Immunologic Effects of Vitamin D on Human Health and Disease

Charoenngam, Nipith; Holick, Michael F.

doi:10.3390/nu12072097

Cited by 674 publications

(690 citation statements)

References 199 publications

(298 reference statements)

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“…, an active form of vitamin D, plays a critical role in the modulation of innate as well as adaptive immune systems 32,33 , renin-angiotensin system (RAS) [33][34][35] as well as in the modulation of the inflammatory response, reducing cytokine storm risk 32,33 . It also stimulates antimicrobial peptides such as defensins and human cathelicidin 32,33,36,37 with antiviral properties. Recent studies related to COVID-19 also indicate that vitamin D deficiency might be a risk factor not only for incidence 2,3 , but also for severity 4 5 and mortality [6][7][8] associated with COVID-19.…”

Section: Radiation and Covid-19 Deaths In Indiamentioning

confidence: 99%

Implications of Monsoon Season & UVB Radiation for COVID-19 in India Manuscript

Moozhipurath

Kraft

2020

Preprint

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Background: India has recorded 66,333 deaths over 36 administrative regions placing India third in the world after the US and Brazil for COVID-19 deaths as of 2 September 2020. Studies indicate that south-west monsoon season plays a role in the dynamics of contagious diseases, which tend to peak post-monsoon season. Recent studies show that vitamin D and its primary source Ultraviolet-B radiation (UVB) may play a protective role in mitigating COVID-19 deaths. However, the combined roles of the monsoon season and UVB in COVID-19 in India are still unclear. In this observational study, we empirically study the respective roles of monsoon season and UVB, whilst further exploring, whether monsoon season negatively impacts the protective role of UVB in COVID-19 deaths in India. Methods: We use a log-linear Mundlak model to a panel dataset of 36 administrative regions in India from 14 March 2020 - 8 August 2020 (n=4005). We use the cumulative COVID-19 deaths as the dependent variable. We isolate the association of monsoon season and UVB as measured by Ultraviolet Index (UVI) from other confounding time-constant and time-varying region-specific factors. Findings: After controlling for various confounding factors, we observe that the monsoon season and a unit increase in UVI are separately associated with 12.8 percentage points and 2.0 percentage points decline in growth rates of COVID-19 deaths in the long run. These associations translate into substantial relative changes. For example, the current monsoon season, that has been going on for two weeks, is associated with a reduction in growth rates of COVID-19 deaths of 59%, whereas a permanent unit increase of UVI is associated with a reduction in growth rates of COVID-19 deaths of 37%. However, the current monsoon season, also reduces the protective role of UVI by 16.3% [0.33 percentage points], plausibly due to lower UVB exposure. Interpretation: We find independent protective roles of both the monsoon season and UVI in mitigating COVID-19 deaths. Furthermore, we find evidence that monsoon season is associated with a significant reduction in the protective role of UVI. The protective role of monsoon season is plausibly due to limited outdoor activities of people. Our study outlines the role of the monsoon season and UVB in COVID-19 in India and supports health-related policy decision making in India.

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Section: Radiation and Covid-19 Deaths In Indiamentioning

confidence: 99%

Implications of Monsoon Season & UVB Radiation for COVID-19 in India Manuscript

Moozhipurath

Kraft

2020

Preprint

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“…The active form of vitamin D3, 1α, 25-dihydroxyvitamin D3 (1,25D3), also known as calcitriol, is a pluripotent hormone and important modulator of both innate and adaptive immunity [5], and serum total 25-hydroxyvitamin D (25(OH)D) is commonly used to assess individual vitamin D (VitD) status [6].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency and Outcome of COVID-19 Patients

et al. 2020

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Infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses an enormous challenge to health care systems throughout the world. Without causal treatment, identification of modifiable prognostic factors may help to improve outcomes. To explore possible associations of vitamin D (VitD) status with disease severity and survival, we studied 185 patients diagnosed with coronavirus disease 2019 (COVID-19) and treated at our center. VitD status at first presentation was assessed retrospectively using accredited laboratory methods. VitD deficiency was defined as serum total 25-hydroxyvitamin D level < 12 ng/mL (<30 nM). Primary endpoint was severe course of disease (i.e., need for invasive mechanical ventilation and/or death, IMV/D). Within a median observation period of 66 days (range 2–92), 23 patients required IMV. A total of 28 patients had IMV/D, including 16 deaths. Ninety-three (50%) patients required hospitalization (inpatient subgroup). A total of 41 (22%) patients were VitD deficient. When adjusted for age, gender, and comorbidities, VitD deficiency was associated with higher risk of IMV/D and death (HR 6.12, 95% CI 2.79–13.42, p < 0.001 and HR 14.73, 95% CI 4.16–52.19, p < 0.001, respectively). Similar correlations were observed in the inpatient subgroup. Our study demonstrates an association between VitD deficiency and severity/mortality of COVID-19, highlighting the need for interventional studies on VitD supplementation in SARS-CoV-2 infected individuals.

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“…Vitamin D would also have an antiviral effect, as well as a positive effect on immunity, modulating T and B cells, and also regulating the expression and secretion of cytokines such as TNF or IL-6. Low levels of serum vitamin D are linked to the occurrence of sepsis, as well as increased morbidity, mortality, and prolonged length of stay in the ICU in septic and critically ill patients [38]. This vitamin also has an anticoagulant effect, inversely correlated with D-dimer.…”

Section: Discussionmentioning

confidence: 99%

Zinc and Vitamin a Deficiency Predisposes to the Need for Intubation and Icu Admission in Patients With COVID-19. An Observational Study

Berrocal

Irriguible

Philibert

et al. 2020

Preprint

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Objective: To analyse whether the micronutrient deficit predicts a worse prognosis in patients infected by SARS-CoV-2 who developed the COVID-19 disease.Methods: We carried out an observational and retrospective study with 120 patients admitted for COVID-19 in the ICU and in the Internal Medicine ward of a tertiary hospital. In the nutritional admission analysis of these patients, we analysed plasmatic levels of vitamins A, B6, C, D, E and zinc. In addition, different variables of interest were collected, such as the need for orotracheal intubation, hospital stay, mortality and multi-organ failure.Results: One hundred and twenty patients were included. The independent variables associated with the need for ICU admission were low levels of zinc (standard error 0.566, 95% CI 0.086 to 0.790, p = 0.017), low levels of vitamin A (standard error 0.582, 95% CI 0.061 to 0.594, p = 0.004), age over 65 (standard error 0.018, 95% CI 0.917 to 0.985, p = 0.005) and male gender (standard error 0.458, 95% CI 1.004 to 6.040, p = 0.049). The only variable that was independently associated with the need for orotracheal intubation was vitamin A deficiency (standard error 0.58, 95% CI 0.042 to 0.405, p = 0.000).Conclusions: Low levels of vitamin A and zinc are associated with a greater need for admission to the ICU and orotracheal intubation. Patients older than 65 years had higher mortality. Randomized clinical trials are needed to examine whether micronutrient supplementation could be beneficial as an adjunctive treatment in COVID-19.

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Immunologic Effects of Vitamin D on Human Health and Disease

Cited by 674 publications

References 199 publications

Implications of Monsoon Season & UVB Radiation for COVID-19 in India Manuscript

Implications of Monsoon Season & UVB Radiation for COVID-19 in India Manuscript

Vitamin D Deficiency and Outcome of COVID-19 Patients

Zinc and Vitamin a Deficiency Predisposes to the Need for Intubation and Icu Admission in Patients With COVID-19. An Observational Study

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