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Rev Endocr Metab Disord. 2022;23(3):579-599.

Association of vitamin D status with COVID-19 and its severity : Vitamin D and COVID-19: a narrative review.

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제1저자 배재현, 최훈지 · 교신저자 임수

소속 (4)
  1. Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
  2. Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
  3. Section of Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University Medical Campus, 715 Albany St #437, Boston, MA, 02118, USA.
  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam, 13620, South Korea. limsoo@snu.ac.kr.

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.

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

COVID-19ImmunomodulationInflammationRenin–angiotensin–aldosterone systemVitamin D

Figures

Fig. 1
Fig. 1 Proposed pathogenic mechanisms leading to severe COVID-19 outcomes in individuals with vitamin D deficiency or insufficiency. ACE2, angiotensin-converting enzyme 2; COVID-19, coronavirus disease 2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2. References for evidence: cytokine production [41]; immune modulation [18, 29]; inflammation [53]; blood glucose concentration [149]; renin and angiotensin II levels [64]; and thromboembolic risk [104]
Fig. 2
Fig. 2 The effects of vitamin D supplementation on (A) SARS-CoV-2 RNA positivity in asymptomatic or mildly symptomatic patients with COVID-19 [17, 122] and (B) all-cause mortality [16, 125] or (C) ICU admission [16, 125] in moderate-to-severe COVID-19 patients. COVID-19, coronavirus disease 2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; CI, confidence interval; ICU, intensive care unit; M-H, Mantel–Haenszel method
Fig. 3
Fig. 3 Potential effects of optimum levels of vitamin D on critical pathways involved in the progress of COVID-19. COVID-19, coronavirus disease 2019; IL-6, interleukin-6; Th1, type 1 helper T cell; Th2, type 2 helper T cell; TNF-α, tumor necrosis factor-α. References for evidence: antimicrobial peptides [36]; T cell responses [43]; apoptosis of infected respiratory epithelial cells [150]; and inflammatory cytokines [58]
Fig. 4
Fig. 4 Impacts of SARS-CoV-2 infection on human biological systems and proposed favorable effects of vitamin D on pathogenic processes involved in COVID-19. ARDS, acute respiratory distress syndrome; COVID-19, coronavirus disease 2019; RAAS, renin–angiotensin–aldosterone system; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; Th1, type 1 helper T cell; Th2, type 2 helper T cell; Th17, type 17 helper T cell; Treg, regulatory T cell

그림 출처: PubMed Central 공개 논문 (PMC8724612)

Conflict of interest statement

The authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article, Review
저널
Reviews in endocrine & metabolic disorders · eISSN 1573-2606
전자 출판
2022-01-04
MeSH
Glucose · Humans · Pandemics · SARS-CoV-2 · Vitamin D · COVID-19 Drug Treatment*
Substances
Vitamin D · Glucose
참고문헌
178편