Protective role of vitamin D status against COVID-19: a mini-review

Abstract

An outbreak of pneumonia caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is called COVID-19 and has led to a pandemic worldwide. It is reasonable to investigate and control factors affecting disease severity and mortality. The relation between vitamin D and viral pneumonia has been previously reported. Vitamin D deficiency is common and may increase hospital admission and mortality rate in patients with COVID-19. This mini-review examines the pathways that show the association between vitamin D and COVID-19. On the other hand, it deals with the available evidence related to the relationship between vitamin D deficiency and the effect of vitamin D supplementation on the prevalence, severity, and mortality of COVID-19. Also, we described the pathophysiology of the organs’ involvement in COVID-19 and the effect of vitamin D on these outcomes. Vitamin D strengthens the innate and adaptive immune system, modulates immune responses, prevents lung and cardiovascular system damage, and reduces thrombotic events. Vitamin D exerts these effects in several pathways. Vitamin D prevents virus entry and replication by maintaining the integrity of the body’s physical barrier. Vitamin D reduces the damage to vital organs and thrombotic events by increasing the level of Angiotensin-converting enzyme 2 (ACE2), nitric oxide, and antioxidants or by reducing inflammatory cytokines and free radicals. Sufficient vitamin D may be reduced morbidity and mortality due to COVID-19. However, this issue should be investigated and confirmed by further research in the future.

The Role of Free Vitamin D and Vitamin D Binding Protein in SARS-Cov-2 Infection in Children

“…Previous studies have reported that the positive effects of vitamin D on the innate and adaptive immune system and immune response modulation may prevent lung and cardiovascular system damage and decrease thrombotic events [23]. Furthermore, vitamin D may prevent virus entry and replication by protecting the integrity of physical barriers and may reduce organ damage and thrombotic events by increasing levels of angiotensin-converting enzyme 2 (ACE2), nitric oxide, and antioxidants or by reducing in ammatory cytokine and free radical levels [23]. A recent meta-analysis found that low levels of vitamin D increased the risk of severe SARS-CoV-2 disease in pediatric patients by 5.5. times and pediatric patients with VDD were at a greater risk of SARS-CoV-2 infection than patients with normal vitamin D levels [24,25].…”

“…Previous studies have reported that the positive effects of vitamin D on the innate and adaptive immune system and immune response modulation may prevent lung and cardiovascular system damage and decrease thrombotic events [23]. Furthermore, vitamin D may prevent virus entry and replication by protecting the integrity of physical barriers and may reduce organ damage and thrombotic events by increasing levels of angiotensin-converting enzyme 2 (ACE2), nitric oxide, and antioxidants or by reducing in ammatory cytokine and free radical levels [23].…”

Influence of the COVID‐19 pandemic on the vitamin D status of children: A cross‐sectional study

“…Carpagnano et al 35 reported that COVID‐19 patients had a high prevalence of hypovitaminosis D and that COVID‐19 patients with severe VD deficiency had a significantly increased risk of mortality. Meanwhile, numerous studies have shown that VD supplementation can help prevent respiratory infections and can lower ICU admission rates, mortality rates, and RT‐PCR‐positive rates in patients with COVID‐19, while having no effect on the risk of COVID‐19 infection 36–43 …”

“…33 Adequate levels of VD in the host could inhibited the release of proinflammatory cytokines, thereby lowering the risk of cytokine storm. 34 Carpagnano et al 35 [36][37][38][39][40][41][42][43] Henan is the birthplace of Han Chinese civilization, with over 3200 years of recorded history, and was China's cultural, economic, and political center until about 1000 years ago. Henan is located at latitude 34.7°N, and longitude 113.7°E, with abundant sunlight.…”

The role of free vitamin D and vitamin D binding protein in SARS‐Cov‐2 infection in children

“…28 Furthermore, vitamin D may prevent virus entry and replication by protecting the integrity of physical barriers and may reduce organ damage and thrombotic events by increasing levels of angiotensin-converting enzyme 2, nitric oxide, and antioxidants or by reducing inflammatory cytokine and free radical levels. 28 A recent meta-analysis found that low levels of vitamin D increased the risk of severe SARS-CoV-2 disease in pediatric patients by 5.5. times and pediatric patients with VDD were at a greater risk of SARS-CoV-2 infection than patients with normal vitamin D levels. 29,30 However, another recent systematic review and meta-analysis investigating the relationship between vitamin D and SARS-CoV-2 severity determined that the currently available results are still too controversial and insufficient for vitamin D to be used in intensive care units (ICUs).…”