Myth Busters: Dietary Supplements and COVID-19

Adams, Kathleen; Baker, William L.; Sobieraj, Diana M

doi:10.1177/1060028020928052

Cited by 132 publications

(123 citation statements)

References 47 publications

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“…Therefore, initially, PubMed and Google Scholar were searched for "COVID-19" AND "Vitamin D" (date range, 2020, omitting citations and patents, no language limitations). Repeated searches confirmed the growing interest in the hypothesis that vitamin D deficiency may play an important role in the COVID-19 pandemic (3,10,12,19,25,110,(112)(113)(114)(115)(116)(117)(118)(119)(120)(121)(122)(123)(124)(125)(126)(127) From May 2 to May 19, Google Scholar hits increased from 49 to 88 and PubMed hits increased from 17 publications to 32. By June 16, the Google Scholar search retrieved 158 possible references and the PubMed publications on the topic had increased to 69.…”

Section: Methods: Literature Searchmentioning

confidence: 70%

“…Early studies of vitamin D supplementation for acute respiratory tract infections produced conflicting results (28,104). Most studies of vitamin D for influenza prevention were conducted on healthy populations with high baseline levels, rather than on the deficient populations who would benefit most (19,30,121,125,147). Despite this, some found that higher 25(OH)D linearly enhance the innate immune response to acute winter respiratory infections, halving the incidence and significantly reducing the duration of illness (31,148,149).…”

Section: Vitamin D Enhances Resistance To Viral Illnessesmentioning

confidence: 99%

“…Serum response to vitamin D supplementation is highly variable between individuals, leading to recommendations of higher doses than the US RDA (28,30). The NIH states that vitamin D supplements of up to 5,000 IU/day have not produced toxicity, leading to a maximum recommended intake for persons 9 years and older of 4,000 IU (100 mcg)/day (125,250). Although the USRDA for vitamin D is 600-800 IU/day, the Endocrine Society and many other experts recommend 1,000-2,000 IU/day (widely available dosages) (31,64,65,250).…”

Section: Covid-19-specific Recommendations Of Expertsmentioning

confidence: 99%

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A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency

Benskin

2020

Front. Public Health

127

130

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As the world's attention has been riveted upon the growing COVID-19 pandemic, many researchers have written brief reports supporting the hypothesis that vitamin D deficiency is related to the incidence and severity of COVID-19. The clear common thread among the top risk groups-vitamin D deficiency-may be being overlooked because of previous overstated claims of vitamin D benefits. However, the need to decrease COVID-19 fatalities among high-risk populations is urgent. Early researchers reported three striking patterns. Firstly, the innate immune system is impaired by vitamin D deficiency, which would predispose sufferers to viral infections such as COVID-19. Vitamin D deficiency also increases the activity of the X-chromosome-linked "Renin-Angiotensin" System, making vitamin D deficient individuals (especially men) more susceptible to COVID-19's deadly "cytokine storm" (dramatic immune system overreaction). Secondly, the groups who are at highest risk for severe COVID-19 match those who are at highest risk for severe vitamin D deficiency. This includes the elderly, men, ethnic groups whose skin is naturally rich in melanin (if living outside the tropics), those who avoid sun exposure for cultural and health reasons, those who live in institutions, the obese, and/or those who suffer with hypertension, cardiovascular disease, or diabetes. And thirdly, the pattern of geographical spread of COVID-19 reflects higher population vitamin D deficiency. Both within the USA and throughout the world, COVID-19 fatality rates parallel vitamin D deficiency rates. A literature search was performed on PubMed, Google Scholar, and RSMLDS, with targeted Google searches providing additional sources. Although randomized controlled trial results may be available eventually, the correlational and causal study evidence supporting a link between vitamin D deficiency and COVID-19 risks is already so strong that it supports action. The 141 author groups writing primarily about biological plausibility detailed how vitamin D deficiency can explain every risk factor and every complication of COVID-19, but agreed that other factors are undoubtedly at work. COVID-19 was compared with dengue fever, for which oral vitamin D supplements of 4,000 IU for 10 days were significantly more effective than 1,000 IU in reducing virus replication and controlling the "cytokine storm" (dramatic immune system over-reaction) responsible for fatalities. Among the 47 original research studies summarized here, chart reviews found that serum vitamin D levels predicted COVID-19 mortality Benskin Evidence Linking Vitamin D, COVID-19 rates (16 studies) and linearly predicted COVID-19 illness severity (8 studies). Two causal modeling studies and several analyses of variance strongly supported the hypothesis that vitamin D deficiency is a causal, rather than a bystander, factor in COVID-19 outcomes. Three of the four studies whose findings opposed the hypothesis relied upon disproven assumptions. The literature review also found that prophylactically correcting possible ...

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Section: Methods: Literature Searchmentioning

confidence: 70%

Section: Vitamin D Enhances Resistance To Viral Illnessesmentioning

confidence: 99%

Section: Covid-19-specific Recommendations Of Expertsmentioning

confidence: 99%

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A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency

Benskin

2020

Front. Public Health

127

130

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“…COVID-19 can develop into acute respiratory distress syndrome, secondary infection, and sepsis [20]. An intravenous treatment with high-dose vitamin C has shown beneficial effects on sepsis and septic shock [18,21].…”

Section: The Role Of Vitamin C In the Immune Systemmentioning

confidence: 99%

The Role of Vitamin C, Vitamin D, and Selenium in Immune System against COVID-19

2020

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Low levels of micronutrients have been associated with adverse clinical outcomes during viral infections. Therefore, to maximize the nutritional defense against infections, a daily allowance of vitamins and trace elements for malnourished patients at risk of or diagnosed with coronavirus disease 2019 (COVID-19) may be beneficial. Recent studies on COVID-19 patients have shown that vitamin D and selenium deficiencies are evident in patients with acute respiratory tract infections. Vitamin D improves the physical barrier against viruses and stimulates the production of antimicrobial peptides. It may prevent cytokine storms by decreasing the production of inflammatory cytokines. Selenium enhances the function of cytotoxic effector cells. Furthermore, selenium is important for maintaining T cell maturation and functions, as well as for T cell-dependent antibody production. Vitamin C is considered an antiviral agent as it increases immunity. Administration of vitamin C increased the survival rate of COVID-19 patients by attenuating excessive activation of the immune response. Vitamin C increases antiviral cytokines and free radical formation, decreasing viral yield. It also attenuates excessive inflammatory responses and hyperactivation of immune cells. In this mini-review, the roles of vitamin C, vitamin D, and selenium in the immune system are discussed in relation to COVID-19.

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“…Doses higher than 2 g/day can cause diarrhoea, abdominal pain and nausea, which are self-limited once the dose is reduced [ 99 , 100 ]. There is a concern that high dose of vitamin C (10 g/day) could lead to a supraphysiological level of vitamin C which causes oxaluria and increases the risk of oxalate nephropathy and oxalate kidney stone [ 101 , 102 ]. In a randomised, crossover, controlled study, vitamin C supplement of 1000 mg twice a day increased urinary oxalate in 40% of the participants, which in turn increases the risk of oxalate kidney stone [ 103 ].…”

Section: The Safety Profile Of Vitamin Cmentioning

confidence: 99%

Overview of the possible role of vitamin C in management of COVID-19

2020

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The mainstay of management of coronavirus disease 2019 (COVID-19) is mainly supportive as to date there is no effective antiviral treatment, apart from remdesivir which has been approved by Food and Drug administration (FDA) for treatment of COVID-19, or vaccine. Supplementation with micronutrients, such as vitamins and minerals, has gained an increasing interest as part of the supportive management of COVID-19. Vitamin C levels in serum and leukocytes are depleted during the acute stage of infection owing to increased metabolic demands. High-dose vitamin C supplement helps to normalise both serum and leukocytes vitamin C levels. Vitamin C has multiple pharmacological characteristics, antiviral, anti-oxidant, anti-inflammatory and immunomodulatory effects, which make it a potential therapeutic option in management of COVID-19. The use of high dose of intravenous vitamin C for management of COVID-19 in China and the United Stated has shown promising results. There were no reported adverse reactions with the short-term use of high dose of vitamin C. Given the fact that vitamin C is cheap, available and safe drug with beneficial effects in management of viral infections and critically ill patients reported in previous clinical trials, it is sensible to add it to COVID-19 management protocol particularly if the current ongoing clinical trials testing the effect of vitamin C in management of COVID-19 show positive results.

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Myth Busters: Dietary Supplements and COVID-19

Cited by 132 publications

References 47 publications

A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency

A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency

The Role of Vitamin C, Vitamin D, and Selenium in Immune System against COVID-19

Overview of the possible role of vitamin C in management of COVID-19

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