VITAMIN D & COVID-19: EVIDENCE OF POTENTIAL THERAPEUTIC IMPLICATIONS

Vitamin D has multiple mechanisms that reduce the risk of microbial infection and death, including natural cellular immunity, physical barrier, and adaptive immunity. Vitamin D supplementation has yielded favourable effects in viral infections, including influenza and HIV. The results of vitamin D supplementation during COVID-19 infection remains controversial. With the endless panorama, it has been found that vitamin D mitigates the scope of acquired immunity and regenerates endothelial lining. If you wonder what potential role vitamin D supplementation can play in COVID-19 infection, read on!

Vitamin D metabolism

Vitamin D3 production is regulated as the thermal action of UVB radiation reaching 7-dehydrocholesterol in the skin. Following this reaction, vitamin D3 is converted in the liver to 25(OH)D, and then kidneys & other organs convert it into hormonal metabolite 1,25(OH)2D (calcitriol) [1,2]. Calcitriol contributes to regulating serum calcium concentrations to modify many important functions in the human body [3].

Relation: Vitamin D and the immune response

Vitamin D contributes majorly to reducing the risk of microbial infection. This mainly involves actions grouped into natural cellular immunity, physical barriers, and adaptive immunity [4]. Vitamin D is known to strengthen cellular immunity, partly through the induction of antimicrobial peptides, while maintaining gap junctions, tight junctions, and adherens junctions [5,6].

Furthermore, 1,25(OH)2D-vitamin D receptor acts on the cathelicidin gene promoter vitamin D response elements to enhance transcription of cathelicidin [7]. COVID-19 subjects reflect innate immune system behaviour in response to bacterial and viral infections, generating pro-inflammatory and anti-inflammatory cytokines [8]. Vitamin D reduces the production of pro-inflammatory T helper (Th)1 cytokine and increases the expression of anti-inflammatory cytokines by macrophages. It also favours T regulatory (Treg) cells, thus inhibiting inflammatory processes. Vitamin D concentrations in serum can be reduced by antineoplastics, antiepileptics, antibiotics, antihypertensives, anti-inflammatory agents, antiretrovirals, endocrine drugs, and some herbal medicines activation of the pregnane-X receptor. The effects of vitamin D on the immune system can be seen here in a figure!

Vitamin D & COVID-19

Vitamin D supplementation in winters seems to reduce the risk of contracting influenza. The potential benefits of vitamin D supplementation have also been described in HIV infection. Baseline vitamin D levels, especially those lower than 32 ng/mL, are independently associated with a more advanced HIV stage progression. These findings confirm the potential benefits of vitamin D administration in HIV patients. Immunotherapy for cancer & oral immunotherapy is already famous for treating cancer, autism and other chronic diseases.

Studies prove the potential impact of vitamin D supplementation in COVID-19 patients with observations that vitamin D has a prominent role in reducing the risk of COVID-19. Vitamin D supplementation can enhance host immune responses against COVID-19, including the aggressive effect on organ systems.

High-dose vitamin D supplementation is a must for subjects with confirmed deficiency, particularly those in higher age groups, obese, with dark skin, and population residing at higher latitudes. Based on protective effects in patients at risk of chronic diseases, including cardiovascular disease, cancers, respiratory tract infections, diabetes mellitus, and hypertension. Vitamin D supplementation can reduce the incidence and severity of various viral diseases, including COVID-19 [9].

ACE2 is the receptor that hosts COVID-19 entry into the cells of the intestine and alveoli, with dysregulation of the renin-angiotensin system. This also contributes to massive cytokine activation, potentially fatal in ARDS. However, vitamin D deficiency can add to airway/gastrointestinal infections. This is why some researchers suggest that vitamin D may be a potential therapeutic approach to fight against COVID-19 and induced ARDS.

Although any protective effect of vitamin D against COVID-19 is related to the suppression of cytokine response, this seems possible that vitamin D prophylaxis can decrease the severity of infection caused by COVID-19, specifically in patients where hypovitaminosis D is common [10]. Some studies suggest that persistent deficiency in vitamin D level may activate RAS, which is solely responsible for inducing lung fibrosis [11]. Hypovitaminosis D promotes renin-angiotensin system (RAS) and chronic activation, leading to chronic CVD and decreased lung function.

COVID-19 infection downregulates ACE2 function, leading to toxic angiotensin II over-accumulation. This, in turn, contributes to ARDS or fulminant myocarditis. Hypovitaminosis D increases the risk for thrombosis, and vitamin D controls the expression of several genes relevant to cellular proliferation, apoptosis, differentiation, and angiogenesis. The overall conclusions drawn in most studies suggest that administration of a high dose of 25(OH) vitamin D can significantly decrease the need to hospitalise COVID-19 patients.

Conclusion and perspectives

The reported literature concerning the effects of vitamin D supplementation might need more research and evidence to present its credibility. But the proven efficiency of GcMAF/VDTP in treating immune diseases can never be neglected. With a high scope of immunotherapy helping cancer and chronic diseases patients, Vitamin D can also be utilized similarly or differently to treat viral infections like SARS-COV2 and the resulting implications. Here’s how you can determine and evaluate levels of Vitamin D in your body! Read in this book, more about VDTP/GcMAF.

Since the pathology of COVID-19 involves a complex interaction between COVID-19 and the immune system, vitamin D has multiple immunomodulating actions to perform. Vitamin D favours the ability of macrophages to mature & prevents macrophages from releasing too many inflammatory cytokines and chemokines, thus, having favourable effects in treating numerous viral infections. But, the fact that a majority of the western world is low in Vitamin D, makes it a difficult scenario.

According to data procured from a German study, people who have had their double doses of vaccine are now on the same scale as those with HIV and AIDS, low on essential vitamins, so they are in real need of Vitamin D.

Finally, the hope for such ailments can only remain high if we adopt a healthy lifestyle and stop portraying COVID-19 like a monster! It’s just an infection associated with immunity, so better work on strengthening your body from inside!

References and Sources:

1. https://pubmed.ncbi.nlm.nih.gov/17634462/
2. https://pubmed.ncbi.nlm.nih.gov/29080638/
3. https://pubmed.ncbi.nlm.nih.gov/17634462/
4. https://pubmed.ncbi.nlm.nih.gov/29853961/
5. https://pubmed.ncbi.nlm.nih.gov/20824663/
6. https://pubmed.ncbi.nlm.nih.gov/22115013/
7. https://pubmed.ncbi.nlm.nih.gov/15322146/
8. https://pubmed.ncbi.nlm.nih.gov/31986264/
9. https://pubmed.ncbi.nlm.nih.gov/31996793/
10. https://pubmed.ncbi.nlm.nih.gov/32281109/
11. https://pubmed.ncbi.nlm.nih.gov/32352080/