Vitamin D and Its Potential Benefit for the COVID-19 Pandemic

Abstract

Vitamin D is known not only for its importance for bone health, but also for its biologic activities on other many other organ systems. This is due to the presence of the vitamin D receptor (VDR) in various types of cells and tissues, including the skin, skeletal muscle, adipose tissue, endocrine pancreas, immune cells and blood vessels. Experimental studies have shown that vitamin D exerts several actions that are thought to be protective against COVID-19 infectivity and severity. These include the immunomodulatory effects on the innate and adaptive immune systems, the regulatory effects on renin-angiotensin-aldosterone-system in the kidneys and the lungs, and the protective effects against endothelial dysfunction and thrombosis. Prior to the COVID-19 pandemic, studies have shown that vitamin D supplementation is beneficial in protecting against risk of acquiring acute respiratory viral infection and may improve outcomes in sepsis and critically ill patients. There are a growing number of data connecting COVID-19 infectivity and severity with vitamin D status, suggesting a potential benefit of vitamin D supplementation for primary prevention or as an adjunctive treatment of COVID-19. Although the results from most ongoing randomized clinical trials aiming to prove the benefit of vitamin D supplementation for these purposes are still pending, there is no downside to increasing vitamin D intake and having sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at least 30 ng/mL (75 nmol/L) and preferably at 40 – 60 ng/mL (100 – 150 nmol/L) to minimize the risk of COVID-19 infection and its severity.

Self-identified Race and COVID-19-Associated Acute Kidney Injury and Inflammation: a Retrospective Cohort Study of Hospitalized Inner-City COVID-19 Patients

“…Vitamin D has been proposed to be protective against COVID-19 infectivity and severity as it modulates the immune system by suppressing T helper 1 immune profile and upregulating the regulatory T cell expression, thereby reducing the severity of cytokine storm. [49][50][51][52] Therefore, Black patients may be at higher risk than White patients of cytokine storm and resulting systemic and intrarenal inflammation. This is also supported by the higher levels of inflammatory markers among Black patients observed in our study.…”

Dexamethasone treatment may mitigate adverse effects of vitamin D deficiency in hospitalized Covid‐19 patients

“…A meta‐analysis of 27 studies found that vitamin D insufficiency among patients with Covid‐19 was significantly associated with higher risks of severe infection, hospitalization, and mortality. 19 At the time of writing, there are several ongoing clinical trials aiming to identify a possible benefit of vitamin D supplementation on hospitalized patient outcomes in Covid‐19. However, the use of dexamethasone is likely to mitigate the identification of any signals due to vitamin D on inpatient outcomes such as respiratory failure.…”

COVID-19 Tedavisinde Vitamin C ve D

“…1,25(OH)2D3 hücre içerisindeki işlevini reseptörüne bağlanarak göstermektedir (1). Vitamin D reseptörleri bağışıklık hücreleri, deri, iskelet kası dahil çeşitli hücre ve doku türlerinde yaygın olarak bulunmaktadır (6). D vitamininin immün sistem de dahil olmak üzere bir çok vücut sisteminde rolü olduğu tespit edilmiştir (1).…”

“…D vitamininin immün sistem de dahil olmak üzere bir çok vücut sisteminde rolü olduğu tespit edilmiştir (1). Hem doğal, hem de edinsel bağışıklık sistemini düzenleyen immünomodülatör bir ajan olarak kabul edilmektedir (6). Zarflı ve zarfsız virüslere karşı doğrudan antimikrobiyal etki gösteren defensin, katelisidin gibi peptidlerin ekspresyonunu arttırarak doğal hücresel immün yanıtı arttırır.…”

“…Vitamin D ayrıca, T helper 1 (Th1) hücre fonksiyonunu baskılayarak, interlökin 6 (IL-6), interferon-gamma (INF-γ) gibi proinflamatuar sitokinlerin üretimini azaltarak ve T helper 2 (Th2) hücrelerinden anti-inflamatuar sitokin salınımını sağ-layarak edinsel bağışık yanıtın düzenlenmesinde de rol almaktadır (8). Böylece COVID-19 hastalarında gelişen sitokin fırtınasını ve çoklu organ yetmezliğini önleyebileceği düşünülmektedir (6). D vitamini eksikliği, bütün yaş gruplarında önemli bir küresel halk sağlığı sorunudur (9).…”