Possible role of vitamin D supplementation in coronavirus disease 2019

<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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Does Vitamin D play a role in the management of Covid-19 in Brazil?

Revista de Saúde Pública ◽

10.11606/s1518-8787.2020054002545 ◽

2020 ◽

Vol 54 ◽

pp. 53 ◽

Cited By ~ 6

Author(s):

Helena Ribeiro ◽

Keila Valente de Souza de Santana ◽

Sofia Lizarralde Oliver ◽

Patricia Helen de Carvalho Rondó ◽

Marcela Moraes Mendes ◽

...

Keyword(s):

Vitamin D ◽

Randomized Controlled Trials ◽

Respiratory Infections ◽

Sun Exposure ◽

Hypovitaminosis D ◽

Controlled Trials ◽

Vitamin D Status ◽

Randomized Controlled ◽

Vitamin D Levels

The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.

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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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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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Vitamin D dan paparan sinar matahari untuk mencegah COVID-19. Fakta atau mitos ?

Medica Hospitalia : Journal of Clinical Medicine ◽

10.36408/mhjcm.v7i1a.474 ◽

2020 ◽

Vol 7 (1A) ◽

pp. 320-328

Author(s):

Maria Mexitalia ◽

Martvera Susilawati ◽

Rina Pratiwi ◽

JC Susanto

Keyword(s):

Vitamin D ◽

Skin Color ◽

Respiratory Infections ◽

Sun Exposure ◽

Vitamin D Supplementation ◽

The Body ◽

High Dose ◽

Vitamin D Metabolism ◽

Vitamin D Levels

Latar Belakang : Paparan sinar matahari pada kulit merupakan cara terbaik untuk sintesis vitamin D. Kadar vitamin D yang adekuat dalam tubuh merupakan proteksi terhadap berbagai penyakit seperti penyakit degeneratif, kanker dan juga infeksi saluran napas. Beberapa penelitian menghubungkan kadar vitamin D yang rendah dengan morbiditas dan mortalitas COVID-19. Hal ini menyebabkan fenomena baru pada masyarakat yaitu kebiasaan berjemur. Tujuan : Artikel ini akan membahas tentang metabolisme vitamin D, peran sinar matahari dalam mengaktifkan vitamin D di dalam tubuh, dan peran vitamin D dalam berbagai penyakit, khususnya mekanisme imunitas untuk COVID-19. Diskusi : Vitamin D meningkatkan kekebalan alami seluler terutama dengan cara menginduksi peptida antimikroba, yang meliputi cathelicidin, LL-37, 1,25-dihdroxyvitamin D dan defensins. Selain itu vitamin D akan meningkatkan sekresi hidrogen peroksida pada sel monosit. Pemberian vitamin D dosis tinggi sebanyak 10.000 IU/hari selama beberapa minggu dilanjutkan 5000 IU/hari bermanfaat untuk mencegah COVID-19, walaupun hasilnya masih memerlukan penelitian lebih lanjut. Absorpsi sinar matahari ke dalam tubuh manusia dipengaruhi oleh warna kulit, penggunaan bahan pakaian dan tabir surya , dan luas pajanan. Paparan sinar matahari sebesar satu Minimal Erythemal Dose (MED) pada orang dewasa dapat meningkatkan konsentrasi vitamin D setara dengan suplementasi 10.000 – 25.000 IU. Penelitian pada bayi yang diberi paparan 3 kali seminggu @ 5 menit pada jam 10.00-14.00, dengan paparan 50% area tubuh selama 2 bulan, mendapatkan kenaikan 25(OH)D sebesar 8,9 ng/mL. Simpulan : Vitamin D yang diaktifkan oleh paparan sinar matahari sangat bermanfaat sebagai proteksi berbagai penyakit termasuk juga pada COVID-19, walaupun efektifitasnya masih memerlukan penelitian lebih lanjut. Kata Kunci : COVID-19, vitamin D, paparan sinar matahari Background : The exposured of sunlight on the skin is the best way for vitamin D synthesis. Adequate vitamin D levels are protection against various diseases such as degenerative diseases, cancer and also respiratory infections. Several studies have linked between low vitamin D levels with COVID-19 morbidity and mortality. This causes a new phenomenon in the community, namely sunbathing. Purpose : This review rearticle will discuss about vitamin D metabolism, the role of sunlight in activating vitamin D in the body, and the role of vitamin D in various diseases, specifically the immune mechanism for COVID-19.Discussion : Vitamin D increases cellular innate immunity mainly by inducing antimicrobial peptides, which include cathelicidin, LL-37, 1,25-dihdroxyvitamin D and defensins, and also increase the secretion of hydrogen peroxide in monocyte cells. The administration of high-dose vitamin D of 10,000 IU / day for several weeks followed by 5000 IU / day is useful to prevent COVID-19, although the results still require further research. The sun exposure to activated vitamin D body is affected by skin color, using of clothing and sunscreen, and area of ??exposure. Sun exposure of one Minimum Erythemal Dose (MED) in adults can increase vitamin D concentrations equivalent to 10,000 - 25,000 IU vitamin D supplementation. Study on infants who were given exposure 3 times a week @ 5 minutes at 10:00 to 14:00, with exposure 50% of body surface area for 2 months, increased 25(OH)D of 8.9 ng/mL. Conclusion : Vitamin D which is activated by sun exposure is very useful as protection for various diseases including COVID-19, although its effectiveness still requires further research. Keywords : vitamin D, sun exposure, COVID-19.

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Impact of Vitamin D Deficiency on Survival for Patients Received Haploidentical Hematopoietic Stem Cell Transplantation (haplo-HSCT)

Blood ◽

10.1182/blood-2021-153911 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 4853-4853

Author(s):

Nicholas Cox ◽

Supawee Saengboon ◽

Amanda L. Olson ◽

Muzaffar H. Qazilbash ◽

Elizabeth J. Shpall ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Research Funding ◽

Conditioning Regimen ◽

Vitamin D Status ◽

Vitamin D Levels ◽

Deficiency Group ◽

The Impact ◽

Very High

Abstract Background Beyond its role in bone health, vitamin D is known to have immunomodulatory effects including cell proliferation, differentiation and apoptosis. Delays in immune reconstitution following HSCT increase transplant-related toxicity. Several studies have explored the role of vitamin D deficiency after HSCT with mixed results regarding its impact on survival outcomes. Our aim in this study was to examine the impact of vitamin D deficiency prior to HSCT on transplant outcomes in patients who received a haplo-HSCT. Methods This retrospective study included consecutive patients who underwent haplo-HSCT at our institution between 02/2009 and 01/2021. Primary objectives were to assess progression-free survival (PFS) and overall survival (OS) by vitamin D status at the time of transplant. Vitamin D deficiency was defined as vitamin D levels < 20 nmol/L within 6 months prior to transplant. Survival estimates were calculated using Kaplan-Meier method. Proportional cox hazards analysis was used to adjust for multivariable analysis (MVA). Results Four-hundred and eighty-four patients out of 508 patients had vitamin D checked at baseline and were included in the final analysis. Table 1 summarizes patient, disease, and transplant characteristics for all study patients, and by vitamin D status. Median age for all study patients was 48 (18-72) years, of which 237 (49%) had vitamin D deficiency and 247 (51%) had normal vitamin D level. Overall, the two groups were comparable, except that patients in the vitamin D deficiency group were younger in age. Furthermore, we adjusted for disease subtype heterogeneity by using the validated disease risk index (DRI). With a median follow-up of 35.4 (range, 1.4-132.8) months, the 3-year PFS and OS for all study patients were 44% and 48%, respectively. The respective 3-year PFS and OS for the vitamin D deficiency group were 42% and 47% compared to 46% and 50% for patients with adequate vitamin D (p=0.773 for PFS; p=0.704 for OS). Furthermore, we found no difference in non-relapse mortality at 3 years (each for 30%; p=0.6682). Univariate analysis (UVA) was performed for the following variables: vitamin D, age, gender, KPS, DRI, HCT-CI, and intensity of conditioning regimen. MVA included only the factors with p value<0.1 in in the UVA (plus vitamin D). In UVA for PFS, age ≥55, KPS <90, high/very-high DRI, HXT-CI >3 and reduced intensity conditioning were associated with inferior outcome. Same factors were significantly associated with inferior OS, but the reduced conditioning regimen. In MVA, age ≥55 (HR 1.627, 95% CI: 1.212-2.212; p=0.0013), high/very-high DRI (HR 1.865, 95% CI: 1.427-2.437; p=<0.0001), and HCT-CI >3 (HR 1.314, 95% CI: 1.001-1.726; p=0.0493) were associated with decreased PFS. Patients in the vitamin D deficiency group had a trend towards decreased PFS (HR 1.292, 95% CI: 0.975-1.712; p=0.0746), but this didn't reach statistical significance. In regard to OS, age ≥55 (HR 1.727, 95% CI: 1.278-2,334; p=0.0004), high/very-high DRI (HR 1.855, 95% CI: 1.396-2.467; p=<0.0001), and HCT-CI >3 (HR 1.411, 95% CI: 1.058-1.882; p=0.0191) were again associated with decreased OS, while vitamin D deficiency patients showed a trend for decreased OS (HR 1.312, 95% CI: 0.973-1.77; p=0.0753). Conclusion Our study demonstrates that serum vitamin D levels prior to haplo-HSCT have no significant impact on either progression-free or overall survival, albeit with a trend for worse outcomes in the vitamin D deficient group. Prospective controlled studies are needed to assess the impact of vitamin D deficiency on transplant outcomes, and on the role of vitamin D supplementation to improve the outcomes. Figure 1 Figure 1. Disclosures Qazilbash: Bristol-Myers Squibb: Other: Advisory Board; Oncopeptides: Other: Advisory Board; Angiocrine: Research Funding; Amgen: Research Funding; Biolline: Research Funding; NexImmune: Research Funding; Janssen: Research Funding. Shpall: Navan: Consultancy; Novartis: Honoraria; Axio: Consultancy; Magenta: Honoraria; Takeda: Patents & Royalties; Bayer HealthCare Pharmaceuticals: Honoraria; Adaptimmune: Consultancy; Affimed: Patents & Royalties; Magenta: Consultancy; Novartis: Consultancy.

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The role of vitamin D in seasonal acute respiratory viral infections and COVID-19

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.11.000785 ◽

2020 ◽

Vol 92 (11) ◽

pp. 98-105

Author(s):

E. A. Pigarova ◽

A. A. Povalyaeva ◽

L. K. Dzeranova ◽

L. Y. Rozhinskaya ◽

N. G. Mokrysheva

Keyword(s):

Vitamin D ◽

Immune Response ◽

Infectious Diseases ◽

Viral Infections ◽

Respiratory Infections ◽

Strong Association ◽

Active Form ◽

Vitamin D Metabolism ◽

Vitamin D Levels

A link between vitamin D deficiency and susceptibility to infectious diseases was suggested over a hundred years ago. Epidemiological studies show a strong association between seasonal fluctuations in vitamin D levels and the incidence of various infectious diseases, including septic shock, acute respiratory infections, and influenza. Our understanding of vitamin D metabolism and its extra-skeletal functions has improved significantly over the past three decades, and the discovery that the vitamin D receptor and 1a-hydroxylase, an enzyme needed to convert vitamin D to its active form, is present in the cells of the immune system, revolutionized in this area. Recent studies have shown that vitamin D regulates the expression of specific endogenous antimicrobial peptides in immune cells, modulates the immune response and the course of autoimmune processes; these actions indicate the potential role of vitamin D in modulating the immune response to various infectious diseases. This publication reviews the literature on the effects of vitamin D on immunity, its potential in the prevention and treatment of viral diseases, with a particular focus on COVID-19.

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

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001686 ◽

2021 ◽

pp. bmjmilitary-2020-001686

Author(s):

Iain T Parsons ◽

R M Gifford ◽

M J Stacey ◽

L E Lamb ◽

M K O'Shea ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Military Studies ◽

Vitamin D Receptors ◽

Area Of Interest ◽

Military Populations ◽

Tract Infections ◽

Recruit Training

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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Role of Vitamin D in Reducing the Frequency of Asthma Attacks in Patients with Frequent Exacerbation of Asthma

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i53b33675 ◽

2021 ◽

pp. 11-16

Author(s):

Mubeen Ahmed Memon ◽

Sheeba Faryal Ansari ◽

Mumtaz Ali Lakho ◽

Mukhtiar Hussain Jaffery ◽

Syed Zulfiquar Ali Shah ◽

...

Keyword(s):

Vitamin D ◽

Corticosteroid Treatment ◽

Vitamin D Supplementation ◽

The Body ◽

P Value ◽

Care Hospital ◽

Asthma Exacerbations ◽

Vitamin D Levels ◽

Interventional Group

Introduction: Vitamin D deficiency is common among asthmatics with literature suggesting that its low levels in the body may trigger exacerbations and decrease the response to corticosteroid treatment. It has also shown to inhibit the production of cytokines, which in turn enhances the body’s response to corticosteroid treatment during an exacerbation. Therefore, maintenance of adequate levels of vitamin D in patients with asthma may reduce the risk of exacerbation and improve their general health. This study aims to explore the role of vitamin D supplementation in preventing asthma exacerbations. Methods: This single blind parallel arm interventional study was conducted in the pulmonology ward in a tertiary care hospital from June 2018 to April 2020. Two hundred (n= 200) participants with a history of frequent acute exacerbation of asthma were enrolled in the study via consecutive convenient non-probability technique. Participants were divided into two groups; the placebo and the interventional group that received 200,000 IU of vitamin D capsule. Results: Compared to day 0, mean episodes of exacerbation in the interventional group were significantly lower after 180 days (1.1 ± 0.4 vs. 0.61 ± 0.3; p-value <0.0001). Similarly, number of asthma attacks in past 7 days was significantly lower in intervention group after 180 days (4.4 ± 2.7 vs. 3.1 ± 1.5; p-value 0.0001) Conclusion: Vitamin D supplementation is a safe and cost-friendly approach to reducing asthma exacerbations. It may also help to improve the condition in severe asthmatics with low vitamin D levels.

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Free Vitamin D Status Among Apparently Healthy Adults Living in Duhok Governorate

10.21203/rs.3.rs-831455/v1 ◽

2021 ◽

Author(s):

masood abdulkareem abdulrahman ◽

Suad Yousif Alkass ◽

Noor Isam Mohammed

Keyword(s):

Vitamin D ◽

Free Form ◽

Vitamin D Status ◽

Cross Sectional ◽

Population Total ◽

Daily Exposure ◽

Vitamin D Levels ◽

Free Vitamin D ◽

The Impact ◽

Apparently Healthy

Abstract Serum total 25-OHD is a main marker of vitamin D which represents the intake and sunlight exposure. Free form of 25‐OHD, the small fraction not bound to a transporter protein has been incorporated as a new marker. This cross-sectional study aimed to evaluate the impact of several factors on total and free vitamin D levels in healthy subjects and to find out if the free form of vitamin D could be a better representative of the body’s vitamin D status. Total and free 25‐OHD were analyzed by ELISA method in a blood sample collected from 391 apparently healthy volunteers (219 female and 172 Male) from Duhok Governorate/Iraq population. Total and free 25‐OHD levels were increased proportionally to BMI with lower values seen in the underweight group, also a significant gender differences in total D3 level with higher values in males (23.90 ± 16.41) ng/ml than females (21.24 ± 15.65) ng/ml was observed. Total and Free 25‐OHD levels were significantly associated with ages, their deficiency most frequent occurs in the younger ages between (16–25) years old. Smokers had higher level of Total 25‐OHD (26.95 ± 19.01) ng/ml and Free 25‐OHD (9.47 ± 4.94) pg/ml than nonsmokers (22.14 ± 14.59) ng/ml and (7.87 ± 4.32) pg/ml respectively. A significant increase in Free 25‐OHD level in the veiled women (9.12 ± 4.64) ng/ml than unveiled (6.16 ± 3.73) ng/ml with a significant positive correlation between Free 25‐OHD level and dress style was also seen. 30% and 33% of the participants whom their daily exposure to sunlight for 30 minutes and > 1hour respectively were severe deficient in total 25‐OHD. 95% of the participants who had Abnormally low level of free D were exposed for ≥ 30 minutes to sunlight. Daily exposure to sunlight was negatively associated with Free 25‐OHD level.

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