Pregnancy and COVID-19: The Possible Contribution of Vitamin D

Abstract

Background: Vitamin D deficiency has been associated with the severity of COVID-19. The role of vitamin D in pregnant women with COVID-19 has been poorly investigated to date. The aim of this study was to evaluate the influence of vitamin D in affecting some clinical features in pregnancy between SARS-CoV-2 positive and negative patients. Methods: Vitamin D pathway related polymorphisms and 25-hydroxyvitamin D levels were quantified in pregnant women followed from the first to the third trimester of pregnancy. Vitamin D deficiency was considered with values ≤ 30 ng/mL. Results: In total, 160 women were enrolled: 23 resulted positive for at least one SARS-CoV-2 related test (molecular swab or antibody tests). Vitamin D-associated polymorphisms were able to affect vitamin D levels in SARS-CoV-2 negative and positive subjects: remarkably, all the VDR TaqICC genotype patients were negative for SARS-CoV-2. In a sub-population (118 patients), vitamin D levels correlated with pregnancy-related factors, such as alpha-fetoprotein levels. Third-trimester vitamin D levels were lower in preterm births compared to full-term pregnancy: this trend was highlighted for SARS-CoV-2 positive patients. Conclusions: This is the first study demonstrating a role of vitamin D in affecting the clinical characteristics of pregnant women during the COVID-19 era. Further studies in larger and different cohorts of patients are required to confirm these findings.

Evaluating the Role of BglI rs739837 and TaqI rs731236 Polymorphisms in Vitamin D Receptor with SARS-CoV-2 Variants Mortality Rate

“…Generally, meta-analyses that include these and other observational research indicate protective relationships [14,15]. Vitamin D's biological effects are mediated via its nuclear receptor, which serves as a ligand-activated transcription factor [16]. Even though the Vitamin D receptor (VDR) is abundantly expressed in lung tissue, the possible significance of vitamin D-VDR signaling in pulmonary immunopathology is unknown [17].…”

Stress of Prematurity in the Experience of the COVID-19 Pandemic—Current State of Knowledge

“…However, the COVID-19 pandemic has raised concerns about vitamin D deficiency in pregnant women, mainly due to reduced exposure to sunlight as a result of isolation and quarantine measures. This deficiency has been linked to an increased risk of preterm birth, but the exact mechanisms underlying this association are yet to be fully understood and require further scientific investigation [ 84 , 85 ].…”

“…A 2022 laboratory study conducted in Turin, Italy, on a group of 160 women, explored genetic variants related to vitamin D and their potential impact on vitamin D levels during pregnancy. The study found a significant correlation between vitamin D levels and a positive result in one of the SARS-CoV-2 tests, indicating that vitamin D deficiency may influence preterm birth [ 84 , 86 ].…”

Transcriptome‐wide profile of 1α,25 dihydroxyvitamin D3 in HTR‐8/SVneo cells

“…Vitamin D deficiency is associated with a higher risk of recurrent pregnancy loss, preeclampsia, gestational diabetes, and other pregnancy disorders, as well as fetal growth restriction, preterm birth, and changes in susceptibility to diseases in later life 8–10 . Not only that, vitamin D deficiency increases the risk of infection with influenza or severe acute respiratory syndrome coronavirus type 2 (SARS‐CoV‐2) in pregnant women 11,12 . Conversely, high vitamin D may lead to hypercalcemia 13 …”

“…[8][9][10] Not only that, vitamin D deficiency increases the risk of infection with influenza or severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in pregnant women. 11,12 Conversely, high vitamin D may lead to hypercalcemia. 13 The metabolite of vitamin D, 1α,25-dihydroxyvitamin D 3 (1,25 (OH) 2 D 3 ), is identified as the main hormone active form of vitamin D. It mainly activates the vitamin D receptor/retinoic X receptor (VDR/RXR) heterodimer complexes to the vitamin D responsive elements (VDREs), which leads to the activation or inhibition of transcription and initiates biological responses in many tissues and cell types.…”