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The Potential Role of Vitamin D in COVID-19 and Other Emerging Viral Infections

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (20 May 2022) | Viewed by 37322

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Special Issue Editor

Prof. Dr. Igor Sergeev

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Guest Editor

Health and Nutritional Sciences, South Dakota State University, Brookings, SD 57007, USA
Interests: vitamin D; calcium; bioactive food components; nutrient regulation of apoptosis; vitamin D, calcium, and bioactives in the prevention of obesity and cancer; vitamin D and cell calcium
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nutrients is planning a Special Issue on the potential role of vitamin D in COVID-19 and other emerging or re-emerging viral infections. Vitamin D is important for the regulation of molecular, cellular, and organismal responses to infection. An increasing number of observational studies have linked vitamin D status to COVID-19 and other viral infections, and an increased vitamin D intake has been suggested for the prevention and even as supplementary treatment of infection diseases. However, understanding of vitamin D functioning in the viral infection processes is lacking. Health professionals receive contradictory messages regarding optimal vitamin D status and recommended vitamin D intake in COVID-19 and other infections. These considerations warrant a Special Issue on vitamin D to include current research on the role of vitamin D in emerging or re-emerging viral infections. Manuscripts presenting basic, applied, and clinical research, observational and meta-analysis studies, and analytical reviews are encouraged in this Special Issue

Prof. Dr. Igor Sergeev
Guest Editor

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Keywords

COVID-19
vitamin D status
vitamin D and infection
vitamin D functions
vitamin D requirements
vitamin D mechanism of action
viral infection

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Published Papers (6 papers)

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Editorial

Jump to: Research, Other

2 pages, 157 KiB

Open AccessEditorial

Vitamin D and COVID-19: How Much Vitamin D Does a Man Need?

by Igor N. Sergeev

Nutrients 2021, 13(12), 4311; https://doi.org/10.3390/nu13124311 - 29 Nov 2021

Cited by 2 | Viewed by 2693

Abstract

A number of observational studies and reviews on the potential role of vitamin D in COVID-19 have been published since the beginning of this ongoing global pandemic [...] Full article

(This article belongs to the Special Issue The Potential Role of Vitamin D in COVID-19 and Other Emerging Viral Infections)

Research

Jump to: Editorial, Other

30 pages, 4180 KiB

Open AccessArticle

Rapidly Increasing Serum 25(OH)D Boosts the Immune System, against Infections—Sepsis and COVID-19

by Sunil J. Wimalawansa

Nutrients 2022, 14(14), 2997; https://doi.org/10.3390/nu14142997 - 21 Jul 2022

Cited by 25 | Viewed by 19700

Abstract

Vitamin D deficiency is a global public health problem, a pandemic that commonly affects the elderly and those with comorbidities such as obesity, diabetes, hypertension, respiratory disorders, recurrent infections, immune deficiency, and malignancies, as well as ethnic minorities living in temperate countries. The same groups were worst affected by COVID-19. Since vitamin D deficiency weakens the immune system, it increases the risk of infections, complications, and deaths, such as from sepsis and COVID-19. Deficiency can be remedied cost-effectively through targeted food fortification, supplementation, and/or daily safe sun exposure. Its endocrine functions are limited to mineral metabolism, musculoskeletal systems, specific cell membrane interactions, and parathyroid gland functions. Except for the rapid, endocrine, and cell membrane-based non-genomic functions, all other biological and physiological activities of vitamin D depend on the adequate intracellular synthesis of 1,25(OH)₂D (calcitriol) in peripheral target cells via the genome. Calcitriol mediates autocrine (intracrine) and paracrine signalling in immune cells, which provides broader, protective immune functions crucial to overcoming infections. The synthesis of 1,25(OH)₂D (calcitriol) in peripheral target cells is dependent on diffusion and endocytosis of D₃ and 25(OH)D from the circulation into them, which requires maintenance of serum 25(OH)D concentration above 50 ng/mL. Therefore, in acute infections such as sepsis and respiratory infections like COVID-19, it is necessary to rapidly provide its precursors, D₃ and 25(OH)D, through the circulation to generate adequate intracellular calcitriol. Immune defence is one of the crucial non-hormonal functions of vitamin D. A single oral (bolus) dose or divided upfront loading doses between 100,000 and 500,000 IU, using 50,000 IU vitamin D₃ increase the serum 25(OH)D concentrations to a therapeutic level of above 50 ng/mL that lasts between two to three months. This takes three to five days to raise serum 25(OH)D. In contrast, a single oral dose of calcifediol (0.014 mg/kg body weight) can generate the needed 25(OH)D concentration within four hours. Considering both D₃ and 25(OH)D enter immune cells for generating calcitriol, using the combination of D₃ (medium-term) and calcifediol (immediate) is cost-effective and leads to the best clinical outcome. To maximise protection against infections, particularly to reduce COVID-19-associated complications and deaths, healthcare workers should advise patients on safe sun exposure, adequate vitamin D supplementation and balanced diets containing zinc, magnesium, and other micronutrients to support the immune system. Meanwhile, governments, the World Health Organisation, the Centers for Disease Control, and governments should consider similar recommendations to physicians and the public, change the outdated vitamin D and other micronutrient recommendations directed to their population, and organise targetted food fortification programs for the vulnerable groups. This article discusses a rational approach to maintaining a sustained serum 25(OH)D concentration above 50 ng/mL, necessary to attain a robust immune system for overcoming infections. Such would cost-effectively improve the population’s health and reduce healthcare costs. It also describes three cost-effective, straightforward protocols for achieving and sustaining therapeutic serum 25(OH)D concentrations above 50 ng/mL (>125 nmol/L) to keep the population healthy, reduce absenteeism, improve productivity, and lower healthcare costs. Full article

(This article belongs to the Special Issue The Potential Role of Vitamin D in COVID-19 and Other Emerging Viral Infections)

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15 pages, 584 KiB

Open AccessArticle

Low Serum Vitamin D in COVID-19 Patients Is Not Related to Inflammatory Markers and Patients’ Outcomes—A Single-Center Experience and a Brief Review of the Literature

by Adina Huțanu, Anca Meda Georgescu, Septimiu Voidăzan, Akos Vince Andrejkovits, Valentina Negrea and Minodora Dobreanu

Nutrients 2022, 14(10), 1998; https://doi.org/10.3390/nu14101998 - 10 May 2022

Cited by 7 | Viewed by 2448

Abstract

The aim of the study was to evaluate the vitamin D status in hospitalized COVID-19 patients and the correlation with C reactive protein (CRP), ferritin, fibrinogen, and peripheral blood leukocytes, as well as inflammatory derived indices. A prospective study was performed on 203 COVID-19 hospitalized patients, classified by disease severity. Blood was collected after admission, and inflammatory biomarkers and vitamin D status were assessed using routine laboratory procedures. No significant correlation was found between vitamin D serum levels and disease severity stratified by different age groups. However, the highest vitamin D levels were found in patients with mild disease: median 29.39 (IQR 12.12–44.02) ng/mL, while for moderate and severe forms the serum levels were significantly lower: median 15.10 (IQR 9.56–24.11) ng/mL for moderate, and 18.86 (IQR 12.50–27.88) ng/mL for severe; p = 0.009. Patients with no comorbidities showed a significantly higher level of vitamin D median 24.72 (IQR 16.05–31.52) ng/mL compared to subjects with at least one comorbidity: median 16.02 (IQR 9.81–25.22) ng/mL, p = 0.004. We did not find an association between vitamin D levels and inflammatory biomarkers except for significantly lower vitamin D levels in moderate and severe COVID-19 compared to mild disease forms. Full article

(This article belongs to the Special Issue The Potential Role of Vitamin D in COVID-19 and Other Emerging Viral Infections)

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11 pages, 1031 KiB

Open AccessArticle

Vitamin D Serum Levels in Subjects Tested for SARS-CoV-2: What Are the Differences among Acute, Healed, and Negative COVID-19 Patients? A Multicenter Real-Practice Study

by Luca Gallelli, Gaia Chiara Mannino, Filippo Luciani, Alessandro de Sire, Elettra Mancuso, Pietro Gangemi, Lucio Cosco, Giuseppe Monea, Carolina Averta, Pasquale Minchella, Manuela Colosimo, Lucia Muraca, Federico Longhini, Antonio Ammendolia, Francesco Andreozzi, Giovambattista De Sarro, G&P Working Group and Erika Cione

Nutrients 2021, 13(11), 3932; https://doi.org/10.3390/nu13113932 - 3 Nov 2021

Cited by 24 | Viewed by 8654

Abstract

Vitamin D might play a role in counteracting COVID-19, albeit strong evidence is still lacking in the literature. The present multicenter real-practice study aimed to evaluate the differences of 25(OH)D₃ serum levels in adults tested for SARS-CoV-2 (acute COVID-19 patients, subjects healed from COVID-19, and non-infected ones) recruited over a 6-month period (March–September 2021). In a sample of 117 subjects, a statistically significant difference was found, with acute COVID-19 patients demonstrating the lowest levels of serum 25(OH)D₃ (9.63 ± 8.70 ng/mL), significantly lower than values reported by no-COVID-19 patients (15.96 ± 5.99 ng/mL, p = 0.0091) and healed COVID-19 patients (11.52 ± 4.90 ng/mL, p > 0.05). Male gender across the three groups displayed unfluctuating 25(OH)D₃ levels, hinting at an inability to ensure adequate levels of the active vitamin D3 form (1α,25(OH)2D3). As a secondary endpoint, we assessed the correlation between serum 25(OH)D₃ levels and pro-inflammatory cytokine interleukin-6 (IL-6) in patients with extremely low serum 25(OH)D₃ levels (<1 ng/mL) and in a subset supplemented with 1α,25(OH)₂D₃. Although patients with severe hypovitaminosis-D showed no significant increase in IL-6 levels, acute COVID-19 patients manifested high circulating IL-6 at admission (females = 127.64 ± 22.24 pg/mL, males = 139.28 ± 48.95 ng/mL) which dropped drastically after the administration of 1α,25(OH)₂D₃ (1.84 ± 0.77 pg/mL and 2.65 ± 0.92 ng/mL, respectively). Taken together, these findings suggest that an administration of 1α,25(OH)₂D₃ might be helpful for treating male patients with an acute COVID-19 infection. Further studies on rapid correction of vitamin D deficiency with fast acting metabolites are warranted in COVID-19 patients. Full article

(This article belongs to the Special Issue The Potential Role of Vitamin D in COVID-19 and Other Emerging Viral Infections)

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