Vitamin D can be effective on the prevention of COVID-19 complications: A narrative review on molecular aspects

Abstract

Abstract. The widespread COVID-19 pandemic has been, currently, converted to a catastrophic human health challenge. Vitamin D (VD) and its metabolites have been used as a palliative treatment for chronic inflammatory and infectious diseases from ancient times. In the current study, some molecular aspects of the potential effects of VD against COVID-19 side-effects have been discussed. An arguable role in autophagy or apoptosis control has been suggested for VD through calcium signaling at the mitochondrial and ER levels. 1,25(OH)2D3 is also an immunomodulator that affects the development of B-cells, T-cells, and NK cells in both innate and acquired immunity. The production of some anti-microbial molecules such as defensins and cathelicidins is also stimulated by VD. The overexpression of glutathione, glutathione peroxidase, and superoxide dismutase, and down-regulation of NADPH oxidase are induced by VD to reduce the oxidative stress. Moreover, the multi-organ failure due to a cytokine storm induced by SARS-CoV2 in COVID-19 may be prevented by the immunomodulatory effects of VD. It can also downregulate the renin-angiotensin system which has a protective role against cardiovascular complications induced by COVID-19. Given the many experimental and molecular evidences due to the potential protective effects of VD on the prevention of the COVID-19-induced morbidities, a VD supplementation is suggested to prevent the lethal side-effects of the infection. It is particularly recommended in VD-deficient patients or those at greater risk of serious or critical effects of COVID-19, including the elderly, and patients with pre-existing chronic diseases, especially those in nursing homes, care facilities, and hospitals.

Evaluation of serum hepatic enzyme activities in different COVID‐19 phenotypes

“…Several viruses including coronavirus that cause a biochemical imbalance in the infected cell resulting in oxidative stress, which may be associated with the development of pathologies and worsening of symptoms 30,31 . Thus, the lower SOD level may indicate a worse prognosis, and antioxidants should be considered as a candidate therapeutic approach against SARS‐CoV‐2 32,33 …”

Determination of interest in vitamin use during COVID-19 pandemic using Google Trends data: Infodemiology study

“…Some vitamins are indicated to be effective in strengthening the immune system [ 2 , 24 ]. During the COVID-19 pandemic, the fact that these vitamins contribute to both protection from disease and the healing process in case of illness has mentioned in many publications [12] , [13] , [14] , [15] , [16] , [17] has been frequently emphasized in the media. Accordingly, in the study, a comparative search was conducted to determine the tendency for vitamins that have positive effects on strengthening the immune system.…”

“…While vitamins C and E strengthen the immune system thanks to their high anti-inflammatory and antioxidant effect [ 10 , 11 ], it has been reported that vitamin D has an effect that can disrupt viral cellular infection by interacting with angiotensin converting enzyme (ACE) [11] . It is thought that vitamin D and vitamin C play an important role in determining the results of COVID-19 in many studies conducted to determine the efficacy of vitamins in the prognosis of COVID-19 [12] , [13] , [14] , [15] , [16] , [17] .…”

Nutraceuticals in Viral Infections: An Overview of the Immunomodulating Properties

“…A relationship between VD status and the incidence or the severity of respiratory infections in children has been found in many observational studies, and a recent review seems to support the protective role of VD against tuberculosis, otitis media, pharyngotonsillitis, bronchiolitis, and viral wheezing [ 5 , 6 , 7 ]. Even during the recent COVID-19 pandemic, VD and its metabolites were found to be useful both in inducing the antiviral response and in negatively regulating the renin-angiotensin-aldosterone system, including the expression of ACE2, the receptor for SARS-CoV2 [ 8 , 9 ]. The influence of VD status on the clinical outcome of patients with COVID-19 is still undefined, as studies have shown conflicting results [ 10 , 11 , 12 ].…”