Therapeutic Vitamin D Supplementation Following COVID-19 Diagnosis: Where Do We Stand?—A Systematic Review

Bania, Angelina; Pitsikakis, Konstantinos; Mavrovounis, Georgios; Mermiri, Maria; Beltsios, Eleftherios T.; Adamou, Antonis; Konstantaki, Vasiliki; Makris, Demosthènes; Tsolaki, Vasiliki; Gourgoulianis, Konstantinos; Pantazopoulos, Ioannis

doi:10.3390/jpm12030419

Cited by 8 publications

(8 citation statements)

References 60 publications

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“…[65] In contrast, treatment with 25(OH)D [calcifediol] does not induce adverse self-regulatory effects, [65] and there are now several observational reports of its use in Covid-19 showing reductions in the need for intensive care and in mortality. [66] In line with what is known about the protective effects of vitamin D against infection, reduced rates of Covid-19 illness are reported with higher pre-pandemic serum 25(OH)D levels in almost 200,000 people across all 50 of the United States of America, [67] the risk reductions plateauing at 25(OH)D values of ~100 nmol/l and similar risk reductions are reported from elsewhere. [68,69] Furthermore, UK-Biobank Data reports reductions in Covid-19 illness rates in those reporting taking vitamin D supplements at recruitment but not in those taking any other types of vitamin supplements.…”

Section: Than Any Others Remains Unacceptable Since Deficiency Increa...supporting

confidence: 63%

Vitamin D deficiency in British South Asians, a persistent but avoidable problem associated with many health risks (including rickets, T2DM, CVD, COVID-19 and pregnancy complications): the case for correcting this deficiency

Boucher

2022

Endocrine Connections

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High vitamin D deficiency rates, with rickets and osteomalacia, have been common in south Asians (SAs) arriving in Britain since the 1950s with preventable infant deaths from hypocalcaemic status-epilepticus and cardiomyopathy. Vitamin D deficiency increases common SA disorders (type 2 diabetes and cardiovascular disease), recent trials and non-linear Mendelian randomisation studies having shown deficiency to be causal for both disorders. Ethnic minority, obesity, diabetes and social deprivation are recognised COVID-19 risk factors but vitamin D deficiency isn’t, despite convincing mechanistic evidence of it. Adjusting analyses for obesity/ethnicity abolishes vitamin D deficiency in COVID-19 risk prediction but both factors lower serum 25(OH)D specifically. Social deprivation inadequately explains increased ethnic-minority COVID-19 risks. SA vitamin D deficiency remains uncorrected after 70 years, official bodies using ‘education’, ‘assimilation’ and ‘diet’ as ‘proxies’ for ethnic differences and increasing pressures to assimilate. Meanwhile, English rickets was abolished from ~1940 by free ‘welfare foods’ (meat, milk, eggs, cod-liver-oil), for all pregnant/nursing mothers and young children (<5 years old). Cod-liver-oil was withdrawn from antenatal clinics from 1994 (for excessive vitamin A teratogenicity), without alternative provision. The take-up of 2006 ‘Healthy-Start’ scheme food-vouchers for low-income families with young children (<3 years old) has been poor, being inaccessible and poorly publicized. COVID-19 pandemic advice for UK adults in ‘lockdown’ was ‘400 IU vitamin D/day’, inadequate for correcting the deficiency seen winter/summer at 17.5%/5.9% in White, 38.5%/30% in Black and 57.2%/50.8% in SA people in representative UK Biobank subjects when recruited ~14 years ago and remaining similar in 2018. Vitamin D inadequacy worsens many non-skeletal health risks. Not providing vitamin D for preventing SA rickets and osteomalacia continues to be unacceptable, as deficiency-related health risks increase ethnic health disparities, while abolishing vitamin D deficiency would be easier and more cost-effective than correcting any other factor worsening ethnic minority health in Britain

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Section: Than Any Others Remains Unacceptable Since Deficiency Increa...supporting

confidence: 63%

Vitamin D deficiency in British South Asians, a persistent but avoidable problem associated with many health risks (including rickets, T2DM, CVD, COVID-19 and pregnancy complications): the case for correcting this deficiency

Boucher

2022

Endocrine Connections

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“…The possible role of vitamin D supplementation in the treatment of COVID-19 has already been assessed in randomized controlled trials, but as pointed out in recent meta-analyses, large variations in vitamin D supplementation schemes in the hitherto published studies means that no definitive conclusion can be drawn on the therapeutic effect of vitamin D, until larger well-designed interventional studies addressing issues such as the appropriate dose, duration and mode of vitamin D administration have been completed [48][49][50] .…”

Section: Discussionmentioning

confidence: 99%

Vitamin D status and severity of COVID-19

Nielsen

Junker

Boelt³

et al. 2022

Sci Rep

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We explored the association between COVID-19 severity and vitamin D status using information from Danish nation-wide health registers, the COVID-19 surveillance database and stored blood samples from the national biobank. 25-hydroxyvitamin D (25(OH)D) was measured using tandem mass spectroscopy. The association between 25(OH)D levels and COVID-19 severity, classified hierarchical as non-hospitalized, hospitalized but not admitted to an intensive care unit (ICU), admitted to ICU, and death, was evaluated by proportional odds ratios (POR) assuming proportionality between the four degrees of severity. Among 447 adults tested SARS-CoV-2 positive in the spring of 2020, low levels of 25(OH)D were associated with a higher risk of severe COVID-19. Thus, odds of experiencing more severe COVID-19 among individuals with insufficient (25 to < 50 nmol/L) and sufficient (≥ 50 nmol/L) 25(OH)D levels were approximately 50% of that among individuals with deficient levels (< 25 nmol/L) (POR = 0.49 (95% CI 0.25–0.94), POR = 0.51 (95% CI 0.27–0.96), respectively). Dividing sufficient vitamin D levels into 50 to < 75 nmol/L and ≥ 75 nmol/L revealed no additional beneficial effect of higher 25(OH)D levels. In this observational study, low levels of 25(OH)D were associated with a higher risk of severe COVID-19. A possible therapeutic role of vitamin D should be evaluated in well-designed interventional studies.

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“…This finding is consistent with the results of several systematic reviews and meta‐analyses, that assessed the impact of vit D supplementation and mortality in patients hospitalized with COVID‐19 and noted that vit D supplement was related to a reduction in the risk of COVID‐19 mortality. 42 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 …”

Section: Discussionmentioning

confidence: 99%

The association between vitamin D intake with inflammatory and biochemical indices and mortality in critically ill patients with COVID‐19: A case‐control study

Rabbani

Ahmadzadeh

Hajipour

et al. 2023

Immunity Inflam & Disease

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Background The coronavirus disease‐2019 (COVID‐19) has become a worldwide health issue with widespread hospitalization and dependence on the intensive care unit (ICU). Vitamin D has a key role in modulating immune cells and modulating the inflammatory responses. This study aimed to investigate the association of vitamin D supplementation with inflammatory, biochemical, and mortality indices in critically ill patients with COVID‐19. Methods This case‐control study was conducted on critically ill COVID‐19 patients hospitalized in the ICU including the survived >30 day patients as the case group and dead patients as the control group. The status of vitamin D supplementation and inflammatory and biochemical indices of the patients were retrieved from the medical records. Logistic regression method was used to assess the association between 30 days survival and vitamin D supplement intake. Results Compared to the group of COVID‐19 patients who died in <30 day, the survived patients had a lower eosinophile level (2.2 ± 0.5 vs. 6 ± 0.0, p < .001) and higher vitamin D supplementation duration (9 ± 4.4 vs. 3.3 ± 1.9 day, p = .001). Vitamin D supplementation had a positive association with survival in COVID‐19 patients (OR: 1.98, 95% CI: 1.15−3.40, p < .05). The association remained significant after adjustments fot age, sex, underlying diseases, and smoking. Conclusion Vitamin D supplementation in critically ill patients with COVID‐19 has the potential to increase survivability within the first 30 days of hospitalization.

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Therapeutic Vitamin D Supplementation Following COVID-19 Diagnosis: Where Do We Stand?—A Systematic Review

Cited by 8 publications

References 60 publications

Vitamin D deficiency in British South Asians, a persistent but avoidable problem associated with many health risks (including rickets, T2DM, CVD, COVID-19 and pregnancy complications): the case for correcting this deficiency

Vitamin D deficiency in British South Asians, a persistent but avoidable problem associated with many health risks (including rickets, T2DM, CVD, COVID-19 and pregnancy complications): the case for correcting this deficiency

Vitamin D status and severity of COVID-19

The association between vitamin D intake with inflammatory and biochemical indices and mortality in critically ill patients with COVID‐19: A case‐control study

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