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Rev Endocr Metab Disord
. 2022 Jan 4.
doi: 10.1007/s11154-021-09705-6. Online ahead of print.
Association of vitamin D status with COVID-19 and its severity : Vitamin D and COVID-19: a narrative review
Jae Hyun Bae # 1 , Hun Jee Choe # 2 , Michael F Holick 3 , Soo Lim 4
Affiliations
- PMID: 34982377
- DOI: 10.1007/s11154-021-09705-6
Abstract
Vitamin D is associated with biological activities of the innate and adaptive immune systems, as well as inflammation. In observational studies, an inverse relationship has been found between serum 25-hydroxyvitamin D (25(OH)D) concentrations and the risk or severity of coronavirus disease 2019 (COVID-19). Several mechanisms have been proposed for the role of vitamin D in COVID-19, including modulation of immune and inflammatory responses, regulation of the renin-angiotensin-aldosterone system, and involvement in glucose metabolism and cardiovascular system. Low 25(OH)D concentrations might predispose patients with COVID-19 to severe outcomes not only via the associated hyperinflammatory syndrome but also by worsening preexisting impaired glucose metabolism and cardiovascular diseases. Some randomized controlled trials have shown that vitamin D supplementation is beneficial for reducing severe acute respiratory syndrome coronavirus 2 RNA positivity but not for reducing intensive care unit admission or all-cause mortality in patients with moderate-to-severe COVID-19. Current evidence suggests that taking a vitamin D supplement to maintain a serum concentration of 25(OH)D of at least 30 ng/mL (preferred range 40-60 ng/mL), can help reduce the risk of COVID-19 and its severe outcomes, including mortality. Although further well designed studies are warranted, it is prudent to recommend vitamin D supplements to people with vitamin D deficiency/insufficiency during the COVID-19 pandemic according to international guidelines.
Keywords: COVID-19; Immunomodulation; Inflammation; Renin–angiotensin–aldosterone system; Vitamin D.
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