Preventive Effects of Vitamin D on Seasonal Influenza A in Infants: A Multicenter, Randomized, Open, Controlled Clinical Trial

Zhou, Jian Zhong; Du, Jiankui; Huang, Lan; Wang, Youcheng; Shi, Yimei; Lin, Hailong

doi:10.1097/inf.0000000000001890

Cited by 79 publications

(74 citation statements)

References 28 publications

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“…The RCTs included confirmed that the respiratory tract infection was indeed derived from influenza. Only two RCTs reported beneficial effects: one among schoolchildren in Japan [52], the other among infants in China [53]. An RCT in Japan that reported no beneficial effect did not measure baseline 25(OH)D concentration [54] and included many participants who had been vaccinated against influenza (M. Urashima; private communication).…”

Section: Seasonal Influenzamentioning

confidence: 99%

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

et al. 2020

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The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D 3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D 3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

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Section: Seasonal Influenzamentioning

confidence: 99%

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

et al. 2020

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“…The RCTs included confirmed that the respiratory tract infection was indeed from influenza. Only two RCTs reported beneficial effects: one among schoolchildren in Japan [52], the other among infants in China [53]. An RCT in Japan that reported no beneficial effect did not measure baseline 25(OH)D concentration [54] and included many participants who had been vaccinated against influenza (M. Urashima; private communication).…”

Section: Seasonal Influenzamentioning

confidence: 99%

Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

Grant

Lahore

McDonnell

et al. 2020

Preprint

581

595

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The world is in the grips of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increase concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D [25(OH)D] concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/ml (100–150 nmol/l). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

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“…These observational findings have laid the foundation for clinical trials of vitamin D supplementation for treatment or prevention of childhood respiratory tract infections, as shown in Table 6 a,b [ 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163 , 164 , 165 , 166 , 167 , 168 , 169 , 170 ].…”

Section: Vitamin Dmentioning

confidence: 99%

“…In 2015 Grant and colleagues analyzed the supplementation of vitamin D to pregnant women and to their infants up to 6 months of age, comparing two regimens: 1000 IU to the mothers and 400 IU to the infants vs. 200–800 IU, and found a lower proportion of children made a primary care visit for respiratory infections up to 18 months of age in the higher dose group [ 163 ]. A 2018 Chinese study tested the efficacy of vitamin D in preventing influenza A, comparing a low dose scheme (400 IU/day) vs. a high dose one (1200 IU/day) for 4 months, and reported less frequent infections in the high dose group [ 167 ].…”

Section: Vitamin Dmentioning

confidence: 99%

“…In this population, the authors reported a mean baseline vitamin D of 65 nmol/L (26 ng/mL), which might be one of the reasons why a further vitamin D supplementation did not lead to the expected results. In the previously cited studies, the baseline vitamin D status is not always reported; where it is known, it is usually lower, from 7 ng/mL, equal to 17.5 nmol/L [ 153 ], to 43 nmol/L, equal to 17.2 nmol/L [ 167 ].…”

Section: Vitamin Dmentioning

confidence: 99%

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The Role of Micronutrients in Support of the Immune Response against Viral Infections

et al. 2020

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Viral infections are a leading cause of morbidity and mortality worldwide, and the importance of public health practices including handwashing and vaccinations in reducing their spread is well established. Furthermore, it is well known that proper nutrition can help support optimal immune function, reducing the impact of infections. Several vitamins and trace elements play an important role in supporting the cells of the immune system, thus increasing the resistance to infections. Other nutrients, such as omega-3 fatty acids, help sustain optimal function of the immune system. The main aim of this manuscript is to discuss of the potential role of micronutrients supplementation in supporting immunity, particularly against respiratory virus infections. Literature analysis showed that in vitro and observational studies, and clinical trials, highlight the important role of vitamins A, C, and D, omega-3 fatty acids, and zinc in modulating the immune response. Supplementation with vitamins, omega 3 fatty acids and zinc appears to be a safe and low-cost way to support optimal function of the immune system, with the potential to reduce the risk and consequences of infection, including viral respiratory infections. Supplementation should be in addition to a healthy diet and fall within recommended upper safety limits set by scientific expert bodies. Therefore, implementing an optimal nutrition, with micronutrients and omega-3 fatty acids supplementation, might be a cost-effective, underestimated strategy to help reduce the burden of infectious diseases worldwide, including coronavirus disease 2019 (COVID-19).

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Preventive Effects of Vitamin D on Seasonal Influenza A in Infants: A Multicenter, Randomized, Open, Controlled Clinical Trial

Abstract: High-dose vitamin D (1200 IU) is suitable for the prevention of seasonal influenza as evidenced by rapid relief from symptoms, rapid decrease in viral loads and disease recovery. In addition, high-dose vitamin D is probably safe for infants.

Cited by 79 publications

References 28 publications

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

The Role of Micronutrients in Support of the Immune Response against Viral Infections

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