Vitamin D in Prevention and Treatment of COVID-19 (16 reasons) – Sept 1, 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

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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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RCT Summary at VitaminDWiki - constantly updated