25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 , with a clinical outcome ranging from mild to severe, including death. To date, it is unclear why some patients develop severe symptoms. Many authors have suggested the involvement of vitamin D in reducing the risk of infections; thus, we retrospectively investigated the 25-hydroxyvitamin D (25(OH)D) concentrations in plasma obtained from a cohort of patients from Switzerland. In this cohort, significantly lower 25(OH)D levels (p = 0.004) were found in PCR-positive for SARS-CoV-2 (median value 11.1 ng/mL) patients compared with negative patients (24.6 ng/mL); this was also confirmed by stratifying patients according to age >70 years. On the basis of this preliminary observation, vitamin D supplementation might be a useful measure to reduce the risk of infection. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations and to confirm our preliminary observation.

The Role of Micronutrients in Support of the Immune Response against Viral Infections

“…), it is not yet completely understood why some patients develop more severe symptoms than others. Considering our knowledge on the role of vitamin D in modulating the immune system and in inhibiting a hyper activation of the inflammatory response, together with data from observational and clinical studies on vitamin D supplementation, various authors have also suggested a potential role of vitamin D in reducing the severity of the disease [ 183 , 184 , 185 , 186 , 187 ]. Vitamin D is especially known for its ability to reduce the “cytokine storm” that contributes to the pathogenesis of various viral infections, including COVID-19 [ 188 ].…”

“…To date, we only have preliminary observations regarding the association of vitamin D deficiency and frequency and severity of COVID-19; the above mentioned study from Ilie and colleagues found a correlation between mean vitamin D levels in each country and COVID-19 cases and deaths [ 181 ]; D’Avolio and colleagues investigated vitamin D concentrations in a small cohort of 107 patients with a positive naso-pharyngeal swab for SARS-CoV2 in Switzerland, and found significantly lower vitamin D levels in patients than in controls with negative swabs [ 187 ]; Lau et al described a high frequency of vitamin D insufficiency (84.6%) in COVID-19 patients admitted to ICU in New Orleans, with a 100% frequency in patients younger than 75 years [ 188 ].…”

Are Adequate Vitamin D Levels Helpful in Fighting COVID-19? A Look at the Evidence

“…Other poor prognostic factors for COVID-19 include older age and underlying comorbidities such as hypertension, diabetes, obesity, and ischemic heart disease [38][39][40], which are also risk factors for vitamin D deficiency [41][42][43][44][45]. Indeed, two retrospective preprint studies have found that serum 25(OH)D levels were lowest in critical cases and highest in mild cases of COVID-19 [46,47], and was significantly correlated with positivity for SARS-CoV-2 [48]. A retrospective cohort study which explored the role of combined vitamin D, vitamin B12, and magnesium supplementation in COVID-19 hospitalised patients found a significant protective effect against clinical deterioration after correction for age and hy- Cumulative COVID-19 data as of 23rd May 2020 [37].…”

The SARS-CoV-2 Crisis: Has Medicine Finally Entered a Reductionist Era?

“…In a second and third step of applying systems thinking to the SARS-CoV-2 crisis, the analysis of the data collected from various sources would depend on their rapid dissemination and transdisciplinary science [4]. Exam-DOI: 10.1159/000510453 ples for transdisciplinary science include research into the modulation of COVID-19 risk and disease severity through nutrients such as vitamin D [10] ("nutritional immunology") or research into the effects of media-driven "angst campaigns" and quarantining measures on mental health and the immune system ("psychoneuroendocrinology") [11][12][13]. It also involves balancing benefits and harms in patient treatment and public health policies by recognizing and weighting insights from different medical systems, i.e., evolutionary, evidence-based, personalized, value-driven, and complementary medicine [14].…”