Vitamin D: A Potential Mitigation Tool for the Endemic Stage of the COVID-19 Pandemic?

Abstract

The impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and associated development of clinical symptoms of COVID-19 have presented an enormous global impact on our health care systems, public health and economy. To date several observational epidemiological studies consistently found that vitamin D deficiency, measured as low levels of circulating 25-hydroxyvitamin D, is associated with cardiovascular diseases, diabetes, certain cancers, autoimmune diseases and many infectious diseases, including acute respiratory infections. Since vitamin D is not merely immunosuppressive but also acts as an immunomodulator in tolerance and homeostasis, many experts have considered a role of vitamin D in the prevalence and severity of immune mediated inflammatory diseases, such as SARS-CoV-2, adding to the evidence of the importance of vitamin D in the immune response against viral respiratory infections and reinforcing the need for targeted vitamin D supplementation, with a focus on high-risk populations and a high-dose supplementation treatment for COVID-19 hospitalized patients. The expected transition to endemicity of SARS-CoV-2 even further corroborates as a potential of vitamin D as an potential mitigation tool for the prevention of COVID-19. The aim of this paper is to analyse the current evidence regarding vitamin D and present a hypothesis of its potential role in the current COVID-19 pandemic and in the future as a potential preventive measurement in public health.

Efficacy and safety of vitamin D supplementation in hospitalized COVID-19 pediatric patients: A randomized controlled trial

“…If the criteria change using the values by the Food and Nutrition Board, children with insufficiency (level between 12 and 20 ng/ml) could participate in a new trial and only patients with vitamin D deficiency (<12 ng/ml) would be excluded. In the recent review by Briceno Noriega et al, several recommendations are made for future research ( 46 ).…”

Pharmacological evaluation of vitamin D in COVID-19 and long COVID-19: recent studies confirm clinical validation and highlight metformin to improve VDR sensitivity and efficacy

“…Therefore, it inhibits inflammatory processes (Bikle 2022 ). Briceno Noriega and Savelkoul ( 2022 ) confirmed that VD plays an important role against the endemic phase of COVID-19 respiratory tract infection by acting as an immune modulator. It would play a protective role in the endemic phase of COVID-19 by stimulating the cellular receptor angiotensin converting enzyme 2 (ACE2)/Ang (1–7)/Mas G and inhibiting the expression of renin and the angiotensin II receptor type I (AT1R) axis.…”

Can vitamin D positively impact one or more postacute-COVID-19 syndrome musculoskeletal and cognitive complications?

“…Multiple articles report that a high rate of vitamin D deficits exists among various cases deemed COVID-19 positive. In addition, many report a probable vitamin D deficit that raises the risk of more severe infection responses than not, 25,26 although this is not an accepted fact to any degree. However, other data are supportive of this aforementioned view because they show that there does appear to be a high rate of deficient vitamin D levels in the acute or post-COVID-19 studied groups although this is not well correlated or consistent.…”