Vnitr Lek 2020, 66(8):494-500 | DOI: 10.36290/vnl.2020.146

Vitamin D supplementation as an important factor in COVID-19 prevention and treatment: what evidence do we have?

Juraj Smaha, Martin Kužma, Peter Jackuliak, Juraj Payer
V. interná klinika LF UK a UN Bratislava, Slovenská republika

The immunomodulatory effect of vitamin D and its potential in prevention and treatment of acute respiratory infections have long been of interest to many scientific teams around the world. Several meta-analyses in the last 10 years have confirmed the protective (albeit of modest size) effect of vitamin D against respiratory infections. Because of many overlapping risk factors for vitamin D deficiency and severe COVID-19 infection, many experts believe that vitamin D supplementation could play an important role in prevention and treatment of the new coronavirus disease. Based on available data on the immunological action of vitamin D, it is possible that vitamin D could modulate the body's response to SARS-CoV-2 infection both in the early viraemic phase and in later hyperinflammatory phase typical for the severe course of the disease. The first available data from epidemiological studies suggest that low serum vitamin D levels are associated with increased susceptibility to the new coronavirus infection as well as with severe course of the disease.

Keywords: acute respiratory infection, cathelicidin, COVID-19, prevention, SARS‑CoV-2, treatment, vitamin D, 25(OH)D.

Published: December 15, 2020  Show citation

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Smaha J, Kužma M, Jackuliak P, Payer J. Vitamin D supplementation as an important factor in COVID-19 prevention and treatment: what evidence do we have? Vnitr Lek. 2020;66(8):494-500. doi: 10.36290/vnl.2020.146.
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    References

    1. Martineau AR, Forouhi NG. Vitamin D for COVID-19: a case to answer? The Lancet Diabetes and Endocrinology 2020; 8(9): 735-736. Go to original source... Go to PubMed...
    2. Hewison M. An update on vitamin D and human immunity. Clin Endocrinol 2012; 76(3): 315-325. Go to original source... Go to PubMed...
    3. Barbour GL, Coburn JW, et al. Hypercalcemia in an aneprhic patient with sarcoidosis: evidence for extrarenal generation of 1,25-dihydroxyvitamin D. N Engl J Med 1981; 305(8): 440-443. Go to original source... Go to PubMed...
    4. Haussler MR, Whitfield GK, Kaneko I, et al. Molecular mechanisms of vitamin D action. Calcified Tissue International 2013; 92: 77-98. Go to original source... Go to PubMed...
    5. Greiller CL, Martineau AR. Modulation of the immune response to respiratory viruses by vitamin D. Nutrients 2015; 7(6): 4240-4270. Go to original source... Go to PubMed...
    6. Hansdottir S, Monick MM, Hinde SL, et al. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J Immunol 2008; 181(10): 7090-7099. Go to original source... Go to PubMed...
    7. Arababadi MK, Nosratabadi R, Asadikaram G. Vitamin D and toll like receptors. Life sciences 2017; 203: 105-111. Go to original source... Go to PubMed...
    8. Liu PT, Stenger S, Li H, et al. Toll‑like receptor triggering of a vitamin D‑mediated human antimicrobial response. Science 2006; 311(5768): 1770-1773. Go to original source... Go to PubMed...
    9. Bilezikian JO, Bikle D, Hewison M, et al. Vitamin D and COVID-19. Eur J Endocrinol 2020; 183(5): R133-R147. Go to original source... Go to PubMed...
    10. Mao J, Lin E, He L, et al. Autophagy and viral infection. Advances in Experimental Medicine and Biology 2019; 1209: 55-78. Go to original source... Go to PubMed...
    11. Dancer RC, Parekh D, Lax S, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax 2015; 70(7): 617-624. Go to original source... Go to PubMed...
    12. Herr C, Shaykhiev R, Bals R. The role of cathelicidin and defensins in pulmonary inflammatory diseases. Expert Opin Biol Ther 2007; 7(9): 1449-1461. Go to original source... Go to PubMed...
    13. Šterzl I. D vitamin a imunita. Vnitr Lek 2012; 58(5): 405-410. Go to PubMed...
    14. Hansdottir S, Monick M. Vitamin D effects on lung immunity and respiratory diseases. Vitam Horm 2011; 86: 217-237. Go to original source... Go to PubMed...
    15. Sigmundsdottir H, Pan J, et al. DCs metabolize sunlight‑induced vitamin D3 to "program" T cell attraction to the epidermal chemokine CCL27. Nat Immunol 2007; 8(3): 285-293. Go to original source... Go to PubMed...
    16. Hrubišková K, Jackuliak P, Payer J. Vitamín D a imunitný system. Klinická imunológia a alergológia 2011; 21(4): 19-24.
    17. Shoenfeld Y, Giacomelli R, Azrielant S, et al. Vitamin D and systemic lupus erythematosus - The hype and the hope. Autoimmun Rev 2018; 17(1): 19-23. Go to original source... Go to PubMed...
    18. Alva‑Murillo N, Tellez‑Perez AD, Medina‑Estrada I, et al. Modulation of the inflammatory response of bovine mammary epithelial cells by cholecalciferol during Staphylococcus aureus internalization. Microbial pathogenesis 2014; 77: 24-30. Go to original source... Go to PubMed...
    19. Li P, Xu X, Cao E, et al. Vitamin D deficiency causes defective resistance to Aspergillus fumigatus in mice via aggravated and sustained inflammation. PloS one 2014; 9:e99805. Go to original source... Go to PubMed...
    20. Choi B, Lee E, Sohn S. Vitamin D3 ameliorates herpes simplex virus‑induced Behcet's disease‑like inflammation in a mouse model through down‑regulation of Toll‑like receptors. Clin Experiment Rheumatol 2010; 29: S13-19.
    21. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Seminars in Immunopathology 2017; 39: 529-539. Go to original source... Go to PubMed...
    22. Martinez‑Moreno J, Hernandez JC, Urcuqui‑Inchima S. Effect of high doses of vitamin D supplementation on dengue virus replication, toll.like receptor expression, and cytokine profiles on dendritic cells. Mol Cell Biochem 2020; 464(1-2):169-180. Go to original source... Go to PubMed...
    23. Mock CK, Ng YL, Ahidjo BA, et al. Calcitriol, the active form of a vitamin D, is a promising candidate for COVID-19 prophylaxis. bioRxiv 2020; publikované online 22. júna (preprint).
    24. Xu J, Yang J, Chen J, et al. Vitamin D alleviates lipopolysaccharide induced acute lung injury via regulation of the renin‑angiotensin system. Mol Med Rep 2017; 16(5): 7432-7483. Go to original source... Go to PubMed...
    25. Kulda V. Metabolizmus vitaminu D. Vnitr Lek 2012; 58(5): 400-404. Go to PubMed...
    26. Lanham‑New SA, Webb AR, Cahman KD, et al. Vitamin D and SARS‑CoV-2 virus/COVID-19 disease. BMJ Nutrition, Prevention and Health 2020; 0. Go to original source... Go to PubMed...
    27. Amrein K, Papinutti A, Mathew E, et al. Vitamin D and critical illness: what endocrinology can learn from intensive care and vice versa. Endocrine Connections 2018; 7(12): R303-R315. Go to original source... Go to PubMed...
    28. Shaman J, Pitzer VE, Vibou C, et al. Absolute humidity and the seasonal onset of influenza in the continental United States. PLoS Biol 2010; 8(2): e1000316. Go to original source... Go to PubMed...
    29. Fisher BJ, Seropian IM, Kraskauskas D, et al. Ascorbic acid attenuates lipopolysaccharide‑induced acute lung injury. Crit Care Med 2011; 39(6): 1454-1460. Go to original source... Go to PubMed...
    30. Calder PC, Carr AC, Gombart AF, et al. Optimal nutritional status for a well‑functioning immune system is an important factor to protect against viral infections. Nutrients 2020; 12(4). Go to original source... Go to PubMed...
    31. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta‑analysis of individual participant data. BMJ 2017; 356: i6583. Go to original source... Go to PubMed...
    32. Jolliffe D, Camargo Jr CA, Sluyter J, et al. Vitamin D supplementation to prevent acute respiratory infections: systematic review and meta‑analysis of aggregated data from randomized controlled trials. medRxiv 2020, publikované online 17. júla (preprint). Go to original source...
    33. Han JE, Jones JL, Tangpricha V, et al. High dose vitamin D administration in ventilated intensive care unit patients: a pilot double blind randomized controlled trial. Journal of Clinical and Translational Endocrinology 2016; 4: 59-65. Go to original source... Go to PubMed...
    34. Ginde AA, Brower RG, Caterino JM, et al. Early high‑dose vitamin D3 for critically ill, vitamin‑D deficient patients. N Eng J Med; 381: 2529-2540. Go to original source... Go to PubMed...
    35. Amrein K, Parekh D, Westphal S, et al. Effect of high‑dose vitamin D3 on 28-day mortality in adult critically ill patients with severe vitamin D deficiency: a study protocol of a multicentre, placebo‑controlled double‑blind phase III RCT (the VITDALIZE study); 9(11): e031083. Go to original source... Go to PubMed...
    36. Laird E, Rhodes J, Kenny RA. Vitamin D and inflammation: potential implications for severity of COVID-19. Ir Med J 2020; 113(5): 81. Go to PubMed...
    37. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res 2020; 32: 1195-1198. Go to original source... Go to PubMed...
    38. Ebadi M, Montano‑Loza. Perspective: improving vitamin D status in the management of COVID-19. European Journal of Clinical Nutrition 2020; 1-4. Go to original source... Go to PubMed...
    39. D'Avolio A, Avataneo V, Manca A, et al. 25-hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS‑CoV-2. Nutrients 2020; 12(5): e1359. Go to original source... Go to PubMed...
    40. Merzon E, Tworowski D, Gorohovski A, et al. Low plasma 25(OH) vitamin D level is associated with increased risk COVID-19 infection: an Israeli population‑based study. medRxiv 2020; publikované online 3. júla (preptint). Go to original source...
    41. Hastie CE, Mackay DF, Ho F, et al. Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes Metab Syndr 2020; 14(4): 561-565. Go to original source... Go to PubMed...
    42. Meltzer DO, Best TJ, Zhang H, et al. Association of vitamin D status and other clinical characteristics with COVID-19 test results. JAMA network open; 3(9): e2019722-e2019722. Go to original source... Go to PubMed...
    43. Panagiotou G, Tee SA, Ihsan Y, et al. Low serum 25-hydroxyvitamin D (25(OH)D) levels in patients hospitalized with COVID-19 are associated with greater disease severity. Clin Endocrinol (Oxf) 2020, publikované online 3. júla. Go to original source... Go to PubMed...
    44. Maghbooli Z, Sahraian MA, Ebrahimi M, et al. Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection. PloS one 2020; 15(9): e0239799. Go to original source... Go to PubMed...
    45. Exposed, silenced, attacked: Failures to protect health and essential workers during the COVID-19 pandemic. Amnesty International 2020; 14-25.
    46. Youssef DA, Ranasinghe T, Grant WB, et al. Vitamin D's potential to reduce the risk of hospital‑aquired infections. Derm Endocrinol 2012; 4(2): 167-175. Go to original source... Go to PubMed...
    47. Grant WB, Lahore H, McDonnell SL, et al. Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients 2020; 12(4):988. Go to original source... Go to PubMed...
    48. Wimalawansa SJ. Global epidemic of coronavirus - COVID-19: What we can do to minimize risks. Eur J Biomed Pharm Sci 2020; 7(3): 432-438.
    49. Kimball S, Vieth R, Dosch HM, et al. Cholecalciferol plus calcium suppresses abnormal PBMC reactivity in patients with multiple sclerosis. J Clin Endocrinol Metab 2011; 96(9): 2826-2834. Go to original source... Go to PubMed...
    50. Henry HL. Regulation of vitamin D metabolism. Best Pract Res Clin Endocrinol Metab 2011; 25(4): 531-541. Go to original source... Go to PubMed...
    51. National Institute for Health and Care Excellence. COVID-19 rapid evidence summary: vitamin D for COVID-19. Evidence summary 2020, publikované 29. júna.Další literatura u autoraa na www.casopisvnitrnilekarstvi.cz
    52. Smaha J, Kužma M, Jackuliak P, et al. Manažment osteoporózy a porúch metabolizmu vápnika v čase pandémie ochorenia COVID-19. Clin Osteol 2020; 25: 5-10.
    53. Joint guidance on vitamin D in the era of COVID-19 of the American Society for Bone and Mineral Research (ASBMR), American Association of Clinical Endocrinologists (AACE), Endocrine Society, European Calcified Tissue Society (ECTS), National Osteoporosis Foundation (NOF), and International Osteoporosis Foundation (IOF). COVID-19 Resources and Information 2020.
    54. Barger‑Lux MJ, Heaney RP. Effect of above average summer sun exposure on serum 25-hydroxyvitamin D and calcium absorption. J Clin Endocrinol Metab 1971; 87(11): 4952-4956. Go to original source... Go to PubMed...
    55. Holick MF, Binkley NC, Bischoff‑Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011; 96(7): 1911-1930. Go to original source... Go to PubMed...
    56. Chandran M, Maung AC, Mithal A, et al. Vitamin D in COVID-19: Dousing the fire or averting the storm? - A perspective from the Asia‑Pacific. Osteoporosis and Sarcopenia 2020; 6: 97-105. Go to original source... Go to PubMed...
    57. Veith R. Vitamin D toxicity, policy, and science. Journal of Bone and Mineral Research 2007; 22(S2): V64-V68. Go to original source... Go to PubMed...
    58. Smith H, Anderson F, Raphael H, et al. Effect of annual intramuscular vitamin D on fracture risk in elderly men and woman - a population‑based, randomized, double‑blind, placebo‑controlled trial. Rheumatology 2007; 46(12): 1852-1857. Go to original source... Go to PubMed...
    59. Amrein K, Schnedl C, Holl A, et al. Effect of high‑dose vitamin D3 on hospital length of stay in critically ill patients with vitamin D deficiency: the VITdAL‑ICU randomized clinical trial. JAMA 2014; 312(5): 1520-1530.
    60. Payer J, Jackuliak P, Smaha J. Manažment vybraných ochorení endokrinného systému u dospelých v čase pandémie COVID-19. Interná medicína 2020; 20(5): 221-229.
    61. Payer J, Killinger Z. Osteoporóza. 1. vydanie. Herba: Bratislava 2012. ISBN 9788089171941.

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