Vitamin D: A key player in COVID‐19 immunity and lessons from the pandemic to combat immune‐evasive variants
https://link.springer.com/article/10.1007/s10787-024-01578-w
As of July 2024
775,754,322 confirmed cases of COVID-19
13,578,710,228 vaccine doses had been administered
It is unclear why some patients develop severe symptoms while others do not,
literature suggests a role for vitamin D.
Vitamin D plays a crucial role in the infection or in ameliorating the severity of symptoms.
VDD is associated with increased hospitalization of severely ill patients and increased levels of COVID-19-caused mortality.
The mechanism of action of vitamin D and vitamin D deficiency (VDD) is well understood.
Vitamin D levels and genetic variations in the vitamin D receptor (VDR) gene significantly impact the severity and out- comes of COVID-19,
especially in the infections caused by Delta and Omicron variants.
Furthermore, VDD causes immune system dysregulation upon infection with SARS-CoV-2,
indicating that vitamin D sufficiency is crucial in fighting against COVID-19 infection.
Potential role as a prophylactic and treatment adjunct.
Immunomodulatory and anti-inflammatory effects of vitamin D
Ability to enhance the efficacy of new antiviral drugs
Large- scale randomized trials are required to reach a definitive conclusion.
Mechanisms of action
Macrophages activated to produce defensive proteins and stimulate naïve T cells
Activate T lymphocytes and mature B lymphocytes into plasma cells
Prevents inflammation, vasoconstriction, and fibrosis of the lungs.
Prevents excess release of cytokines from macrophages
Prevents excessive CRP production in the liver
Vit D can reduce viral replication
Vitamin D can protect against ARDS, the main death-causing complication of COVID-19
Seven out of nine studies reviewed by Yisak
https://pubmed.ncbi.nlm.nih.gov/33447107/
have indicated a crucial role in vitamin D status in COVID-19 infection, prognosis, and mortality.
Vitamin D dose
To decrease the risk of contracting a new infection,
people at high risk of COVID-19 to take 10,000 IU d−1 of vitamin D for a few weeks,
followed by 5000 IU d−1 to raise the concentrations of the active form of vitamin D.
Blood levels
Levels below 12 ng/mL indicate severe deficiency.
Levels between 12 and 20 ng/mL suggest deficiency
Treatment recommended for levels below 30 ng/mL
Optimal levels are 30–60 ng/mL,
Recommended prophylactic dose
0–1 years, 400 IU/day (10 mcg)
over 1 year, 600 IU (15 mcg)
over 8 years, half an adult dose
Adults, 800– 2000 IU of cholecalciferol
Routine toxicity monitoring is unnecessary for doses under 10,000 IU/day
