Vitamin D and Covid-19
Press release from the French National Academy of Medicine 22 May 2020
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Vitamin D is a prohormone
Synthesized in the dermis under the effect of ultraviolet light
Transported to the liver and kidneys, where it is transformed into an active hormone
Responsible for intestinal absorption of calcium and bone health.
Modulates the functioning of the immune system by stimulating macrophages and dendritic cells
Role in regulating and suppressing the cytokine inflammatory response
Acute respiratory distress syndrome
A significant correlation between low serum vitamin D levels and mortality from Covid- 19
This phenomenon follows a North-South gradient
Exceptions are Nordic countries, vitamin D supplementation
Not a preventive or a therapeutic
By mitigating the inflammatory storm and its consequences, considered as an adjunct to any form of therapy.
Simple and inexpensive measure
Confirms its recommendation to ensure vitamin D supplementation in the French population
Recommends the rapid serum vitamin D (i.e. 25 OHD) testing in people over 60 years of age with Covid-19
Loading dose of 50,000 to 100,000 IU in case of deficiency, which could help limit respiratory complications;
Recommends vitamin D supplementation of 800 to 1000 IU/day in people under 60, as soon as the diagnosis of Covid-19 is confirmed.
Vitamin D: A Low-Hanging Fruit in COVID-19? (Medscape)
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Observational data from various countries suggest inverse links;
Severity of COVID-19 responses
Mortality
No randomized controlled trial
Having adequate vitamin D is important, especially for those at the highest risk of COVID-19
No role
Simply a marker
A causal factor
Spain and northern Italy, high rates of vitamin D deficiency
Spain and Italy not formally fortify foods or recommend supplementation
Norway, Finland, and Sweden had higher vitamin D levels
European countries, P = .046, 95.4% confidence, (4.6% chance this result arose by chance)
Correlation is not causality
Optimizing vitamin D status to recommendations by national and international public health agencies will certainly have, potential benefits for COVID-19 (Irish Medical Journal), [ Ссылка ]
Immune Modulation
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Data from China, France, Germany, Italy, Iran, South Korea, Spain, Switzerland, United Kingdom, United States
Risk of severe COVID-19
Vitamin D deficiency was 17.3%
Normal Vitamin D level was 14.6%
(a reduction of 15.6%).
Ethnic Minorities Disproportionately Affected
British Association of Physicians of Indian Origin (BAPIO) to get their vitamin D levels tested.
LARGE, SINGLE-DOSE, ORAL VITAMIN D SUPPLEMENTATION IN ADULT POPULATIONS: A SYSTEMATIC REVIEW
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They suggest a booster dose of 100,000 IU as a one-off
Single vitamin D3 doses ≥300,000 IU are most effective at improving vitamin D status…for up to 3 months
Daily doses of 1000 IU seem reasonable
Testing and Governmental Recommendations During COVID-19
US National Institute of Health
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400 IU to 800 IU per day, will result in blood levels that are sufficient to maintain bone health and normal calcium metabolism in healthy people
Public Health England (PHE)
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There is not sufficient evidence to support recommending Vitamin D for reducing the risk of COVID-19 (PHE)
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