Possible role of vitamin D in Covid-19 infection in pediatric population

Abstract

Purpose Covid-19 is a pandemic of unprecedented proportion, whose understanding and management is still under way. In the emergency setting new or available therapies to contrast the spread of COVID-19 are urgently needed. Elderly males, especially those affected by previous diseases or with comorbidities, are more prone to develop interstitial pneumonia that can deteriorate evolving to ARDS (acute respiratory distress syndrome) that require hospitalization in Intensive Care Units (ICUs). Even children and young patients are not spared by SARS-CoV 2 infection, yet they seem to develop a milder form of disease. In this setting the immunomodulatory role of Vitamin D, should be further investigated. Methods: We reviewed the literature about the immunomodulatory role of Vitamin D collecting data from the databases Medline and Embase. Results Vitamin D proved to interact both with the innate immune system, by activating Toll-like receptors (TLRs) or increasing the levels of cathelicidins and β-defensins, and adaptive immune system, by reducing immunoglobulin secretion by plasma cells and pro-inflammatory cytokines production, thus modulating T cells function. Promising results have been extensively described as regards the supplementation of vitamin D in respiratory tract infections, autoimmune diseases and even pulmonary fibrosis. Conclusions In this review, we suggest that vitamin D supplementation might play a role in the prevention and/or treatment to SARS-CoV-2 infection disease, by modulating the immune response to the virus both in the adult and pediatric population.

Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study

“…Hence, low 25(OH)D level was identified as independently associated with the likelihood of COVID‐19 infection. This finding is in agreement with the results of other studies [5,7,9–15,19,30–42]. Further, reduced risk of acute respiratory tract infection following vitamin D supplementation has been reported [43,44].…”

Faculty Opinions recommendation of Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study.

“…Hence, low 25(OH)D level was identified as independently associated with the likelihood of COVID-19 infection. This finding is in agreement with the results of other studies (5,7,(9)(10)(11)(12)(13)(14)(15)19,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). Further, reduced risk of acute respiratory tract infection following vitamin D supplementation has been reported (43,44).…”

“…Further, reduced risk of acute respiratory tract infection following vitamin D supplementation has been reported (43,44). Notably, a recent study from the UK (31-33) that included 449 subjects (from the UK Biobank) with confirmed COVID-19 infection did not find an association between vitamin D metabolite concentration and the risk of viral infections (45) as well as COVID-19 infection (5,7,(9)(10)(11)(12)(13)(14)(15)19,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)46). Particularly, the participants were recruited by UK Biobank in the period 2006-2010 (31)(32)(33).…”

Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19

“…This antifibrotic role could be an additional element supporting the use of vitamin D supplementation before and after COVID 19 infection. However, this hypothesis will be supported by studies with longer follow-up on survivors [ 16 ].…”