Evidence of protective role of Ultraviolet-B (UVB) radiation in reducing COVID-19 deaths

Moozhipurath, Rahul Kalippurayil; Kraft, Lennart; Skiera, Bernd

doi:10.1038/s41598-020-74825-z

Cited by 43 publications

(44 citation statements)

References 67 publications

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“…These latitude associations will of course change as we go through the seasons. They imply an effect of ultraviolet light and this has been supported by a further study showing an association between UVB exposure and COVID-19 mortality across 152 countries [50]. This could be mediated by a direct effect of viral killing by UVB in the environment but is also compatible with an effect mediated by vitamin Dthe latter would of course fit with the link between COVID-9 severity and ethnicity, whereas the former would not.…”

Section: Latitude Associations With Covid-19 Mortality Imply Seasonalmentioning

confidence: 80%

Vitamin D and COVID-19: evidence and recommendations for supplementation

et al. 2020

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Vitamin D is a hormone that acts on many genes expressed by immune cells. Evidence linking vitamin D deficiency with COVID-19 severity is circumstantial but considerable—links with ethnicity, obesity, institutionalization; latitude and ultraviolet exposure; increased lung damage in experimental models; associations with COVID-19 severity in hospitalized patients. Vitamin D deficiency is common but readily preventable by supplementation that is very safe and cheap. A target blood level of at least 50 nmol l −1 , as indicated by the US National Academy of Medicine and by the European Food Safety Authority, is supported by evidence. This would require supplementation with 800 IU/day (not 400 IU/day as currently recommended in UK) to bring most people up to target. Randomized placebo-controlled trials of vitamin D in the community are unlikely to complete until spring 2021—although we note the positive results from Spain of a randomized trial of 25-hydroxyvitamin D3 (25(OH)D3 or calcifediol) in hospitalized patients. We urge UK and other governments to recommend vitamin D supplementation at 800–1000 IU/day for all, making it clear that this is to help optimize immune health and not solely for bone and muscle health. This should be mandated for prescription in care homes, prisons and other institutions where people are likely to have been indoors for much of the summer. Adults likely to be deficient should consider taking a higher dose, e.g. 4000 IU/day for the first four weeks before reducing to 800 IU–1000 IU/day. People admitted to the hospital with COVID-19 should have their vitamin D status checked and/or supplemented and consideration should be given to testing high-dose calcifediol in the RECOVERY trial. We feel this should be pursued with great urgency. Vitamin D levels in the UK will be falling from October onwards as we head into winter. There seems nothing to lose and potentially much to gain.

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Section: Latitude Associations With Covid-19 Mortality Imply Seasonalmentioning

confidence: 80%

Vitamin D and COVID-19: evidence and recommendations for supplementation

et al. 2020

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“…These data suggest that there are benefits from UV light independently of vitamin D formation in reducing COVID-19 mortality. Benefits for the UVB component of sunlight have also been reported, in which a negative association between the UV Index and COVID-19 deaths were observed in data from 152 countries using modeling that considered other potential effects of local weather (e.g., temperature, humidity) across January–May 2020 ( 49 ). Beneficial inverse associations between COVID-19 severity or death and local ambient UV levels or annual mean sunlight hours were also observed in Spain ( 50 ) and France ( 51 ), respectively, although this French study has been critiqued for the statistical approach undertaken ( 52 ).…”

Section: Uv Light Sun Exposure and Covid-19mentioning

confidence: 96%

Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update

Gorman

Weller

2020

Front. Cardiovasc. Med.

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During the COVID-19 (coronavirus disease of 2019) pandemic, researchers have been seeking low-cost and accessible means of providing protection from its harms, particularly for at-risk individuals such as those with cardiovascular disease, diabetes and obesity. One possible way is via safe sun exposure, and/or dietary supplementation with induced beneficial mediators (e.g., vitamin D). In this narrative review, we provide rationale and updated evidence on the potential benefits and harms of sun exposure and ultraviolet (UV) light that may impact COVID-19. We review recent studies that provide new evidence for any benefits (or otherwise) of UV light, sun exposure, and the induced mediators, vitamin D and nitric oxide, and their potential to modulate morbidity and mortality induced by infection with SARS-CoV-2 (severe acute respiratory disease coronavirus-2). We identified substantial interest in this research area, with many commentaries and reviews already published; however, most of these have focused on vitamin D, with less consideration of UV light (or sun exposure) or other mediators such as nitric oxide. Data collected to-date suggest that ambient levels of both UVA and UVB may be beneficial for reducing severity or mortality due to COVID-19, with some inconsistent findings. Currently unresolved are the nature of the associations between blood 25-hydroxyvitamin D and COVID-19 measures, with more prospective data needed that better consider lifestyle factors, such as physical activity and personal sun exposure levels. Another short-coming has been a lack of measurement of sun exposure, and its potential to influence COVID-19 outcomes. We also discuss possible mechanisms by which sun exposure, UV light and induced mediators could affect COVID-19 morbidity and mortality, by focusing on likely effects on viral pathogenesis, immunity and inflammation, and potential cardiometabolic protective mechanisms. Finally, we explore potential issues including the impacts of exposure to high dose UV radiation on COVID-19 and vaccination, and effective and safe doses for vitamin D supplementation.

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“…Early studies show a protective role of UVB and vitamin D in COVID-19 5 , 6 , 11 , 14 . 1,25-dihydroxyvitamin D (1,25 (OH) 2 D), an active form of vitamin D, plays a critical role in the modulation of innate as well as adaptive immune systems 38 , 39 , renin-angiotensin system (RAS) 39 – 41 as well as in the modulation of the inflammatory response, reducing cytokine storm risk 38 , 39 .…”

Section: Impact Of Monsoon On Healthcare System Uvb Radiation and Comentioning

confidence: 99%

“…Recent observational and clinical studies show that vitamin D deficiency might be linked to incidence 5 – 8 , severity 7 , 9 and mortality 10 – 12 associated with COVID-19 13 . Emerging studies also show that vitamin D and its primary source Ultraviolet-B radiation (UVB) may play a protective role in mitigating COVID-19 deaths 14 . Limited hours of sunlight and dense cloud cover 15 limit the intensity of UVB radiation, mitigating its protective role 14 during the monsoon season.…”

Section: Introductionmentioning

confidence: 99%

“…Emerging studies also show that vitamin D and its primary source Ultraviolet-B radiation (UVB) may play a protective role in mitigating COVID-19 deaths 14 . Limited hours of sunlight and dense cloud cover 15 limit the intensity of UVB radiation, mitigating its protective role 14 during the monsoon season. Further, the onset of the monsoon season may also alter the behaviour of people limiting their exposure to UVB radiation.…”

Section: Introductionmentioning

confidence: 99%

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Implications of monsoon season and UVB radiation for COVID-19 in India

Moozhipurath

Kraft

2021

Sci Rep

Self Cite

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India has recorded 142,186 deaths over 36 administrative regions placing India third in the world after the US and Brazil for COVID-19 deaths as of 12 December 2020. Studies indicate that south-west monsoon season plays a role in the dynamics of contagious diseases, which tend to peak post-monsoon season. Recent studies show that vitamin D and its primary source Ultraviolet-B (UVB) radiation may play a protective role in mitigating COVID-19 deaths. However, the combined roles of the monsoon season and UVB radiation in COVID-19 in India remain still unclear. In this observational study, we empirically study the respective roles of monsoon season and UVB radiation, whilst further exploring, whether the monsoon season negatively impacts the protective role of UVB radiation in COVID-19 deaths in India. We use a log-linear Mundlak model to a panel dataset of 36 administrative regions in India from 14 March 2020–19 November 2020 (n = 6751). We use the cumulative COVID-19 deaths as the dependent variable. We isolate the association of monsoon season and UVB radiation as measured by Ultraviolet Index (UVI) from other confounding time-constant and time-varying region-specific factors. After controlling for various confounding factors, we observe that a unit increase in UVI and the monsoon season are separately associated with 1.2 percentage points and 7.5 percentage points decline in growth rates of COVID-19 deaths in the long run. These associations translate into substantial relative changes. For example, a permanent unit increase of UVI is associated with a decrease of growth rates of COVID-19 deaths by 33% (= − 1.2 percentage points) However, the monsoon season, mitigates the protective role of UVI by 77% (0.92 percentage points). Our results indicate a protective role of UVB radiation in mitigating COVID-19 deaths in India. Furthermore, we find evidence that the monsoon season is associated with a significant reduction in the protective role of UVB radiation. Our study outlines the roles of the monsoon season and UVB radiation in COVID-19 in India and supports health-related policy decision making in India.

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Evidence of protective role of Ultraviolet-B (UVB) radiation in reducing COVID-19 deaths

Cited by 43 publications

References 67 publications

Vitamin D and COVID-19: evidence and recommendations for supplementation

Vitamin D and COVID-19: evidence and recommendations for supplementation

Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update

Implications of monsoon season and UVB radiation for COVID-19 in India

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