Vitamin D in Prevention and Treatment of COVID-19 (16 reasons)

Created September 2020

Vitamin D in Prevention and Treatment of COVID-19: Current Perspective and Future Prospects

J Am Coll Nutr. 2020 Sep 1;1-14. doi: 10.1080/07315724.2020.1806758

Navya Vyas 1 2, Shilia Jacob Kurian 2 3, Debasis Bagchi 4, Mohan K Manu 2 5, Kavitha Saravu 2 6, Mazhuvancherry Kesavan Unnikrishnan 7, Chiranjay Mukhopadhyay 8, Mahadev Rao 3, Sonal Sekhar Miraj 2 3

COVID-19 treated by Vitamin D - studies, reports, videos as of July 29 includes * 21 trials (generally treatment, not prevention), +10 observational studies, * * 7 recommendations, +34 associations, +58 speculations, +20 videos, and has the following recent updates {include}

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Vitamin D deficiency (VDD) partly explains geographical differences in COVID-19 susceptibility, severity, and mortality. VDD among African-Americans, diabetics, hypertensive, and aged populations possibly explain the higher death rate, aggravated by cocooning. Vitamin D is pleiotropic, mediating bone metabolism, calcium homeostasis, and immune functions, whereas VDD is associated with inflammatory reactions and immune dysfunction, predisposing individuals to severe infections.

Vitamin D modulates innate and adaptive immunity via the expression of genes that code antimicrobial peptides (AMPs). And the expression of cluster of differentiation (CD)14, the co-receptor for epidermal toll-like receptor (TLR)4. AMPs stimulate TLR2 in macrophages, increasing the conversion of vitamin D into its active form by cytochrome P450 27B1. Antiviral properties of vitamin D-induced AMPs can shift the polarization of the adaptive immune response from helper T cells (Th)1 to the more regulatory Th2 responses that suppress immune over-reactivity by preventing cytokine storm, which is already demonstrated during the Spanish flu episode.

Vitamin D induces antiviral effects by both direct and indirect mechanisms via

  • AMPs,

  • immunomodulation,

  • the interplay between major cellular and viral elements,

  • induction of autophagy and apoptosis,

  • variation of genetic and epigenetic factors.

The crosstalk between vitamin D and intracellular signaling pathways may operate as a primary regulatory action on viral gene transcription.

VDD may increase the likelihood of infection with enveloped viruses, including

  • retrovirus,

  • hepatitis, and

  • dengue.

    Key teaching points

Vitamin D induces antiviral effects by direct and indirect mechanisms via

  • AMPs,

  • immunomodulation,

  • induction of autophagy, etc.

Epidemiology of VDD partly explains geographical differences in COVID-19

  • susceptibility,

  • severity, and

  • mortality.

Global data correlates severe VDD with COVID-19 associated

  • coagulopathy,

  • disrupted immune response and

  • mortality,

  • reduced platelet count, and

  • prolonged prothrombin time,

together suggesting benefits from supplementation. Many clinical trials are underway globally to delineate the role of vitamin D in both prevention and treatment of COVID-19.

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Tags: Virus