Does Vitamin D play a role in the management of Covid-19 in Brazil?

Ribeiro, Helena; Santana, Keila Valente de Souza de; Oliver, Sofia Lizarralde; Rondó, Patrícia Helen de Carvalho; Mendes, Marcela Moraes; Charlton, Karen E; Lanham-New, Susan A

doi:10.11606/s1518-8787.2020054002545

Cited by 28 publications

(27 citation statements)

References 22 publications

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“…Hence, low 25(OH)D level was identified as independently associated with the likelihood of COVID‐19 infection. This finding is in agreement with the results of other studies [5,7,9–15,19,30–42]. Further, reduced risk of acute respiratory tract infection following vitamin D supplementation has been reported [43,44].…”

Section: Discussionsupporting

confidence: 94%

Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study

et al. 2020

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Vitamin D deficiency is a worldwide pandemic. The aim of this study was to evaluate associations of plasma 25(OH)D levels with the likelihood of coronavirus disease 2019 (COVID‐19) infection and hospitalization. The study population included the 14 000 members of Leumit Health Services, who were tested for COVID‐19 infection from February 1st to April 30th, 2020, and who had at least one previous blood test for the plasma 25(OH)D level. ‘Suboptimal’ or ‘low’ plasma 25(OH)D level was defined as plasma 25‐hydroxyvitamin D, or 25(OH)D, concentration below the level of 30 ng/mL. Of 7807 individuals, 782 (10.02%) were COVID‐19‐positive, and 7025 (89.98%) COVID‐19‐negative. The mean plasma vitamin D level was significantly lower among those who tested positive than negative for COVID‐19 [19.00 ng/mL (95% confidence interval (CI) 18.41–19.59) vs. 20.55 (95% CI: 20.32–20.78)]. Univariate analysis demonstrated an association between the low plasma 25(OH)D level and increased likelihood of COVID‐19 infection [crude odds ratio (OR) of 1.58 (95% CI: 1.24–2.01, P < 0.001)], and of hospitalization due to the SARS‐CoV‐2 virus [crude OR of 2.09 (95% CI: 1.01–4.30, P < 0.05)]. In multivariate analyses that controlled for demographic variables, and psychiatric and somatic disorders, the adjusted OR of COVID‐19 infection [1.45 (95% CI: 1.08–1.95, P < 0.001)] and of hospitalization due to the SARS‐CoV‐2 virus [1.95 (95% CI: 0.98–4.845, P = 0.061)] were preserved. In the multivariate analyses, age over 50 years, male gender and low–medium socioeconomic status were also positively associated with the risk of COVID‐19 infection; age over 50 years was positively associated with the likelihood of hospitalization due to COVID‐19. We concluded that low plasma 25(OH)D levels appear to be an independent risk factor for COVID‐19 infection and hospitalization.

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Section: Discussionsupporting

confidence: 94%

Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study

et al. 2020

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“…An adjustment in Vitamin D levels in the intake would also strengthen the immune system. [130][131][132][133][134][135][136] Plant-based fiber has prebiotic effects such as promoting the growth of bacteria that are associated with health benefits, such as Bifidobacterium and Lactobacillus spp. Moreover, reduce potential pathogens such as Clostridium spp.…”

Section: Changes In the Gut Microbiota Composition Through Diet To Dementioning

confidence: 99%

Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome

Villapol

2020

Translational Research

305

302

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the greatest worldwide pandemic since the 1918 flu. The consequences of the coronavirus disease 2019 (COVID-19) are devastating and represent the current major public health issue across the globe. At the onset, SARS-CoV-2 primarily attacks the respiratory system as it represents the main point of entry in the host, but it also can affect multiple organs. Although most of the patients do not present symptoms or are mildly symptomatic, some people infected with SARS-CoV-2 that experience more severe multiorgan dysfunction. The severity of COVID-19 is typically combined with a set of comorbidities such as hypertension, diabetes, obesity, and/or advanced age that seriously exacerbates the consequences of the infection. Also, SARS-CoV-2 can cause gastrointestinal symptoms, such as vomiting, diarrhea, or abdominal pain during the early phases of the disease. Intestinal dysfunction induces changes in intestinal microbes, and an increase in inflammatory cytokines. Thus, diagnosing gastrointestinal symptoms that precede respiratory problems during COVID-19 may be necessary for improved early detection and treatment. Uncovering the composition of the microbiota and its metabolic products in the context of COVID-19 can help determine novel biomarkers of the disease and help identify new therapeutic targets. Elucidating changes to the microbiome as reliable biomarkers in the context of COVID-19 represent an overlooked piece of the disease puzzle and requires further investigation. (Translational Research 2020; 226:57À69) Abbreviations: ARDS = acute respiratory distress syndrome; ACE2 = Angiotensin-Converting Enzyme II; CNS = central nervous system; COVID-19 = coronavirus disease 2019; CPR = C-reactive protein; H1N1 = influenza A virus; IL = Interleukin; MERS = Middle East respiratory syndrome; PRS = proteomic risk score; SARS = severe acute respiratory syndrome; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2; SCFA = short-chain fatty acids; RAS = renin-angiotensin system; ROS = Reactive oxygen species; RT-PCR = reverse transcription-polymerase chain reaction; TMPRSS2 = transmembrane serine protease 2; TNFa = tumor necrosis factor alpha;

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“…Two May 2020 Centre for Evidence-Based Medicine rapid reviews concluded, without discussing any of the recent studies, that there is no evidence to support a role for vitamin D in prevention or treatment of COVID-19 or the cytokine storm (45,55). Alarmed by the media response to a literature review suggesting a link between COVID-19 and vitamin D, two Brazilian medical associations jointly published a note stating that vitamin D supplements are only approved for bone health (56)(57)(58). The high mortality rates among minorities are providing momentum for various public health program expansions, which could diminish if vitamin D deficiency, rather than access to care and economic disparities, were found to be even a partial explanation (59)(60)(61)(62).…”

Section: The Vitamin D Debatementioning

confidence: 99%

“…Current increased "stay at home" regulations and increased boredom and stress can be expected to result in eating patterns which increase obesity and the comorbidities with which it is associated (189). In part because vitamin D is fat-soluble, obese individuals have increased daily vitamin D intake requirements and are often deficient (25,34,57,91,175,190,191). In addition, vitamin D deficiency causes the body to store more fat by increasing parathyroid hormone levels (192).…”

Section: Risk For Severe Covid-19 Parallels Risk For Vitamin D Deficimentioning

confidence: 99%

A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency

Benskin

2020

Front. Public Health

137

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As the world's attention has been riveted upon the growing COVID-19 pandemic, many researchers have written brief reports supporting the hypothesis that vitamin D deficiency is related to the incidence and severity of COVID-19. The clear common thread among the top risk groups-vitamin D deficiency-may be being overlooked because of previous overstated claims of vitamin D benefits. However, the need to decrease COVID-19 fatalities among high-risk populations is urgent. Early researchers reported three striking patterns. Firstly, the innate immune system is impaired by vitamin D deficiency, which would predispose sufferers to viral infections such as COVID-19. Vitamin D deficiency also increases the activity of the X-chromosome-linked "Renin-Angiotensin" System, making vitamin D deficient individuals (especially men) more susceptible to COVID-19's deadly "cytokine storm" (dramatic immune system overreaction). Secondly, the groups who are at highest risk for severe COVID-19 match those who are at highest risk for severe vitamin D deficiency. This includes the elderly, men, ethnic groups whose skin is naturally rich in melanin (if living outside the tropics), those who avoid sun exposure for cultural and health reasons, those who live in institutions, the obese, and/or those who suffer with hypertension, cardiovascular disease, or diabetes. And thirdly, the pattern of geographical spread of COVID-19 reflects higher population vitamin D deficiency. Both within the USA and throughout the world, COVID-19 fatality rates parallel vitamin D deficiency rates. A literature search was performed on PubMed, Google Scholar, and RSMLDS, with targeted Google searches providing additional sources. Although randomized controlled trial results may be available eventually, the correlational and causal study evidence supporting a link between vitamin D deficiency and COVID-19 risks is already so strong that it supports action. The 141 author groups writing primarily about biological plausibility detailed how vitamin D deficiency can explain every risk factor and every complication of COVID-19, but agreed that other factors are undoubtedly at work. COVID-19 was compared with dengue fever, for which oral vitamin D supplements of 4,000 IU for 10 days were significantly more effective than 1,000 IU in reducing virus replication and controlling the "cytokine storm" (dramatic immune system over-reaction) responsible for fatalities. Among the 47 original research studies summarized here, chart reviews found that serum vitamin D levels predicted COVID-19 mortality Benskin Evidence Linking Vitamin D, COVID-19 rates (16 studies) and linearly predicted COVID-19 illness severity (8 studies). Two causal modeling studies and several analyses of variance strongly supported the hypothesis that vitamin D deficiency is a causal, rather than a bystander, factor in COVID-19 outcomes. Three of the four studies whose findings opposed the hypothesis relied upon disproven assumptions. The literature review also found that prophylactically correcting possible ...

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Does Vitamin D play a role in the management of Covid-19 in Brazil?

Cited by 28 publications

References 22 publications

Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study

Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study

Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome

A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency

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