COVID and Vitamin D, What's cooking?

KEYWORDS: Vitamin D, Treg cells, inflammation, COVID19, pandemic, Cytokine Release Syndrome, sepsis, supplements, Vitamin D toxicity

The pandemic of COVID has affected worldly lives just like those epidemics and infections prior in the history occurred. Its pathogenesis is still under trials and observations, however, when we analyse the role of vitamin D in COVID, we get to know some interesting facts.The severity of coronavirus 2019 infection (COVID-19) is determined by the presence of pneumonia, severe acute respiratory distress syndrome (SARS-CoV-2), myocarditis, microvascular thrombosis and/or cytokine storms, all of which involve underlying inflammation. A principal defence against uncontrolled inflammation, and against viral infection in general, is provided by T regulatory lymphocytes (Tregs). Treg levels have been reported to be low in many COVID-19 patients and can be increased by vitamin D supplementation. Low vitamin D levels have been associated with an increase in inflammatory cytokines and a significantly increased risk of pneumonia and viral upper respiratory tract infections. Vitamin D deficiency is associated with an increase in thrombotic episodes, which are frequently observed in COVID-19. Vitamin D deficiency has been found to occur more frequently in patients with obesity and diabetes. These conditions are reported to carry a higher mortality in COVID-19. If vitamin D does in fact reduce the severity of COVID-19 in regard to pneumonia/ARDS, inflammation, inflammatory cytokines and thrombosis, it is our opinion that supplements would offer a relatively easy option to decrease the impact of the pandemic. A lot of studies showed that people deficient in vitamin D are more prone to carry COVID19.

According to Pulse International Pakistan, a clinical trial conducted by Prof. Javed Akram, Vice Chancellor of University of Health Sciences showed that almost 79% of Pakistani population is suffering from Vitamin-D deficiency. Speaking on Covid19, Vitamin-D and infectious diseases Prof. Faridoon Jawad said that vitamin-D is also helpful in controlling the symptoms of Flue. It has been found extremely helpful in improving the symptoms of Covid19 patients as well. Also LDH level improve after the use of Sunny Vitamin-D. He further tells that the data of this trial is currently being analyzed and molecule level, inflammatory level is also under analysis.

 

The presence and severity of COVID19 has been determined by acute respiratory syndrome, pneumonia and several conditions carrying inflammation in or around the respiratory tract. But as a matter of fact, when body is bound to start defense mechanisms, a number of white blood cells, including B cells, T cells, natural killer cells, macrophages and monocytes are activated and release inflammatory cytokines which activate more white blood cells in a positive feedback loop of pathogenic inflammation. As a consequence, increased inflammatory cells will lead to more inflammation of already inflamed conditions in acute respiratory syndrome, this is known as Cytokine Release Syndrome leading to hyper inflammation & sepsis. However, T regulatory cells, which regulate/suppress this abnormal increment in immune response to prevent autoimmune disease; can be a rescue to the condition.

These Treg cells have been recently reported to be low in many of the COVID infected patients, illustrated by the fact that low vitamin D levels are commonly associated with a significantly increased risk of upper respiratory tract infections. Hence Treg cells can be increased by the intake of vitamin D and supplementation. Low levels of vitamin D are also associated with an increase in inflammatory cytokines.KEYWORDS: Vitamin D, Treg, inflammation, COVID 19, coronavirus

According to Journal of the College of Physicians and Surgeons Pakistan (JCPSP):

“A meta-analysis did show benefit of taking vitamin D supplementation among patients with low 25 hydroxy-vitamin D levels presenting with upper respiratory tract infections URTIs”

In addition; According to a peer reviewed data from healthline.com

“Hospital data of 235 patients with COVID-19 were analyzed. In patients older than age 40, those who had adequate levels of vitamin D were 51.5% less likely to have adverse outcomes, including becoming unconscious, hypoxia, and death, as compared to vitamin D-deficient patients”

Whereas it is important to synchronize the intake of vitamin D and supplements to avoid ‘Vitamin D toxicity’. For the aforementioned reason, the chronic intake of low doses of vitamin D is efficacious rather than bolus administration of large doses. Besides, before taking vitamin D supplements one should have a word with the physician if they are having prior impairment complexities and get their vitamin D levels tested.