Vitamin D deficiency associates inversely with COVID-19 risks; might avoidance of vitamin D inadequacy reduce those risks?
Main Article Content
Abstract
The risks of COVID-19, whether of becoming infected, needing intensive care or dying, consistently relate inversely to vitamin D status [serum 25(OH)D concentration], but low 25(OH)D is not just due to COVID-19 since they are seen in relation to pre-pandemic 25(OH)D values, both in individual cohorts and across many populations. Furthermore, many recognised risk factors for increased COVID-19 severity themselves reduce vitamin D status [e.g., obesity, dark skin, indoor lifestyles, low socio-economic status and increasing age], which complicates data analyses. Vitamin D has many mechanistic effects likely to provide adjunctive benefits protecting against COVID-19 severity. For example, vitamin D reduces the risks of microbial infection by promoting innate immunity and reduces tissue damage in severe infections by modulating the severity of adaptive immune responses. The protective mechanistic effects of correcting vitamin D inadequacy discussed support the view that increasing vitamin D status should reduce COVID-19 risks. However, many trials of cholecalciferol treatment have failed to do so, probably because it takes many weeks to raise serum 25(OH)D levels adequately whilst the increasing clinical use of the 25(OH)D metabolite [calcifediol] in COVID-19 treatment, which raises serum 25(OH)D concentrations rapidly, has led to reports of clinical benefits in COVID-19 illness.
Keywords:
Vitamin D deficiency, COVID-19
Article Details
How to Cite
BOUCHER, Barbara J.
Vitamin D deficiency associates inversely with COVID-19 risks; might avoidance of vitamin D inadequacy reduce those risks?.
Medical Research Archives, [S.l.], v. 12, n. 4, may 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5382>. Date accessed: 23 nov. 2024.
doi: https://doi.org/10.18103/mra.v12i4.5382.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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3. Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol. 2009;19(2):73-78. doi: 10.1016.
4. Dror AA, Morozov N, Daoud A, Namir Y, Yakir O, Shachar Y et al. Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness. PLoS One. 2022; 17(2):e0263069. doi: 10.1371/journal.pone.0263069
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6. Ahmad AS, Juber NF, Al-Naseri H, Heumann C, Ali R, Oliver T. Association between Average Vitamin D Levels and COVID-19 Mortality in 19 European Countries-A Population-Based Study. Nutrients. 2023;15(22):4818. doi: 10.3390/nu 15224818.
7. Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, et al. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol. 2019;180(4):23-54. doi: 10.1530/EJE-18-0736.
8. Adami S, Romagnoli E, Carnevale V, Scillitani A, Giusti A, Rossini M, et al. Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS). Linee guida su prevenzione e trattamento dell'ipovitamino si D con colecalciferolo. SIOMMMS [Guidelines on prevention and treatment of vitamin D deficiency. Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS)]. Reumatismo. 2011;63( 3):129-147. Italian. doi: 10.4081/reumatismo.
9. Villasis-Keever MA, López-Alarcón MG, Miranda-Novales G, Zurita-Cruz JN, Barrada-Vázquez AS, González-Ibarra J, et al. Efficacy and Safety of Vitamin D Supplementation to Prevent COVID-19 in Frontline Healthcare Workers. A Randomized Clinical Trial. Arch Med Res. 2022;53(4):423-430. doi: 10.1016/j.arcmed 2022.04.003.
10. Ismailova A, White JH. Vitamin D, infections and immunity. Rev Endocr Metab Disord. 2022;23(2):265-277. doi: 10.1007/s11 154-021-09679-5.
11. Dancer RC, Parekh D, Lax S, D'Souza V, Zheng S, Bassford CR, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015;70(7):617-24. doi: 10.1136/thoraxjnl-2014-206680.
12. Wang Q, Iketani S, Li Z, Liu L, Guo Y, Huang Y, et al. Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants. Cell. 2023;186(2):279-286.e8. doi : 10.1016/j.cell.2022.12.018.
13.Malek Mahdavi A. A brief review of interplay between vitamin D and angiotensin-converting enzyme 2: Implications for a potential treatment for COVID-19. Rev Med Virol. 2020;30(5):e2119. doi: 10.1002/rmv.2119.
14. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002;110(2): 229-238. doi: 10.1172/JCI15219..
15. Martín Giménez VM, Inserra F, Tajer CD, Mariani J, Ferder L, Reiter RJ, et al. Lungs as target of COVID-19 infection: Protective common molecular mechanisms of vitamin D and melatonin as a new potential synergistic treatment. Life Sci. 2020;254:117808. doi: 10.1016/j.lfs.2020.117808..
16. Quesada-Gomez JM, Entrenas-Castillo M, Bouillon R. Vitamin D receptor stimulation to reduce acute respiratory distress syndrome (ARDS) in patients with coronavirus SARS-CoV-2 infections: Revised Ms SBMB 2020_166. J Steroid Biochem Mol Biol. 2020; 202:105719. doi: 10.1016/j.jsbmb.2020.105719.
17. Bishop E, Ismailova A, Dimeloe S, Hewison M, White JH. Vitamin D and Immune Regulation: Antibacterial, Antiviral, Anti-Inflammatory. JBMR Plus. 2020;5(1):e10405. doi: 10.1002/jbm4.10405.
18. Chung C, Silwal P, Kim I, Modlin RL, Jo EK. Vitamin D-Cathelicidin Axis: at the Crossroads between Protective Immunity and Pathological Inflammation during Infection. Immune Netw. 2020;20(2):e12. doi: 10.4110/in.2020.20.e12.
19. Liu PT, Stenger S, Li H, Wenzel L, Tan BH, Krutzik SR, et al. Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science. 2006;311(5768):1770-177 3. doi: 10.1126/science.1123933..
20. Clark GJ, Angel N, Kato M, López JA, MacDonald K, Vuckovic S, et al. The role of dendritic cells in the innate immune system. Microbes Infect. 2000;2(3):257-272. doi: 10.1 016/s1286-4579(00)00302-6.
21. Wu N, Joyal-Desmarais K, Ribeiro PAB, Vieira AM, Stojanovic J, Sanuade C, et al. Long-term effectiveness of COVID-19 vaccines against infections, hospitalisations, and mortality in adults: findings from a rapid living systematic evidence synthesis and meta-analysis up to December, 2022. Lancet Respir Med. 2023;11(5):439-452. doi: 10.1016 /S2213-2600(23)00015-2.
22. Gray R, Boyle I, DeLuca HF. Vitamin D metabolism: the role of kidney tissue. Science. 1971;172(3989):1232-1234. doi: 10.1126/scie nce.172.3989.1232.
23. Zehnder D, Bland R, Williams MC, McNinch RW, Howie AJ, Stewart PM, et al. Extrarenal expression of 25-hydroxyvitamin d(3)-1 alpha-hydroxylase. J Clin Endocrinol Metab. 2001;86(2):888-894. doi: 10.1210/jce m.86.2.7220..
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