Does vitamin D supplementation prevent SARS-CoV-2 infection in military personnel? Review of the evidence

For most individuals residing in Northwestern Europe, maintaining replete vitamin D status throughout the year is unlikely without vitamin D supplementation and deficiency remains common. Military studies have investigated the association with vitamin D status, and subsequent supplementation, with the risk of stress fractures particularly during recruit training. The expression of nuclear vitamin D receptors and vitamin D metabolic enzymes in immune cells additionally provides a rationale for the potential role of vitamin D in maintaining immune homeostasis. One particular area of interest has been in the prevention of acute respiratory tract infections (ARTIs). The aims of this review were to consider the evidence of vitamin D supplementation in military populations in the prevention of ARTIs, including SARS-CoV-2 infection and consequent COVID-19 illness. The occupational/organisational importance of reducing transmission of SARS-CoV-2, especially where infected young adults may be asymptomatic, presymptomatic or paucisymptomatic, is also discussed.

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Vitamin D and respiratory infection in adults

Proceedings of The Nutrition Society ◽

10.1017/s0029665111003351 ◽

2011 ◽

Vol 71 (1) ◽

pp. 90-97 ◽

Cited By ~ 27

Author(s):

Ilkka Laaksi

Keyword(s):

Vitamin D ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Uvb Radiation ◽

Promoter Regions ◽

Vitamin D Receptors ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Tract Infections

Vitamin D insufficiency is a global issue that has significant implications for health. The classical role of vitamin D in bone mineralisation is well known; vitamin D deficiency leads to rickets, osteomalacia or osteoporosis. The role of vitamin D in an immune system is less known. Vitamin D is not an actual vitamin but a secosteroid hormone produced in the skin from 7-dehydrocholesterol after exposure to sunlight UVB radiation. Nutrition and supplements are main sources of vitamin D in wintertime in northern countries as sunlight exposure is inadequate for the production. For activation vitamin D needs to be hydroxylated in liver to form 25-hydroxyvitamin D and in kidney to 1,25-dihydroxyvitamin D, the most active hormone in Ca absorption in the gut. For determination of vitamin D status serum 25-hydroxyvitamin D level, the major circulating form of the hormone is to be measured. Vitamin D regulates gene expression through binding with vitamin D receptors, which dimerises with retinoid X receptor. This complex binds to vitamin D-responsive elements inside the promoter regions of vitamin D-responsive genes. Vitamin D has a key role in innate immunity activation; the production of antimicrobial peptides (cathelicidin and defensins) following Toll-like receptor stimulation by pathogen lipopeptides is dependent on sufficient level of 25-hydroxyvitamin D. Clinically, there is evidence of the association of vitamin D insufficiency and respiratory tract infections. There is also some evidence of the prevention of infections by vitamin D supplementation. Randomised controlled trials are warranted to explore this preventive effect.

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Prognostic Role of Vitamin D Status and Efficacy of Vitamin D Supplementation in Cancer Patients: A Systematic Review

The Oncologist ◽

10.1634/theoncologist.2011-0098 ◽

2011 ◽

Vol 16 (9) ◽

pp. 1215-1227 ◽

Cited By ~ 60

Author(s):

Consuelo Buttigliero ◽

Chiara Monagheddu ◽

Paola Petroni ◽

Andrea Saini ◽

Luigi Dogliotti ◽

...

Keyword(s):

Systematic Review ◽

Vitamin D ◽

Cancer Patients ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Prognostic Role

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Extraskeletal effects of vitamin D

Reviews in Health Care ◽

10.7175/rhc.v2i2.25 ◽

2011 ◽

Vol 2 (2) ◽

pp. 87-100

Author(s):

Maurizio Rossini

Keyword(s):

Metabolic Syndrome ◽

Vitamin D ◽

Hypovitaminosis D ◽

Vitamin D Supplementation ◽

Response To Therapy ◽

Vitamin D Metabolites ◽

Upper Respiratory Tract ◽

Vitamin D Status ◽

Increased Risk ◽

Tract Infections

In the last years we observed an increasing number of publications about the vitamin D, due to its recognised therapeutic actions and to the widespread hypovitaminosis D. In addition to the well known skeletal benefits, vitamin D can have multiple effects on other tissues.Muscular apparatus: hypovitaminosis D is associated with myopathy, sarcopenia, muscular strength reduction and increased risk of falls. The vitamin D supplementation increases the muscle functionality indexes. Cardiovascular system: low levels of vitamin D are related to increased levels of cardiovascular risk factors, heart failure, stroke, and cardiovascular mortality, while a good vitamin D status is associated with a decreased incidence of cardiovascular diseases. Diabetes and metabolic syndrome: a good vitamin D status is related to a decreased incidence of type 2 diabetes and metabolic syndrome; a vitamin D supplementation in the early childhood reduces (nearly 30%) the risk of having type 1 diabetes. Cancer: vitamin D deficit is associated with breast, colorectal cancer and melanoma relapses. Low and high levels of 25-hydroxy-vitamin D (25(OH)D) are related to a higher neoplastic mortality. Infectious diseases: hypovitaminosis D is associated with higher incidence of upper respiratory tract infections and worse interferon response in chronic hepatitis C. Vitamin D supplementation decreases the risk of having type A influence. Rheumatic diseases: in rheumatoid arthritis low serum levels of vitamin D metabolites are related to a higher disease activity, while a good vitamin D status is associated with a higher probability of remission or response to therapy and a lower degree of disability. Neurologic diseases: associations between vitamin D deficit and risk of multiple sclerosis, depression, cognitive deficits, and Parkinson’s disease have been reported.There is evidence of the extraskeletal effects of vitamin D, but most derive from observational studies: clinical trials are required the better to determine the therapeutic role of vitamin D.

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Outcome of total hip and total knee arthroplasty and vitamin D homeostasis

British Medical Bulletin ◽

10.1093/bmb/ldaa018 ◽

2020 ◽

Vol 135 (1) ◽

pp. 50-61

Author(s):

Lorenzo Brambilla ◽

Giuseppe Maria Peretti ◽

Paolo Sirtori ◽

Nicola Maffulli ◽

Laura Mangiavini

Keyword(s):

Vitamin D ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Total Hip ◽

Vitamin D Levels ◽

Total Knee ◽

Retrospective Database

Abstract Background Low levels of vitamin D are common in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA), but it is still unclear whether the outcome of such surgery is related to vitamin D levels. Sources of data Publicly available electronic databases were systematically reviewed to update knowledge about the role of vitamin D in THA and TKA patients, and to appraise the correlation between vitamin D levels before surgery and post-surgical outcomes. Eight studies were included in our review: six employed prospective observational designs, two reported retrospective database interrogations. Six prospective observational studies and two retrospective database interrogations matched inclusion and exclusion criteria. Areas of agreement Patients undergoing THA and TKA have a high prevalence of hypovitaminosis D. Five of eight studies (62.5%) report a statistically significant association between low vitamin D status and worse outcomes after THA and TKA. Areas of controversy Different explanations have been proposed for vitamin D insufficiency, but some authors have questioned the correctness of the methods used to measure the vitamin D levels. Growing points A trial focusing on the role of vitamin D supplementation on safety and outcomes of patients undergoing THA and TKA with low vitamin D status is ongoing. Areas timely for developing research Further studies should explore the possible causal relationship between vitamin D status and outcomes of THA and TKA and verify the laboratory methods to analyse it.

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Putative role of vitamin D in the mechanism of alcoholism and other addictions – a hypothesis

Acta Neuropsychiatrica ◽

10.1017/neu.2020.41 ◽

2020 ◽

pp. 1-8

Author(s):

Tanya M. Galyuk ◽

Anton J.M. Loonen

Keyword(s):

Vitamin D ◽

Clinical Problem ◽

Serum Levels ◽

Vitamin D Supplementation ◽

Practice Research ◽

Future Research ◽

Blood Levels ◽

Vitamin D Status ◽

Dopaminergic Transmission

Abstract Objective: Vitamin D deficiency may be a clinical problem in patients with addictions. The authors systematically searched for studies addressing vitamin D and addiction and develop a hypothesis which can direct future research of the possible mechanistic role of vitamin D in the process of addiction. Methods: Systematic review of the literature found in PubMed and EMBASE followed by narrative review combined with clinical experiences leading to hypotheses for future research. Results: Only five articles were identified about a role of vitamin D in the pathophysiology of addiction. Their results are in line with a possible influence of vitamin D in dopaminergic transmission. The cerebral vitamin D status depends on the functionality of genetic variants of vitamin D receptor and other involved genes. Routine serum calcidiol levels may not adequately reflect cerebral vitamin D status. Uncertainty exists regarding appropriate calcidiol blood levels and proper dosages for affecting the central nervous system (CNS). Conclusions: The putative pathophysiological role of vitamin D in substance abuse has been insufficiently studied which calls to more studies how to measure cerebral vitamin D status in clinical practice. Research is indicated whether vitamin D supplementation should use higher dosages and aim to reach higher calcidiol serum levels. Measuring dopaminergic functioning within the prefrontal cortex as reflected by neuropsychological tests selected as suitable could be a appropriate proxy for the cerebral vitamin D status when studying the pharmacogenomics of this functionality in patients.

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Vitamin D for secondary prevention of acute wheeze attacks in preschool and school-age children

Thorax ◽

10.1136/thoraxjnl-2019-213278 ◽

2019 ◽

Vol 74 (10) ◽

pp. 977-985 ◽

Cited By ~ 3

Author(s):

Christos Stefanidis ◽

Adrian R Martineau ◽

Chinedu Nwokoro ◽

Christopher J Griffiths ◽

Andrew Bush

Keyword(s):

Vitamin D ◽

Secondary Prevention ◽

Vitamin D Supplementation ◽

Small Sample ◽

Preschool Age ◽

School Age Children ◽

School Age ◽

Vitamin D Status ◽

Increased Risk ◽

Tract Infections

IntroductionVitamin D is best known for its role in bone health; however, the discovery of the vitamin D receptor and the expression of the gene encoding the vitamin D 1α-hydroxylase (CYP27B1) enzyme in a wide variety of tissues including immune cells and respiratory epithelium has led to the discovery of potential roles for vitamin D in the prevention of acute wheeze.MethodsWe review here the literature concerning the relationships between circulating 25-hydroxyvitamin D (25(OH)D) concentration and secondary prevention of acute wheeze attacks in preschool and school-age children.ResultsEpidemiological data suggest that vitamin D insufficiency (25(OH)D <75 nmol/L) is highly prevalent in preschool and school-age children with wheeze. Preschool age children with a history of wheeze attacks and circulating 25(OH)D <75 nmol/L are at increased risk and frequency of future acute wheeze. However, no consistent association between low vitamin D status and risk of acute wheeze is reported in school-age children. Seven randomised controlled trials (RCTs) with relatively small sample sizes (30–430) and variable quality showed inconsistent results regarding the effect of oral vitamin D supplementation during childhood on the risk of asthma attacks, asthma symptom control, inhaled corticosteroid requirements, spirometry and unscheduled healthcare attendances for wheeze. A RCT showed that vitamin D supplementation had no effect on the frequency of unplanned healthcare attendances due to acute wheeze in 22 preschool children.DiscussionAn evidence-based recommendation for the use of vitamin D as a preventive therapy for wheeze attacks cannot be made until results of further trials are available. The assessment of circulating 25(OH)D concentration and the optimisation of vitamin D status to prevent acute respiratory tract infections, and to maintain skeletal and general health in preschool and school-age children with acute wheeze is worthwhile in its own right, but whether this will reduce the risk of acute wheeze attacks is unclear.

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The Role of Polymorphisms in Vitamin D-Related Genes in Response to Vitamin D Supplementation

Nutrients ◽

10.3390/nu12092608 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2608

Author(s):

Sara Tomei ◽

Parul Singh ◽

Rebecca Mathew ◽

Valentina Mattei ◽

Mathieu Garand ◽

...

Keyword(s):

Vitamin D ◽

Serum Vitamin ◽

Vitamin D Supplementation ◽

Nucleotide Polymorphisms ◽

Vitamin D Status ◽

Vdr Gene ◽

Individual Level ◽

Serum Vitamin D ◽

Vitamin D Levels

Background. Vitamin D deficiency represents a major healthcare problem. Vitamin D status is influenced by genetic and environmental determinants. Several observational studies have evaluated the association of single-nucleotide polymorphisms (SNPs) in vitamin D-related genes and vitamin D levels. Nevertheless, little is known about the role of these SNPs in the response to vitamin D supplementation. We conducted an interventional study to define the association between SNPs in vitamin D-related genes and the response to vitamin D supplementation in 100 self-reported healthy women of Arab ancestry for the majority. Methods. A total of 100 healthy female subjects received a weekly oral dose of 50,000 IU vitamin D for 12 weeks. Serum vitamin D concentration and metabolic profiles were measured at baseline and 12 weeks post-vitamin D supplementation. The genotypes of 37 SNPs selected from previously reported vitamin D-related genes have been assessed by Fluidigm genotyping assay. Results. Rs731236 (VDR gene) and rs7116978 (CYP2R1 gene) showed a significant association with vitamin D status. The rs731236 GG genotype and the rs7116978 CC genotype were associated with a “vitamin D sufficiency” state. Rs731236 GG and rs7116978 CC genotypes showed a higher response to vitamin D supplementation. Transcription factor binding site prediction analysis showed altered binding sites for transcription factors according to the different rs7116978 alleles. Interestingly, the 37 SNPs previously established to play a role in vitamin D-related pathways explained very little of the response to vitamin D supplementation in our cohort, suggesting the existence of alternative loci whose number and effect size need to be investigated in future studies. Conclusion. In this paper, we present novel data on vitamin D-related SNPs and response to vitamin D supplementation demonstrating the feasibility of applying functional genomic approaches in interventional studies to assess individual-level responses to vitamin D supplementation.

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Possible role of vitamin D supplementation in coronavirus disease 2019

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20203554 ◽

2020 ◽

Vol 6 (9) ◽

pp. 376

Author(s):

Devi Dayal

Keyword(s):

Vitamin D ◽

Viral Infections ◽

Respiratory Infections ◽

Winter Season ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Vitamin D Levels ◽

Respiratory Viral Infections ◽

The Impact

<p>Vitamin D deficiency (VDD) is presumed to play a role in several infective and non-infective conditions such as acute respiratory infections, tuberculosis, diabetes, hypertension, stroke etc. Most of the respiratory viral infections occur during winter season when the vitamin D levels in most individuals are generally low. The current pandemic of coronavirus disease 2019 (COVID-19) which began during winter season similar to the previous epidemics due to coronaviruses, has again stirred a debate on the role of VDD in the initiation and spread of the pandemic. The data on vitamin D status in patients with COVID-19 is however lacking. Different vitamin D supplementation strategies have recently been suggested as part of several countermeasures aimed at reducing the impact of COVID-19 pandemic. This brief narrative review discusses the evidence for the link between VDD and COVID-19 and the approaches suggested for vitamin D supplementation.</p>

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Role of Vitamin D in Systemic Lupus Erythematosus

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2014.119 ◽

2014 ◽

Vol 2 (4) ◽

pp. 662-667 ◽

Cited By ~ 1

Author(s):

Rada Miskovic ◽

Aleksandra Plavsic ◽

Jasna Bolpacic ◽

Sanvila Raskovic ◽

Mirjana Bogic

Keyword(s):

Systemic Lupus Erythematosus ◽

Vitamin D ◽

Lupus Erythematosus ◽

Animal Studies ◽

Potential Role ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Systemic Lupus

Vitamin D is a steroid hormone that in addition to its well known role in the metabolism of calcium and phosphorus exerts immunoregulatory properties. Data from animal studies and from prospective clinical trials on patients with rheumatoid arthritis, multiple sclerosis and type 1 diabetes point to the potential role of vitamin D as important environmental factor in the development of autoimmune diseases. Such role of vitamin D in systemic lupus erythematosus (SLE) has not yet been sufficiently studied. This review shows the sources, metabolism and mechanism of action of vitamin D, its effect on the cells of the immune system, prevalence and causes of vitamin D deficiency in patients with SLE, the link between vitamin D status and disease activity as well as recommendations for vitamin D supplementation.

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Role of Vitamin D in Preeclampsia

10.5772/intechopen.100139 ◽

2021 ◽

Author(s):

Simmi Kharb

Keyword(s):

Vitamin D ◽

Immune Dysfunction ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Infant Outcomes ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Vitamin D Signaling ◽

Maternal And Infant Outcomes

Pathogenesis of preeclampsia involves immune dysfunction, placental implantation, abnormal angiogenesis, excessive inflammation, hypertension that may be affected by vitamin D. Human placenta expresses all the components for vitamin D signaling: Vitamin D receptor (VDR), retinoid X receptor (RXR), 1-alpha- hydroxylase (CYP27B1) and 24- hydroxylase (CYP24A1). Vitamin D binding protein plays a role in binding and transportation of 25 hydroxyvitamin D [25(OH)D] and 1,25(OH)2D3. Vitamin D is activated by 25-hydroxylase (CYP2R1) and 1-alpha -hydroxylase (CYP27B1) and is degraded by 24-hydroxylase (CYP24A1). Vitamin D supplementation is not recommended by WHO for pregnant women and allows recommended nutrient intake (RNI) of 200 IU (5 μg) per day. Further research requires serum 25(OH)D analysis and assessment of maternal and infant outcomes; pre-conceptional vitamin D status.

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