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1.
BMJ Open ; 12(8): e059477, 2022 08 04.
Article in English | MEDLINE | ID: covidwho-1973842

ABSTRACT

OBJECTIVES: Since the onset of the COVID-19 pandemic in 2020, there have been plausible suggestions about the need to augment vitamin D intake by supplementation in order to prevent SARS-CoV2 infection and reduce mortality. Some groups have advocated supplementation for all adults, but governmental agencies have advocated targeted supplementation. We sought to explore the effect of the COVID-19 pandemic on both vitamin D status and on the dose of new-to-market vitamin D supplements. SETTING: University hospital, Dublin, Ireland. PARTICIPANTS: Laboratory-based samples of circulating 25-hydroxyvitamin D (25OHD) (n=100 505). PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes: comparing yearly average 25OHD prior to the pandemic (April 2019 to March 2020) with during the pandemic (April 2020 to March 2021) and comparing the dose of new-to-market vitamin D supplements between 2017 and 2021 (n=2689). SECONDARY OUTCOME: comparing prevalence of vitamin D deficiency and vitamin D excess during the two time periods. RESULTS: The average yearly serum 25OHD measurement increased by 2.8 nmol/L (61.4, 95% CI 61.5 to 61.7 vs 58.6, 95% CI 58.4 to 58.9, p<0.001), which was almost threefold higher than two similar trend analyses that we conducted between 1993 and 2016. There was a lower prevalence of low 25OHD and a higher prevalence of high 25OHD. The dose of new-to-market vitamin D supplements was higher in the years 2020-2021 compared with the years 2017-2019 (p<0.001). CONCLUSIONS: We showed significant increases in serum 25OHD and in the dose of new-to-market vitamin D supplements. The frequency of low vitamin D status reduced indicating benefit, but the frequency of vitamin D excess increased indicating risk of harm. Rather than a blanket recommendation about vitamin D supplementation for all adults, we recommend a targeted approach of supplementation within current governmental guidelines to at-risk groups and cautioning consumers about adverse effects of high dose supplements on the market.


Subject(s)
COVID-19 , Vitamin D Deficiency , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Dietary Supplements , Humans , Pandemics/prevention & control , RNA, Viral , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/prevention & control , Vitamins
2.
Int J Environ Res Public Health ; 19(5)2022 Mar 03.
Article in English | MEDLINE | ID: covidwho-1736920

ABSTRACT

Human milk is the best food for infants. Breastfeeding has been associated with a reduced risk of viral and bacterial infections. Breast milk contains the perfect amount of nutrients needed to promote infant growth, except for vitamin D. Vitamin D is crucial for calcium metabolism and bone health, and it also has extra-skeletal actions, involving innate and adaptive immunity. As exclusive breastfeeding is a risk factor for vitamin D deficiency, infants should be supplemented with vitamin D at least during the first year. The promotion of breastfeeding and vitamin D supplementation represents an important objective of public health.


Subject(s)
Breast Feeding , Vitamin D Deficiency , Dietary Supplements , Female , Humans , Infant , Milk, Human , Vitamin D/therapeutic use , Vitamin D Deficiency/drug therapy , Vitamin D Deficiency/prevention & control
3.
Acta Biomed ; 92(S6): e2021451, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1472540

ABSTRACT

BACKGROUND AND AIM: Vitamin D is known to modulate immune response and its deficiency was associated with respiratory distress in patients hospitalized for pneumonia. Nevertheless, numerous reviews on vitamin D in COVID-19 patients have shown conflicting results, as previously reported also for other respiratory diseases (e.g., influenza). METHODS: This umbrella review aims to assess whether low serum 25-OHD is associated with susceptibility to COVID 19, their severity, and mortality. A total of 1559 studies were excluded after the title, abstract and full-text articles screening and 9 papers were included in this review: 2 systematic reviews and 7 metanalysis. RESULTS: The findings of this review that summarized studies from 5 WHO regions (European Region, Region of the Americas, South-East Asia Region, Eastern Mediterranean Region, Western Pacific Region) to exclusion only African region, show that low serum 25-OHD levels are associated with higher infection risks for COVID-19. CONCLUSIONS: Although the umbrella findings indicate a potential role of vitamin D deficiency in COVID-19 severity in hospitalized patients and showing an association between Vitamin D supplementation and COVID-19 severity, however, more robust data from randomized controlled trials are further needed to confirm a possible association with the mortality rates.


Subject(s)
COVID-19 , Vitamin D Deficiency , Humans , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/prevention & control , Vitamins/therapeutic use
6.
Photodermatol Photoimmunol Photomed ; 36(5): 412-413, 2020 09.
Article in English | MEDLINE | ID: covidwho-1388391
10.
J Steroid Biochem Mol Biol ; 211: 105883, 2021 07.
Article in English | MEDLINE | ID: covidwho-1155560

ABSTRACT

Vitamin D modulates the systemic inflammatory response through interaction with immune system. As such, it has a possible protective role against the risk of respiratory tract infections and other diseases. It may be useful in particular, during COVID-19 pandemic. PubMed, the Cochrane Library, and EMBASE were searched from inception until January 31, 2021, for observational or clinical studies reporting the prognosis (and therapeutic effect) of COVID-19 infection in patients with deficient vitamin D levels. The infection rate, severity, and death from COVID-19 infection were pooled to provide an odds ratio with a 95 % confidence interval (OR 95 % CI). An OR > 1 was associated with the worst outcome in deficient compared with nondeficient patients. We assessed the association between vitamin D and risk, severity, and mortality for COVID-19 infection, through a review of 43 observational studies. Among subjects with deficient vitamin D values, risk of COVID-19 infection was higher compared to those with replete values (OR = 1.26; 95 % CI, 1.19-1.34; P < .01). Vitamin D deficiency was also associated with worse severity and higher mortality than in nondeficient patients (OR = 2.6; 95 % CI, 1.84-3.67; P < .01 and OR = 1.22; 95 % CI, 1.04-1.43; P < .01, respectively). Reduced vitamin D values resulted in a higher infection risk, mortality and severity COVID-19 infection. Supplementation may be considered as preventive and therapeutic measure.


Subject(s)
COVID-19/epidemiology , Dietary Supplements , Pandemics , SARS-CoV-2/pathogenicity , Vitamin D Deficiency/epidemiology , Vitamin D/therapeutic use , COVID-19/blood , COVID-19/mortality , COVID-19/prevention & control , Humans , Immunity, Innate/drug effects , Incidence , Observational Studies as Topic , Odds Ratio , Prognosis , Risk , Severity of Illness Index , Survival Analysis , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/mortality , Vitamin D Deficiency/prevention & control
11.
Eur Rev Med Pharmacol Sci ; 25(4): 2131-2145, 2021 02.
Article in English | MEDLINE | ID: covidwho-1116634

ABSTRACT

The world is currently facing the COVID-19 pandemic, caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Due to a lack of specific treatment and prophylaxis, protective health measures that can reduce infection severity and COVID-19 mortality are urgently required. Clinical and epidemiological studies have shown that vitamin D deficiency can be linked to an increased risk of viral infection, including COVID-19. Therefore, in this review, we looked at various possible roles of vitamin D in reducing the risk of COVID-19 infection and severity. We describe in this article that individuals at high risk of vitamin D deficiency should consider taking vitamin D supplements to keep optimal concentrations. Moreover, we discuss different possible mechanisms by which vitamin D can efficiently reduce the risk of infections through modulation of innate and adaptive immunity against various types of infections. It is advisable to perform further studies addressing the observed influence of vitamin D levels to reduce the risk of COVID-19 infection and mortality.


Subject(s)
COVID-19/drug therapy , Protective Agents/therapeutic use , SARS-CoV-2 , Vitamin D Deficiency/prevention & control , Vitamin D/therapeutic use , Adaptive Immunity/drug effects , Bystander Effect , COVID-19/immunology , COVID-19/mortality , COVID-19/transmission , Dietary Supplements , Humans , Immunity, Innate/drug effects , Protective Agents/administration & dosage , Severity of Illness Index , Vitamin D/administration & dosage , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/immunology
12.
Clin Med (Lond) ; 21(2): e144-e149, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1089178

ABSTRACT

The value of vitamin D supplementation in the treatment or prevention of various conditions is often viewed with scepticism as a result of contradictory results of randomised trials. It is now becoming apparent that there is a pattern to these inconsistencies. A recent large trial has shown that high-dose intermittent bolus vitamin D therapy is ineffective at preventing rickets - the condition that is most unequivocally caused by vitamin D deficiency. There is a plausible biological explanation since high-dose bolus replacement induces long-term expression of the catabolic enzyme 24-hydroxylase and fibroblast growth factor 23, both of which have vitamin D inactivating effects. Meta-analyses of vitamin D supplementation in prevention of acute respiratory infection and trials in tuberculosis and other conditions also support efficacy of low dose daily maintenance rather than intermittent bolus dosing. This is particularly relevant during the current COVID-19 pandemic given the well-documented associations between COVID-19 risk and vitamin D deficiency. We would urge that clinicians take note of these findings and give strong support to widespread use of daily vitamin D supplementation.


Subject(s)
COVID-19 , Dietary Supplements , Respiratory Tract Infections , Rickets , Vitamin D Deficiency , Vitamin D , Humans , Pandemics , Respiratory Tract Infections/prevention & control , Rickets/prevention & control , SARS-CoV-2 , Vitamin D/therapeutic use , Vitamin D Deficiency/drug therapy , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/prevention & control
14.
Int J Environ Res Public Health ; 18(2)2021 01 16.
Article in English | MEDLINE | ID: covidwho-1067729

ABSTRACT

The foremost mortality-causing symptom associated with COVID-19 is acute respiratory distress syndrome (ARDS). A significant correlation has been identified between the deficiency in vitamin D and the risk of developing ARDS. It has been suggested that if we can reduce or modify ARDS in COVID-19 patients, we may significantly reduce the severity of COVID-19 symptoms and associated mortality rates. The increased mortality of dark-skinned people, who have a reduced UV absorption capacity, may be consistent with diminished vitamin D status. The factors associated with COVID-19 mortality, such as old age, ethnicity, obesity, hypertension, cardiovascular diseases, and diabetes, are all found to be linked with vitamin D deficiency. Based on this review and as a precautionary measure, it is suggested that the adoption of appropriate and safe solar exposure and vitamin D enriched foods and supplements should be considered to reduce the possible severity of COVID-19 symptoms. Safe sun exposure is deemed beneficial globally, specifically in low and middle-income countries, as there is no cost involved. It is also noted that improved solar exposure and vitamin D levels can reduce the impact of other diseases as well, thus assisting in maintaining general human well-being.


Subject(s)
COVID-19/therapy , Sunlight , Vitamin D/therapeutic use , COVID-19/prevention & control , Humans , Respiratory Distress Syndrome/prevention & control , Respiratory Distress Syndrome/therapy , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/prevention & control
15.
Int J Environ Res Public Health ; 18(2)2021 01 16.
Article in English | MEDLINE | ID: covidwho-1031135

ABSTRACT

The foremost mortality-causing symptom associated with COVID-19 is acute respiratory distress syndrome (ARDS). A significant correlation has been identified between the deficiency in vitamin D and the risk of developing ARDS. It has been suggested that if we can reduce or modify ARDS in COVID-19 patients, we may significantly reduce the severity of COVID-19 symptoms and associated mortality rates. The increased mortality of dark-skinned people, who have a reduced UV absorption capacity, may be consistent with diminished vitamin D status. The factors associated with COVID-19 mortality, such as old age, ethnicity, obesity, hypertension, cardiovascular diseases, and diabetes, are all found to be linked with vitamin D deficiency. Based on this review and as a precautionary measure, it is suggested that the adoption of appropriate and safe solar exposure and vitamin D enriched foods and supplements should be considered to reduce the possible severity of COVID-19 symptoms. Safe sun exposure is deemed beneficial globally, specifically in low and middle-income countries, as there is no cost involved. It is also noted that improved solar exposure and vitamin D levels can reduce the impact of other diseases as well, thus assisting in maintaining general human well-being.


Subject(s)
COVID-19/therapy , Sunlight , Vitamin D/therapeutic use , COVID-19/prevention & control , Humans , Respiratory Distress Syndrome/prevention & control , Respiratory Distress Syndrome/therapy , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/prevention & control
18.
Health Secur ; 19(3): 302-308, 2021.
Article in English | MEDLINE | ID: covidwho-978574

ABSTRACT

Each patient's immune defenses play a major role in mitigating the impact (ie, morbidity and mortality) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). Vitamin D is an important modulator of the immune system. Although serum 25-hydroxyvitamin D levels can be raised through diet or supplements, most vitamin D in the body is the result of dermal synthesis from ultraviolet radiation. The production of vitamin D in the skin, however, can be limited by latitude, skin-covering clothes, the use of sunblock, and skin pigmentation. Vitamin D deficiency affects a high percentage of the world population. Serum 25-hydroxyvitamin D levels are suboptimal, not only in specific risk groups but also in adults from many countries. Low vitamin D levels, therefore, represent a risk factor for several different pathologies, including SAR-CoV-2. This study used an ecological design to assess the association between vitamin D deficiency and COVID-19 incidence, complications, and mortality across 46 countries. All data were obtained from published sources. The results of the study suggest an association at the population level between the prevalence of vitamin D deficiency and the risk of being infected with COVID-19, severity of the disease, and risk of dying from it.


Subject(s)
COVID-19/mortality , Vitamin D Deficiency/mortality , Vitamin D/therapeutic use , Vitamins/therapeutic use , COVID-19/blood , COVID-19/prevention & control , Dietary Supplements/statistics & numerical data , Humans , Incidence , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/prevention & control
20.
Clin Med (Lond) ; 21(1): e48-e51, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-914784

ABSTRACT

There is growing evidence linking vitamin D deficiency with risk of COVID-19. It is therefore distressing that there is major disagreement about the optimal serum level for 25-hydroxyvitamin D (25(OH)D) and appropriate supplement dose. The UK Scientific Advisory Committee for Nutrition has set the lowest level for defining sufficiency (10 ng/ml or 25 nmol/L) of any national advisory body or scientific society and consequently recommends supplementation with 10 micrograms (400 IU) per day. We have searched for published evidence to support this but not found it. There is considerable evidence to support the higher level for sufficiency (20 ng/ml or 50 nmol/L) recommended by the European Food Safety Authority and the American Institute of Medicine and hence greater supplementation (20 micrograms or 800 IU per day). Serum 25(OH)D concentrations in the UK typically fall by around 50% through winter. We believe that governments should urgently recommend supplementation with 20-25 micrograms (800-1,000 IU) per day.


Subject(s)
COVID-19/epidemiology , Pandemics , Vitamin D Deficiency/prevention & control , Vitamin D/analogs & derivatives , Vitamin D/administration & dosage , Dietary Supplements , Dose-Response Relationship, Drug , Humans , SARS-CoV-2 , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/epidemiology , Vitamins/administration & dosage
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