Elsevier

Endocrine Practice

Volume 27, Issue 5, May 2021, Pages 484-493
Endocrine Practice

Review Article
Vitamin D and Its Potential Benefit for the COVID-19 Pandemic

https://doi.org/10.1016/j.eprac.2021.03.006Get rights and content

Abstract

Vitamin D is known not only for its importance for bone health but also for its biologic activities on many other organ systems. This is due to the presence of the vitamin D receptor in various types of cells and tissues, including the skin, skeletal muscle, adipose tissue, endocrine pancreas, immune cells, and blood vessels. Experimental studies have shown that vitamin D exerts several actions that are thought to be protective against coronavirus disease (COVID-19) infectivity and severity. These include the immunomodulatory effects on the innate and adaptive immune systems, the regulatory effects on the renin-angiotensin-aldosterone-system in the kidneys and the lungs, and the protective effects against endothelial dysfunction and thrombosis. Prior to the COVID-19 pandemic, studies have shown that vitamin D supplementation is beneficial in protecting against risk of acquiring acute respiratory viral infection and may improve outcomes in sepsis and critically ill patients. There are a growing number of data connecting COVID-19 infectivity and severity with vitamin D status, suggesting a potential benefit of vitamin D supplementation for primary prevention or as an adjunctive treatment of COVID-19. Although the results from most ongoing randomized clinical trials aiming to prove the benefit of vitamin D supplementation for these purposes are still pending, there is no downside to increasing vitamin D intake and having sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at a level of least 30 ng/mL (75 nmol/L) and preferably 40 to 60 ng/mL (100-150 nmol/L) to minimize the risk of COVID-19 infection and its severity.

Key words

COVID-19
25-hydroxyvitamin D
SARS-CoV-2
vitamin D

Abbreviations

ACE2
angiotensin converting enzyme 2
ARDS
acute respiratory distress syndrome
COVID-19
coronavirus disease
IL
interleukin
IU
international units
OR
odds ratio
PBMC
peripheral blood mononuclear cell
RAAS
renin-angiotensin-aldosterone
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
TH1
T helper 1
TH17
T helper 17
VDR
vitamin D receptor

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