Vitamin D micronutrient and COVID-19: the missing link

Authors

  • Sanjukta Mishra Department of Biochemistry, Kalinga Institute of Medical Science, KIIT University, Bhubaneshwar, Odisha http://orcid.org/0000-0002-0729-0034
  • Amaresh Mishra Department of Surgery, Kalinga Institute of Medical Science, KIIT University, Bhubaneshwar, Odisha
  • Swarnalata Das Department of Padiatrics, Kalinga Institute of Medical Science, KIIT University, Bhubaneshwar, Odisha

DOI:

https://doi.org/10.18203/2349-3933.ijam20210504

Keywords:

COVID-19, Immunomodulatory, Transmission, Mortality

Abstract

The current onset and expeditious increase of COVID-19, caused by severe acute respiratory distress syndrome coronavirus (SARS-CoV-2), has established a global health predicament. Declared as pandemic and public health emergency by the World Health Organization (WHO), it follows an extremely heterogeneous course from mild flu like symptoms to severe acute respiratory distress syndrome. This outbreak intimidates the public with human to human escalation, which is the primary concern worldwide with a still unforeseeable result. With limited data on plausible therapy and vaccination, it is significant to unravel the virulence mechanism of SARS-CoV-2 to delineate chemoprevention that might curb the fatal outcome. It may be acknowledged here that the primary stage of disease prevention depends on the protective immune response to eliminate the virus. This postulation kindles interest in the intervention of vitamin D micronutrient, which might unfold the feasibility of slowing disease advancement and decreasing the risk of mortality. Taking into account, the wide spectrum of beneficial effects ascribed to vitamin D like antiviral, immunomodulatory, anti-inflammatory, and antioxidant action, it can be administered to affect immune cell proliferation and angiotensin-converting enzyme (ACE) 2 expression, which is the basis of pathogenesis of transmission of SARS-CoV-2. Recently, several observational clinical and epidemiological studies underline the hypothesis regarding mean vitamin D level and COVID-19 mortality. More so some retrospective analysis reported the correlation between vitamin D level and disease severity. Nevertheless, potential clinical researches and randomised control trials are recommended in COVID-19 patients with different levels of disease extremity to appraise the useful outcomes. 

Author Biography

Sanjukta Mishra, Department of Biochemistry, Kalinga Institute of Medical Science, KIIT University, Bhubaneshwar, Odisha

Department of Biochemistry , Professor

References

Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3.

Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020;215:108427.

Harpan H, Itoh N, Yufika A, Winardi W. Coronavirus disease 2019(VOVID-19): A Literature review. J Infect Public Health. 2020;5(13):667-73.

Hoffmann M, Klein-Weber H, Schroeder S, Kruger N. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020.

Coronavirus outbreak. Available at: http://www.wordometers.info/coronavirus/. Accessed on: 24 August 2020.

Du R, Liang L, Yang C, Wang W, Cao T, Li M, et al. Predictors of mortality for patients with COVID-19 Pneumonia caused by SARS-CoV-2: A prospective cohort study. Eur Respir J. 2020.

Zaki N, Alashwal H, Ibrahim S. Association of hypertension, diabetes, stroke, cancer, kidney disease, and high-cholesterol with COVID-19 disease severity and fatality: A systematic review. Diabet Metab Synd. 2020;14(5):1133-42.

Lu R, Zhao X, Li J, Niu P. Genomic characterisation and epidemiology of 2019 novel coronavirus: implication for virus origin and receptor binding. Lancet. 2020;395(10224):565-74.

Wall AC, Park YJ, Tortorici MA, Wall A. Structure, function, and antigenicity of SARS-CoV-2 glycoprotein. Cell. 2020;16:281-92.

Qin C, Zhou L, Hu Z, Zhang S, Yang Y, Tao C, et al. Dysregulation of immune response in patients with COVID0-19 in Wuhan, China. Clin Infect Dis. 2020;12:248.

Conti P, Ronconi G, Caraffa A, Gallenga CE, Ross R, et al. Induction of pro-inflammatory cytokines(IL-1 and IL-6) and lung inflammation by coronavirus-19(COVI-19 or SARS-CoV-2): anti-inflammatory strategies. J Biol Regulators and Homeostatic Agent. 2020;14:34(2).

Mendes MM, Charlton K, Thakur S. Future perspectives in addressing the global health issues of vitamin D deficiency. Nutr Soc .2020;79:246-51.

Melamed ML, Michos ED, Post W, Astor B. 25-hydroxy vitamin D levels, and the risk of mortality in the general population. Arch Intern Med. 2008;168:1629-37.

Holick MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment, and prevention. Rev Endocrine Metab Disord. 2017;18:153-65.

Coussens AK, Martineau AR, Wilkinson RJ. Anti-inflammatory and antimicrobial actions of vitamin D in combating TB/HIV. Scientifica (Cairo). 2014;903680.

Skrobot A, Demkow U, Wachowsks M. Immunomodulatory role of vitamin D: A review. 2018;1108:13-23.

Mitchelle F. Vitamin D and COVID-19: do deficient risk a poorer outcome. The Lancet. 2020;8(7):570.

Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: a helpful immunomodulator. Immunology. 2011;134:123-239.

Gombart AF. The vitamin D- antimicrobial peptide pathway and its role in protection against infection. Future Microbiol. 2009;4:1151.

Agier J, Efenberger M, Brzezinska-Blaszczyk E. Cathelicidin impact on inflammatory cells. Cent Eur J Immunol. 2015;40:225-35.

Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020;12:236.

Cantorna MT, Snyder L, Lin YD, Yang L. Vitamin D, and 1,25-(OH)2D regulation of T cells. Nutrients. 2015;7:3011-21.

Ebadi M, Bhanji RA, Mazurak VC, Lytvyak E, MNason A, et al. Severe vitamin D deficiency is a prognostic biomarker in autoimmune hepatitis. Aliment Pharmacol Ther. 2019;49:173-82.

Ali N. Role of vitamin D in pteventing of COVID-19 infection, progression and severity. 2020;13(10):1373-80.

Grant WB, Lahore H, McDonnel SL, Baggerly CA, French CB, et al. Evidence that vitamin D supplementation could reduce the risk of influenza and COVID-19 infections and death. Nutrient. 2020;12:988.

Gröber U, Kisters K. Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinol. 2012;4(2):158-66.

Ebadi M, Montano-Loza AJ. Perspective: Improving vitamin D status in the management of COVID-19. Eur J Clin Nutr. 2020;74:856-9.

Ilie PC, Stefanescu S, Smith L. Role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. 2020;32:1195-8.

Merzon E, Tworowski D, Gorohovski A, Vinker S, Cohen AG, et al. Low plasma 25(OH) vitamin D is associated with increased risk of COVID-19 infection: an Israeli population based study. 2020;287(17):3693-702.

Daneshkhah A, Agrawal V, Eshein A, Subramanian H, Roy HK, Backman V. The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. MedRxiv. 2020;4(8):20058578.

Meltzer DO, Best TJ, Zhang H, Vokes T, Arora V, Solway J. Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results. JAMA Netw Open. 2020;3(9):2019722.

Cui C, Xu P, Li G, Qiao Y, Han W, et al. Vitamin D receptor activation regulates microglia polarization and oxidative stress in spontaneously hypertensive rats and angiotensin II-exposed microglial cells: role of the renin-angiotensin system. Redox Biol. 2019;26:101295.

Alipio M. Vitamin D Supplementation Could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (COVID-19). 2020;3571484.

Hastie CE, Mackay DF, Ho F, Celis-Morales CA, Katikireddi SV, et al. Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes Metab Syndr. 2020;14(4):561-5.

Charan J, Goyal JP, Saxena D, Yadav P. Vitamin D for prevention of respiratory tract infection: A systematic review and meta-analysis. J Pharmacol Pharmacotherap. 2012;3(4)300-3.

Loeb M, Dang AD, Thiem VD, Thanabalan V, Wang B, Nguyen NB, Tran HTM, Luong TM, Singh P, Smieja M, et al. Effect of Vitamin D supplementation to reduce respiratory infections in children and adolescents in Vietnam: A randomized controlled trial. Influenza Other Respir. Viruses. 2019;13:176-83.

Martineau AR, Cates CJ, Urashima M. Vitamin D for the management of asthma. Cochrane Database Syst Rev. 2016;9(9):CD011511.

Bergman P, Norlin AC, Hansen S. Vitamin D3 supplementation in patients with frequent respiratory tract infections: a randomised and double-blind intervention study. BMJ Open. 2012;2(6):e001663.

Ross AC, Manso JE, Abrams SA. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96:5-8.

Wimalawansa SJ. Global epidemic of coronavirus: What can we do to minimize the risks. Eur J Biomed Pharm Sci. 2020;7:432-8.

Manning J, Mitchell B, Appadurai DA. Vitamin C promotes maturation of T-cells. Antioxid Redox Signal. 2013;19(17):2054-67.

Patel N, Penkert RR, Jones BG, Sealy RE, Surman SL, Sun Y, Tang L, et al. Baseline serum vitamin A and D levels determine the benefit of oral vitamin A & D supplements to humoral immune responses following pediatric influenza vaccination. Viruses. 2019;11:907.

Velthuis AJ, vanden Worm SH, Sims AC, Baric RS, Snijder EJ, van Hemert MJ. Zn inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog. 2010;6(11):e1001176.

Downloads

Published

2021-02-23

Issue

Section

Educational Forum