Vitamin D as it Relates to Covid19
- Round up of all recent news regarding vitamin D as it relates to Covid19
Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis - 2023 Jan 16
In conclusion, the positive results highlighted again and now validated by TSAs suggest that an indisputable association between vitamin D supplementation and the protective effect on ICU admission can be considered definitive evidence.
In conclusion, the positive results highlighted again and now validated by TSAs suggest that an indisputable association between vitamin D supplementation and the protective effect on ICU admission can be considered definitive evidence.
Association between vitamin D supplementation and COVID-19 infection and mortality - November 2022
"Among VA patients, vitamin D3 and vitamin D2 supplementation reduced the associated risk of COVID-19 infection by 20% and 28%, and COVID-19 infection ending in death within 30-days by 33% and 25%. Black veterans receiving supplementation had a larger associated reduction than whites, although both were statistically significant, and the difference was not accounted for by differences in vitamin D serum levels. Patients with low vitamin D levels at baseline benefited more from supplementation than patients with higher serum levels. Finally, patients receiving higher cumulative dosages and higher average daily dosages had a greater associated reduction in COVID-19 infection rates than patients receiving lower dosages conditional on similar vitamin D serum levels. The most substantial dose–response relation was found in patients with the lowest vitamin D serum levels. As a widely available, inexpensive, and safe treatment, vitamin D3 could be a helpful tool for reducing the spread of COVID-19 infection and related mortality and reducing racial disparities in COVID-19 outcomes. Our findings are especially relevant to the US population, given that about half of Americans are estimated to have sub-optimal vitamin D serum levels."
"Among VA patients, vitamin D3 and vitamin D2 supplementation reduced the associated risk of COVID-19 infection by 20% and 28%, and COVID-19 infection ending in death within 30-days by 33% and 25%. Black veterans receiving supplementation had a larger associated reduction than whites, although both were statistically significant, and the difference was not accounted for by differences in vitamin D serum levels. Patients with low vitamin D levels at baseline benefited more from supplementation than patients with higher serum levels. Finally, patients receiving higher cumulative dosages and higher average daily dosages had a greater associated reduction in COVID-19 infection rates than patients receiving lower dosages conditional on similar vitamin D serum levels. The most substantial dose–response relation was found in patients with the lowest vitamin D serum levels. As a widely available, inexpensive, and safe treatment, vitamin D3 could be a helpful tool for reducing the spread of COVID-19 infection and related mortality and reducing racial disparities in COVID-19 outcomes. Our findings are especially relevant to the US population, given that about half of Americans are estimated to have sub-optimal vitamin D serum levels."
Efficacy and Safety of Vitamin D Supplementation to Prevent COVID-19 in Frontline Healthcare Workers. A Randomized Clinical Trial - study published June 2022
"Our results suggest that VD-supplementation in highly exposed individuals prevents SARS-CoV-2 infection without serious AEs and regardless of VD status."
"Our results suggest that VD-supplementation in highly exposed individuals prevents SARS-CoV-2 infection without serious AEs and regardless of VD status."
Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness - study published February 3, 2022
Vitamin D and COVID-19: The Current State of the Evidence - Chris Masterjohn
"Altogether, the Entrenas-Castillo protocol reigns supreme, because it is one out of two trials that examined the impact of vitamin D on serious endpoints in hospitalized patients, and its success can be attributed to the biological superiority of its approach: when someone is seven days into illness, vitamin D deficient, and facing acute inflammation, high-dose oral 25(OH)D is needed to rapidly raise the blood levels."
"Altogether, the Entrenas-Castillo protocol reigns supreme, because it is one out of two trials that examined the impact of vitamin D on serious endpoints in hospitalized patients, and its success can be attributed to the biological superiority of its approach: when someone is seven days into illness, vitamin D deficient, and facing acute inflammation, high-dose oral 25(OH)D is needed to rapidly raise the blood levels."
What Every MD Should Know About Vitamin D and the Immune System
Great article, with references, explaining how vitamin D works - particularly in respect of the immune system and ability to defend against the ill effects of Covid-19
"By 2020, most people could have been vitamin D replete. It would take about a tonne of D3 a day for all of humanity, at a total ex-factory cost of around USD$1B a year - 13 cents per person per year, plus the cost of making and distributing suitable weekly tablets of capsules.
"Then there would be almost no influenza, sepsis, Kawasaki disease or Multisystem Inflammatory Syndrome. Auto-immune and inflammatory diseases would be significantly reduced - but see https://aminotheory.com/cv19/#helminthsgone for the other cause of these overly-aggressive immune responses, which is harder to fix and which is the subject of promising research.
"SARS-CoV-2 would not have got very far, since most infected people would have minimal or no symptoms, and the total amount of virus shed, per such infected person, on average, would be too low, in general, to infect more than one person.
" If MDs had been doing their job properly, in respect of ensuring everyone's immune system has the nutrients it needs for proper operation - and this would involve revising or replacing advisory bodies to get rid of big-pharma influence and those who think they have nothing to learn - then there would be no COVID-19 pandemic, or the multiple horrors it has spawned: social and economic devastation, government control, loss of freedom, inability to travel etc.
Great article, with references, explaining how vitamin D works - particularly in respect of the immune system and ability to defend against the ill effects of Covid-19
"By 2020, most people could have been vitamin D replete. It would take about a tonne of D3 a day for all of humanity, at a total ex-factory cost of around USD$1B a year - 13 cents per person per year, plus the cost of making and distributing suitable weekly tablets of capsules.
"Then there would be almost no influenza, sepsis, Kawasaki disease or Multisystem Inflammatory Syndrome. Auto-immune and inflammatory diseases would be significantly reduced - but see https://aminotheory.com/cv19/#helminthsgone for the other cause of these overly-aggressive immune responses, which is harder to fix and which is the subject of promising research.
"SARS-CoV-2 would not have got very far, since most infected people would have minimal or no symptoms, and the total amount of virus shed, per such infected person, on average, would be too low, in general, to infect more than one person.
" If MDs had been doing their job properly, in respect of ensuring everyone's immune system has the nutrients it needs for proper operation - and this would involve revising or replacing advisory bodies to get rid of big-pharma influence and those who think they have nothing to learn - then there would be no COVID-19 pandemic, or the multiple horrors it has spawned: social and economic devastation, government control, loss of freedom, inability to travel etc.
Vitamin D3 and K2 and their potential contribution to reducing the COVID-19 mortality rate
Recent COVID-19-related data evaluation showed indications that a high 25(OH)D blood serum level might have an impact on the mortality rate of coronavirus patients. Even though ethical issues might arise (Muthuswamy, 2013), the paper’s hypothesis requires clinical randomized trials to verify the circumstantial evidence. This publication illustrated the metabolic mechanisms behind that observed phenomenon. It is highly suggested to also consider K2 and magnesium intake to avoid unintended long-term side-effects such as arteriosclerosis and osteoporosis.
Recent COVID-19-related data evaluation showed indications that a high 25(OH)D blood serum level might have an impact on the mortality rate of coronavirus patients. Even though ethical issues might arise (Muthuswamy, 2013), the paper’s hypothesis requires clinical randomized trials to verify the circumstantial evidence. This publication illustrated the metabolic mechanisms behind that observed phenomenon. It is highly suggested to also consider K2 and magnesium intake to avoid unintended long-term side-effects such as arteriosclerosis and osteoporosis.
Vitamin D supplementation and COVID-19 risk: a population-based, cohort study
"Conclusions: In this large, population-based study, we observed that patients supplemented with cholecalciferol or calcifediol achieving serum 25OHD levels ≥ 30 ng/ml were associated with better COVID-19 outcomes.
"Conclusions: In this large, population-based study, we observed that patients supplemented with cholecalciferol or calcifediol achieving serum 25OHD levels ≥ 30 ng/ml were associated with better COVID-19 outcomes.
"Effect of Calcifediol Treatment and best Available Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study"
Highlights
Highlights
- The vitamin D endocrine system may have a variety of actions on cells and tissues involved in COVID-19 progression.
- Administration of calcifediol or 25-hydroxyvitamin D to hospitalized COVID-19 patients significantly reduced their need for Intensive Care United admission.
- Calcifediol seems to be able to reduce severity of the disease.
Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers
Vitamin D deficiency markedly increases the chance of having severe disease after infection with SARS Cov-2. The intensity of inflammatory response is also higher in vitamin D deficient COVID-19 patients. This all translates to increase morbidity and mortality in COVID-19 patients who are deficient in vitamin D. Keeping the current COVID-19 pandemic in view authors recommend administration of vitamin D supplements to population at risk for COVID-19.
Vitamin D deficiency markedly increases the chance of having severe disease after infection with SARS Cov-2. The intensity of inflammatory response is also higher in vitamin D deficient COVID-19 patients. This all translates to increase morbidity and mortality in COVID-19 patients who are deficient in vitamin D. Keeping the current COVID-19 pandemic in view authors recommend administration of vitamin D supplements to population at risk for COVID-19.
Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results
Findings
Findings
- In this cohort study of 489 patients who had a vitamin D level measured in the year before COVID-19 testing, the relative risk of testing positive for COVID-19 was 1.77 times greater for patients with likely deficient vitamin D status compared with patients with likely sufficient vitamin D status, a difference that was statistically significant.
Mortality Risk in COVID-19 Infections
Abstract:
Abstract:
- A primary action of vitamin D is regulation of gene transcription. Many cell types possess genes that make antimicrobial peptides (AMPS) (endogenous antibiotics), recently discovered to be regulated by vitamin D. Two examples are cathelicidin and beta defensins, both bioactive against many different bacteria, fungi, mycobacteria, parasites and viruses. The signal transduction pathway is triggered by sensing microorganisms via cell surface receptors, causing intracellular production of calcitriol (1,25(OH)2D) and vitamin D receptors, leading to upregulation of AMP production. Serum 25(OH)D concentrations required to sustain adequate AMP production to eradicate infections are unknown. Vitamin D3 is photosynthesized in skin in amounts ranging from 10,000 (250 mcg) to 25,000 (625 mcg) International Units (IU) from 7-dehydrocholesterol after whole-body exposure to one minimal erythemal dose (MED) of ultraviolet B (UVB) radiation, and is impacted by many factors including geographic localities, seasonal changes and skin pigmentation. We and others have reported extended daily oral dosing with these amounts of vitamin D3 safe. We routinely observe serum 25(OH)D concentrations below 20ng/ml on new admissions, which have been reported insufficient to sustain AMP production. In contrast serum 25(OH)D concentrations above 100ng/ml have been reported after serial UVB treatments for psoriasis. Little vitamin D naturally occurs in food, and insufficient sun exposure may be causing worldwide deficiency. We review evidence suggesting that higher daily intakes of vitamin D3 than the currently recommended 600 (15 mcg) IU/day may be necessary to sustain AMP production in the face of an overwhelming infection, particularly in non-Hispanic blacks, a high risk population suffering the worst outcomes from COVID-19. We propose that increased vitamin D supplementation could provide a safe and cost-effective way to protect all populations from infections, in particular those from pandemic COVID-19.
Low plasma 25(OH) vitamin D level is associated with increased risk of COVID‐19 infection: an Israeli population‐based study
- We concluded that low plasma 25(OH)D levels appear to be an independent risk factor for COVID‐19 infection and hospitalization
The link between vitamin D deficiency and Covid-19 in a large population
- In this large observational population study, we show a strong association between vitamin D
deficiency and Covid-19 occurrence. After adjustment for baseline characteristics and prior
vitamin D levels, acquisition of liquid vitamin D formulations is associated with decreased risk for
Covid-19 infection.
Vitamin-D and COVID-19: do deficient risk a poorer outcome? (Lancet article)
Relationships between hyperinsulinaemia, magnesium, vitamin D, thrombosis and COVID-19: rationale for clinical management
- Patients with COVID-19 admitted with hyperglycaemia and/or hyperinsulinaemia should be placed on a restricted refined carbohydrate diet, with limited use of intravenous dextrose solutions. Degree/level of restriction is determined by serial testing of blood glucose, insulin and ketones. Supplemental magnesium, vitamin D and zinc should be administered. By implementing refined carbohydrate restriction, three primary risk factors, hyperinsulinaemia, hyperglycaemia and hypertension, that increase inflammation, coagulation and thrombosis risk are rapidly managed.
Immune Modulatory Effects of Vitamin D on Viral Infections
- Vitamin D has immuno-modulating properties that affect both innate and adaptive immunity (Figure 1). As vitamin D plays an integral role in regulating the immune system, researchers have been studying the role of vitamin D disease mechanisms (Table 1). Our review compiles the recent findings on the work done on relating the levels of vitamin D with different viral infections outcomes. We found that only few viruses have been studied in relation to the effect vitamin D has on them. While most of the work has been done on chronic infections such as HCV and HIV, there is some substantial research done on the influenza and other viruses. Until now, there has been no direct correlation made to vitamin D levels and Covid-19 outcome. Other viruses have not been studied in depth. However, as this paper shows that vitamin D affects the immune system in various ways, future studies are needed to understand the role of vitamin D in preventing infections caused by various viruses as well as how re- stabilizing the vitamin D levels in diseased patients can improve the outcome of the disease. Some of the works mentioned above have shown some promising results and if experimentation with other viruses shows similar results, vitamin D can be used as a readily available and inexpensive form of adjunct therapy. This will help improve the outcome of the disease and the quality of life of patients.
Study: Vitamin D Is More Effective Than Flu Vaccine
- “When a T cell is exposed to a foreign pathogen, it extends a signaling device or “antenna” known as a vitamin D receptor, with which it searches for vitamin D. This means the T cell must have vitamin D or activation of the cell will cease. If the T cells cannot find enough vitamin D in the blood, they won’t even begin to mobilize.”
Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data
Conclusions Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.
Conclusions Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.
Selenium, zinc, and vitamin D supplementation affect the clinical course of COVID-19 infection in Hashimoto’s thyroiditis
Most Hashimoto’s patients (93%) who had COVID-19 were euthyroid. The study showed that Hashimoto’s patients (24.2%) who did not take selenium, zinc and vitamin D increased their risk of adverse outcomes from COVID-19 infection. In those who did not take supplements, 28% required hospitalization. There were no deaths. After adjusting for age, gender, BMI, smoking status, we found an association between the absence of supplements and the risk of hospitalization, and invasive mechanical ventilation. Patients with Hashimoto’s thyroiditis who had COVID-19 infection and who had previously taken supplements such as selenium, zinc, and vitamin D had milder clinical outcomes, or no symptoms compared to those who did not receive supplements who had a moderate or severe outcome (P <0.05).
Most Hashimoto’s patients (93%) who had COVID-19 were euthyroid. The study showed that Hashimoto’s patients (24.2%) who did not take selenium, zinc and vitamin D increased their risk of adverse outcomes from COVID-19 infection. In those who did not take supplements, 28% required hospitalization. There were no deaths. After adjusting for age, gender, BMI, smoking status, we found an association between the absence of supplements and the risk of hospitalization, and invasive mechanical ventilation. Patients with Hashimoto’s thyroiditis who had COVID-19 infection and who had previously taken supplements such as selenium, zinc, and vitamin D had milder clinical outcomes, or no symptoms compared to those who did not receive supplements who had a moderate or severe outcome (P <0.05).
A good explanation of how Vitamin D will help reduce mortality rate from Covid19 in the video below
The importance of Vitamin D in the Covid-19 pandemic: reports from Israel
"The conclusions and implications of the two studies from Israel are perfectly clear and irrefutable. The blood level of Vitamin D is the major determinant of outcome from symptomatic Covid-19. The target blood level must be 40ng/ml, 100nmol/L, so as to optimise immunity against severe and critical Covid-19. "Had this approach been instituted as a public health initiative at the onset of the Covid-19 pandemic, there would have been many fewer deaths and very much reduced pressure on hospitals and intensive care units.
Blood level of Vitamin D less than 20ng/ml, 40nmol/L, should be regarded as critically low and requiring immediate correction. Testing the population for blood level of Vitamin D must become a public health policy. This is easily affordable."
"The conclusions and implications of the two studies from Israel are perfectly clear and irrefutable. The blood level of Vitamin D is the major determinant of outcome from symptomatic Covid-19. The target blood level must be 40ng/ml, 100nmol/L, so as to optimise immunity against severe and critical Covid-19. "Had this approach been instituted as a public health initiative at the onset of the Covid-19 pandemic, there would have been many fewer deaths and very much reduced pressure on hospitals and intensive care units.
Blood level of Vitamin D less than 20ng/ml, 40nmol/L, should be regarded as critically low and requiring immediate correction. Testing the population for blood level of Vitamin D must become a public health policy. This is easily affordable."
