New Vitamin D paper

Vitamin D: A key player in COVID‐19 immunity and lessons from the pandemic to combat immune‐evasive variants

As of July 2024

775,754,322 confirmed cases of COVID-19

13,578,710,228 vaccine doses had been administered

It is unclear why some patients develop severe symptoms while others do not,

literature suggests a role for vitamin D.

Vitamin D plays a crucial role in the infection or in ameliorating the severity of symptoms.

VDD is associated with increased hospitalization of severely ill patients and increased levels of COVID-19-caused mortality.

The mechanism of action of vitamin D and vitamin D deficiency (VDD) is well understood.

Vitamin D levels and genetic variations in the vitamin D receptor (VDR) gene significantly impact the severity and out- comes of COVID-19,

especially in the infections caused by Delta and Omicron variants.

Furthermore, VDD causes immune system dysregulation upon infection with SARS-CoV-2,

indicating that vitamin D sufficiency is crucial in fighting against COVID-19 infection.

Potential role as a prophylactic and treatment adjunct.

Immunomodulatory and anti-inflammatory effects of vitamin D

Ability to enhance the efficacy of new antiviral drugs

Large- scale randomized trials are required to reach a definitive conclusion.

Mechanisms of action

Macrophages activated to produce defensive proteins and stimulate naïve T cells

Activate T lymphocytes and mature B lymphocytes into plasma cells

Prevents inflammation, vasoconstriction, and fibrosis of the lungs.

Prevents excess release of cytokines from macrophages

Prevents excessive CRP production in the liver

Vit D can reduce viral replication

Vitamin D can protect against ARDS, the main death-causing complication of COVID-19

Seven out of nine studies reviewed by Yisak

have indicated a crucial role in vitamin D status in COVID-19 infection, prognosis, and mortality.

Vitamin D dose

To decrease the risk of contracting a new infection,

people at high risk of COVID-19 to take 10,000 IU d−1 of vitamin D for a few weeks,

followed by 5000 IU d−1 to raise the concentrations of the active form of vitamin D.

Blood levels

Levels below 12 ng/mL indicate severe deficiency.

Levels between 12 and 20 ng/mL suggest deficiency

Treatment recommended for levels below 30 ng/mL

Optimal levels are 30–60 ng/mL,

Recommended prophylactic dose

0–1 years, 400 IU/day (10 mcg)

over  1 year, 600 IU (15 mcg)

over 8 years, half an adult dose

Adults, 800– 2000 IU of cholecalciferol

Routine toxicity monitoring is unnecessary for doses under 10,000 IU/day