Relation of vitamin D to COVID-19

Impact of vitamin D on COVID-19 and other viral diseases

This editorial aims to elucidate the intricate relationship between vitamin D and viral pathogenesis. It explores the anticipated role of vitamin D as a modulator in the immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other viral pathogens. The editorial comments are based on the review article by Engin et al. The potential role of vitamin D in modulating immune responses has been highlighted by several studies, suggesting that it may influence both the risk and severity of infections. Vitamin D receptors are present in immunocompetent cells, which indicates that vitamin D can potentially modulate innate and adaptive immune responses. This context is relevant in the pathophysiology of coronavirus disease 2019 (COVID-19), where the immune response to the virus can significantly impact the disease progression and outcome. The immunomodulatory effects of vitamin D can protect against SARS-CoV-2 infection by enhancing innate and adaptive immune responses. It also maintains the integrity of the body's physical barriers and modulates inflammatory responses, thereby preventing entry and replication of the virus. Many studies have suggested that adequate vitamin D levels help alleviate morbidity and mortality associated with COVID-19. Furthermore, vitamin D supplementation has been linked with a lower risk of severe disease and mortality in COVID-19 patients, particularly in those with a deficiency during seasons with less sunlight exposure.

Effect of Vitamin D3 Supplementation on Severe COVID-19: A Meta-Analysis of Randomized Clinical Trials

Since the beginning of the COVID-19 pandemic, vitamin D has attracted interest due to its immunomodulatory properties. Numerous studies show a correlation between vitamin D levels and COVID-19 cases and mortality. Therefore, we conducted a meta-analysis in order to assess the relationship between vitamin D3 supplementation and COVID-19 severity. We included 13 randomized clinical trials that contained the analyzed endpoints: length of COVID-19 hospitalization, number of intensive care unit (ICU) admissions, length of stay in the ICU, number of cases requiring any supplemental oxygenation, duration of any supplemental oxygenation, number of overall mortality and number of deaths associated with COVID-19. The relative risk with 95% confidence interval (CI) and the mean difference with 95% CI were calculated to compare the effect. A random effects model was used to calculate effect sizes. Our meta-analysis showed a positive effect of vitamin D3 supplementation on ICU admission (RR = 0.73; 95% CI [0.57; 0.95], p = 0.02, I2 = 19.6%) and mortality associated with COVID-19 among patients (RR = 0.56; 95% CI [0.34; 0.91]; p = 0.02; I2 = 0%). Vitamin D3 supplementation may potentially reduce the risk of ICU admission and death associated with COVID-19.

Modeling risk factors of degree of severity of Coronavirus disease 2019 (COVID-19) infection in inpatient patients at Dr. M. Djamil Padang

Background

RSUP Dr. M. Djamil was one of the COVID referral hospitals that treats patients with degrees of severity ranging from mild to critical. The high prevalence of COVID-19 differs from the severity of which it is necessary to know the risk factors as a preventive measure to minimize the higher risk. This study aims to determine the factors associated with the severity of COVID-19 in inpatients at Dr. M. Djamil Hospital, Padang, Indonesia.

Design and methods

A quantitative study with a cross-sectional design was conducted by reviewing the medical record data of COVID-19 inpatients from March 2020 to February 2021. Sampling using a simple random sampling technique with a total of 95 patients. The Prevalence Odds Ratio (POR) is a statistical measure used in epidemiology and medical research to assess the association between an exposure or risk factor and a particular outcome in a cross-sectional study.

Results

Based on research, there are 41 (43.2%) severe patients. There is a relationship between age with p-value 0.004 (POR 4.5; 95% CI; 1.48-12.1), cardiovascular disease with p-value 0.003 (POR 5.9; 95% CI 1.7-21.4), and respiratory disease with p-value 0.001 (POR 6.6; 95% CI; 2.1-20.8) against COVID-19 infection. Diabetes Mellitus is the confounding variable. Respiratory disease is the dominant factor associated with the severity of COVID-19. Respiratory disease has 6.6 POR or Prevalence Odds Ratio values which means that COVID-19 patients with respiratory disease 6.6 more severe than those who has not respiratory disease history.

Conclusions

Age, cardiovascular, and respiratory diseases are associated with the severity of COVID-19 infection in patients at Dr. M. Djamil Hospital, Padang, Indonesia. It is highly recommended to increase health promotion regarding risk factors for the severity of COVID-19 to the community to avoid a more severe outcome.

Potential Role of Vitamin D, ACE2 and the Proteases as TMPRSS2 and Furin on SARS-CoV-2 Pathogenesis and COVID-19 Severity

BACKGROUND

COVID-19, the 21^st century pandemic disease caused by SARS-CoV-2, has shown a wide clinical spectrum ranging from asymptomatic to deadly serious pneumonia.

OBJECTIVE

In our study, the relationship between the pathogenesis and clinical severity of COVID-19 and vitamin D, ACE2, Furin and TMPRSS2 was investigated.

METHODS

Serum 25(OH)D, 1,25(OH)₂D and ACE2 protein were measured in 85 COVID-19 cases, divided into 5 groups, according to disease severity, from asymptomatic to severe and including a healthy control group. Expression levels of ACE2, VDR, TMPRSS2 and Furin mRNAs in PBMC were also measured. The relationship of the parameters within each group, the severity of the disease and the effect on the patients' fate were investigated.

RESULTS

Statistically significant differences were found between the severity of COVID-19 and all study parameters, except for serum 25(OH)D. A strong negative correlation was found between serum ACE2 protein, 1,25(OH)₂D, and ACE2 mRNA, and disease severity, length of hospital stay and death/survival rate. Vitamin D deficiency increased the death risk by 5.6-fold (95% CI 0.75-41.47), and the levels of 1,25(OH)₂D lower than 1 ng/mL increased the risk of death by 3.8-fold (95% CI 1.07-13.30).

CONCLUSION

This study suggests that vitamin D supplementation could be beneficial in the treatment and/or prevention of COVID-19.

Yeast as a biological platform for vitamin D production: A promising alternative to help reduce vitamin D deficiency in humans

Vitamin D is an important human hormone, known primarily to be involved in the intestinal absorption of calcium and phosphate, but it is also involved in various non-skeletal processes (molecular, cellular, immune, and neuronal). One of the main health problems nowadays is the vitamin D deficiency of the human population due to lack of sun exposure, with estimates of one billion people worldwide with vitamin D deficiency, and the consequent need for clinical intervention (i.e., prescription of pharmacological vitamin D supplements). An alternative to reduce vitamin D deficiency is to produce good dietary sources of it, a scenario in which the yeast Saccharomyces cerevisiae seems to be a promising alternative. This review focuses on the potential use of yeast as a biological platform to produce vitamin D, summarizing both the biology aspects of vitamin D (synthesis, ecology and evolution, metabolism, and bioequivalence) and the work done to produce it in yeast (both for vitamin D₂ and for vitamin D₃ ), highlighting existing challenges and potential solutions. This article is protected by copyright. All rights reserved.