Vitamin D and coronavirus (COVID-19)

Whilst the current pandemic continues to cause uncertainty around the world there has been lots of discussion around vitamin D and coronavirus (COVID-19). There have been multiple scientific publications commenting on the potential benefits vitamin D could have against coronavirus (1,2). As we know there is currently no proven treatment or vaccine to prevent the coronavirus infection. However, there is mounting evidence from around the world suggesting that vitamin D could play an important part in the fight against coronavirus mortality.

What happens when you contract COVID-19?

So what actually happens to those who contract COVID-19 and become seriously ill? Infection with SARS-CoV-2, which causes the COVID-19 disease, can lead to an acute respiratory distress syndrome due to the rapid release of inflammatory cytokines (which has been described as ‘cytokine storm’). A cytokine storm is an overreaction of the immune system, leading to an uncontrolled response of the immune cells. In susceptible populations such as the elderly, or patients with chronic diseases, this overreaction can be fatal (2).

What does Vitamin D do?

Vitamin D plays an important role in maintaining the immune system, and it has been shown to help the body against respiratory viruses, including syncytial virus, influenza (flu) and coronaviruses (3,4).  

Several studies have suggested that low vitamin D levels are associated with higher mortality rates in COVID-19 patients (3,5-8). However, currently these are just observational studies, and further studies will have to be carried out before we can draw conclusions.

There are several clinical trials currently underway to investigate the role of vitamin D on COVID-19 severity (9-11), including CORONAVIT12, a study that will be done by researchers from Queen Mary University in London. 

Whilst it is clear that vitamin D supplementation will not prevent or revert coronavirus, the increasing data suggests it could be one of the most easily accessible tools we have that can help our immune system to be at its best.

References:

1. Chakhtoura M, Napoli N, El Hajj Fuleihan G. Commentary: Myths and facts on vitamin D amidst the COVID-19 pandemic. Metabolism. 2020; 109:154276. https://pubmed.ncbi.nlm.nih.gov/32470350/

2. Arboleda JF, Urcuqui-Inchima S. Vitamin D supplementation: a potential approach for coronavirus/COVID-19 Therapeutics? Front Immunol. 2020; 11:1523.https://pubmed.ncbi.nlm.nih.gov/32655583/

3. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. 2020; 32(7):1195-1198. https://pubmed.ncbi.nlm.nih.gov/32377965/

4. Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50(3):194-200 https://pubmed.ncbi.nlm.nih.gov/21242105/

5. Rhodes JM, Subramanian S, Laird E, Kenny RA. Editorial: low population mortality from COVID-19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity. Aliment Pharmacol Ther. 2020; 51(12):1434-1437 https://pubmed.ncbi.nlm.nih.gov/32311755/

6. Panarese A, Shahini E. Letter: Covid-19, and vitamin D. Aliment Pharmacol Ther. 2020; 51(10):993-995 https://pubmed.ncbi.nlm.nih.gov/32281109/

7. Al-Ani AH, Prentice RE, Rentsch CA, Johnson D, Ardalan Z, Heerasing N, Garg M, Campbell S, Sasadeusz J, Macrae FA, Ng SC, Rubin DT, Christensen B. Review article: prevention, diagnosis and management of COVID-19 in the IBD patient. Aliment Pharmacol Ther. 2020; 52(1):54-72 https://pubmed.ncbi.nlm.nih.gov/32348598/

8. Carpagnano GE, Di Lecce V, Quaranta VN, Zito A, Buonamico E, Capozza E, Palumbo A, Di Gioia G, Valerio VN, Resta O. Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. J Endocrinol Invest. 2020;1-7 https://pubmed.ncbi.nlm.nih.gov/32772324/

9. ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US).  Identifier NCT04334005. Vitamin D on prevention and treatment of COVID-19 (COVTID-19). April 3, 2020

10. ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US).  Identifier NCT04344041. COvid-19 and vitamin D supplementation: a multicenter randomized controlled trial or high dose versus standard dose vitamin D3 in high-risk COVID-19 patients (CoVitTrial). April 14, 2020

11. ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US).  Identifier NCT04363840. The LEAD COVID-19 Trial: Low-risk, early aspirin and vitamin D to reduce COVID-19 hospitalizations (LEAD COVID-19). April 27, 2020

12. ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US).  Identifier NCT04579640. Trial of vitamin D to reduce risk and severity of COVID-19 and other acute respiratory infections (CORONAVIT). October 8, 2020