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Vitamin D as it Relates to Covid19

In recent news - the Coronavirus... ​
  • Round up of all recent news regarding vitamin D as it relates to Covid19
​​"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
  • 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.
Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results

​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:
  • 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.”
A good explanation of how Vitamin D will help reduce mortality rate from Covid19 in the video below