mL increased 1.46 fold the risk of being infected by SARS-CoV-2 [84].…”

Section: Circulating 25ohd Levels and Incidence And Severity Of Covid-19mentioning

confidence: 99%

Vitamin D Endocrine System and COVID-19: Treatment with Calcifediol

et al. 2022

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The COVID-19 pandemic is the greatest challenge facing modern medicine and public health systems. The viral evolution of SARS-CoV-2, with the emergence of new variants with in-creased infectious potential, is a cause for concern. In addition, vaccination coverage remains in-sufficient worldwide. Therefore, there is a need to develop new therapeutic options, and/or to optimize the repositioning of drugs approved for other indications for COVID-19. This may include the use of calcifediol, the prohormone of the vitamin D endocrine system (VDES) as it may have potential useful effects for the treatment of COVID-19. We review the aspects associating COVID-19 with VDES and the potential use of calcifediol in COVID-19. VDES/VDR stimulation may enhance innate antiviral effector mechanisms, facilitating the induction of antimicrobial peptides/autophagy, with a critical modulatory role in the subsequent host reactive hyperinflammatory phase during COVID-19: By decreasing the cytokine/chemokine storm, regulating the renin–angiotensin–bradykinin system (RAAS), modulating neutrophil activity and maintaining the integrity of the pulmonary epithelial barrier, stimulating epithelial repair, and directly and indirectly decreasing the increased coagulability and prothrombotic tendency associated with severe COVID-19 and its complications. Available evidence suggests that VDES/VDR stimulation, while maintaining optimal serum 25OHD status, in patients with SARS-CoV-2 infection may significantly reduce the risk of acute respiratory distress syndrome (ARDS) and severe COVID-19, with possible beneficial effects on the need for mechanical ventilation and/or intensive care unit (ICU) admission, as well as deaths in the course of the disease. The pharmacokinetic and functional characteristics of calcifediol give it superiority in rapidly optimizing 25OHD levels in COVID-19. A pilot study and several observational intervention studies using high doses of calcifediol (0.532 mg on day 1 and 0.266 mg on days 3, 7, 14, 21, and 28) dramatically decreased the need for ICU admission and the mortality rate. We, therefore, propose to use calcifediol at the doses described for the rapid correction of 25OHD deficiency in all patients in the early stages of COVID-19, in association, if necessary, with the new oral antiviral agents.

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Section: Circulating 25ohd Levels and Incidence And Severity Of Covid-19mentioning

confidence: 99%

Vitamin D Endocrine System and COVID-19: Treatment with Calcifediol

et al. 2022

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Seasonal UV exposure and vitamin D: association with the dynamics of COVID‐19 transmission in Europe

et al. 2021

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Several recent studies have demonstrated that low plasma 25(OH) vitamin D levels are associated with the risk of COVID‐19 infection. The primary source of vitamin D production in humans is environmental UV radiation. In many viral respiratory diseases, peak infection rates are observed during winter due to reduced UV exposure and low temperatures. In Europe, the second wave of COVID‐19 began early in the winter of 2020. Investigating the impact of seasonal temperature and UV exposure on COVID‐19 transmission could thus aid in prevention and intervention. As such, we first performed a comprehensive meta‐analysis of all related published literature based on the association between vitamin D and COVID‐19, which supported the hypothesis that the low vitamin D level is a critical risk factor for COVID‐19 infection. Next, to understand the potential impact of seasonal UV and temperature levels on COVID‐19 cases, we analyzed meteorological data and daily COVID‐19 cases per million in the populations of 26 European countries. We observed that low temperature, UV index, and cloud‐free vitamin D UV dose (UVDVF) levels are negatively correlated with COVID‐19 prevalence in Europe. Furthermore, a distributed lag nonlinear model was used to assess the nonlinear delayed effects of individual seasonal factors on COVID‐19 cases. Such analysis highlighted the significantly delayed impact of UVDVF on the cumulative relative risk of COVID‐19 infection. The findings of this study suggest that low UV exposure can affect the required production of vitamin D in the body, which substantially influences the dynamics of COVID‐19 transmission and severity.

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Nutritional risk of vitamin D, vitamin C, zinc, and selenium deficiency on risk and clinical outcomes of COVID-19: A narrative review

Pedrosa

Barros

Leite-Lais

2022

Clinical Nutrition ESPEN

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The pathogenicity of the current coronavirus disease shows postulates that optimal status of essential nutrients is crucial in supporting both the early viraemic and later hyperinflammatory phases of COVID-19. Micronutrients such as vitamin C, D, zinc, and selenium play roles in antioxidant, antiinflammatory, antithrombotic, antiviral, and immuno-modulatory functions and are useful in both innate and adaptive immunity. The purpose of this review is to provide a high-level summary of evidence on clinical outcomes associated with nutritional risk of these micronutrients observed in patients with COVID-19. A literature search was performed on PubMed and Google Scholar to obtain findings of crosssectional and experimental studies in humans. The search resulted in a total of 1212 reports including all nutrients, but only 85 were included according to the eligibility criteria. Despite the diversity of studies and the lack of randomized clinical trials and prospective cohorts, there is evidence of the potential protective and therapeutic roles of vitamin C, D, zinc, and selenium in COVID-19. The findings summarized in this review will contribute to guide interventions in clinical practice or in future clinical studies.

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Addendum to vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis

Cited by 10 publications

References 29 publications

Vitamin D Endocrine System and COVID-19: Treatment with Calcifediol

Vitamin D Endocrine System and COVID-19: Treatment with Calcifediol

Seasonal UV exposure and vitamin D: association with the dynamics of COVID‐19 transmission in Europe

Nutritional risk of vitamin D, vitamin C, zinc, and selenium deficiency on risk and clinical outcomes of COVID-19: A narrative review

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