Clinical aspects of SARS-CoV-2 infection and vitamin D

Abstract

In December 2019, the first cases of severe acute respiratory syndrome due to a new coronavirus (SARS-Cov-2), later designated as Covid-19, were described in China. With rapid advance of the infection to several continents, in March 2020, WHO declared this to be a pandemic. In April 2020, the first papers suggesting a possible role of Vitamin D deficiency in the severity of this infection began to appear and dozens of articles evaluating a potential relationship of vitamin D with COVID have emerged subsequntly. This possibility was raised based on pre-existing evidence of the effects of Vitamin D on the immune system, and more specifically on acute respiratory viral infections. In addition, most Covid-19 victims belong to groups at risk for vitamin D deficiency such as the elderly, obese, chronically ill, and specific ethnic groups. Although with some contradictory reports exist, most observational and cohort studies find a relationship of low vitamin D status with greater Covid severity, others, including the few interventional studies available show inconsistent results. This paper aims to present the rapidly expanding literature to date regarding the clinical relevance of vitamin D in Covid-19 and, consequently, the reasonableness of avoiding its deficiency to keep the immune system able to respond in the best way to this acute viral infection. In the meantime, we wait for publication of several prospective randomized controlled studies that are underway, evaluating the effects of treatment with vitamin D or metabolites on the severity of Covid-19 outcomes.

Vitamin D and SARS-CoV-2 Infection: SERVE Study (SARS-CoV-2 Exposure and the Role of Vitamin D among Hospital Employees)

“…Vitamin D plays key role in both innate and adaptive immunity ( 2 , 3 ); for this reason there has been a great deal of interest in the link between vitamin D and susceptibility to, and severity of, infection with SARS-CoV-2 ( 4 , 5 ). Vitamin D has been reported to regulate innate immunity by increased production of peptides like cathelidicin and beta-defensin-2, subsequently blocking viral entry into cells and suppressing replication ( 6 , 7 ).…”

Epidemiological situation of SARS-CoV-2 infection in Douala, the most populated and highly heterogeneous town of Cameroon: a post-vaccination update

“…Health systems of several countries have been overwhelmed by COVID-19, and this impacted control of other major infectious diseases such as malaria, tuberculosis and human immunodeficiency virus infection - HIV ( Dongang Nana et al, 2022 ; Hogan et al, 2020 ). The virus has a strong cell tropism for respiratory system, with clinical symptomatology mainly represented by respiratory signs, along with gastrointestinal, cardiovascular and neurologic manifestations ( Bandeira et al, 2022 ; Gautret et al, 2020 ).…”

High‐dose vitamin D supplementation in patients with COVID‐19: A meta‐analysis of randomized controlled trials

“…All these investigations were not focused on the effects of high-dose vitamin D supplementation. Actually, research did show that a high dose of vitamin D increases plasma 25(OH)D levels differently than physiologic doses(Bandeira et al, 2022) and may not result in an improved immune response or better clinical outcomes compared to standard, chronic supplementation(Annweiler et al, 2021) Jolliffe et al (2021)…”