These past few weeks, I have seen several neighbors regularly sunbathing in their front yards, soaking in the sun’s golden morning rays. Why is that, I wondered. Is it just another pandemic hobby of Jakartans, or does the activity reward them with something more than just a tan? It turns out, vitamins such as vitamin D along with the antiparasitic agent Ivermectin have swept the media, suggesting that daily supplementation can protect against the virus. In their 2020 paper, D’Avolio et al. found that COVID-19 patients have repeatedly been shown to have lower vitamin D levels, with mean plasma concentrations half that of controls. Therefore, scientists hypothesize that the supplementation of vitamin D should boost immunity against COVID-19.
Vitamin D is a fat-soluble vitamin found in food such as oily fish and egg yolks and is naturally produced by our bodies upon exposure to UV rays. A randomized controlled trial shows that vitamin D supplementation (whether daily or weekly) significantly reduces the risk of acute respiratory diseases by 12%. Furthermore, another meta-analysis indicates that daily doses of the vitamin bring down the risk of respiratory tract infections by a whopping 49%. Given COVID’s effects on respiratory health, it is only logical to think that vitamin D can indeed help protect against adverse symptoms of the disease.
As for the immune system, ultimately, vitamin D will inhibit the release of proinflammatory cytokines (which can cause life-threatening cytokine storms in many COVID patients) by upregulating antimicrobial peptides that have antiviral potential lessening inflammatory responses towards SARS-CoV-2. Alipio’s meta-analysis examines 212 COVID-19 patients concerning their vitamin D levels. The average vitamin D level was 31.2 g/mL for patients with mild symptoms, 27.4 g/ml at moderate symptoms, and 21.2 g/ml in severe symptoms. Undoubtedly, there is a positive correlation between the decline in vitamin D concentration and increasing disease severity. This study concludes that vitamin D levels are associated with the clinical outcomes of COVID-19 patients; however, large-sampling randomized clinical trials are yet to confirm this.
In Indonesia, 780 COVID-19 infected patients participated in a retrospective study that analyses the relationship between vitamin D levels and patient mortality rate. With factors such as comorbidities and age ruled out, the study found that the vitamin is indeed closely linked to mortality in COVID-infected people. Those deficient in vitamin D had a higher mortality rate as compared to those with normal levels, the risk of death in the latter group being 10.1 times lower. Conversely, the National Heart, Lung, and Blood Institute conducted a randomized controlled trial. It has been concluded that high doses of vitamin D did not provide a greater benefit than placebo on the mortality of critically ill patients with vitamin D deficiency. Therefore, they recommend replenishing vitamin D supplementation according to standard daily nutritional needs instead.
With multiple takes and conclusions on the hypothesis and the lack of larger human-tested clinical trials, it is difficult to firmly say whether or not vitamin D has a direct role in helping treat COVID-19 patients. However, with ample evidence pointing toward the benefits of higher vitamin D levels on better respiratory health and the lack of truly effective COVID-19 therapies, we can remain open-minded on emerging results regarding these studies. What we can do now is to get our recommended amount of vitamin D through healthy food and, of course, staying active and healthy.
References:
D’Avolio A., Avataneo V., Manca A., Cusato J., De Nicolò A., Lucchini R., Keller F., Cantù M. 25-hydroxyvitamin d concentrations are lower in patients with positive PCR for SARS-CoV-2. Nutrients. 2020;12(5):1359. [PMC free article] [PubMed] [Google Scholar]
Raharusun P, Priambada S, Budiarti C, Agung E, Budi C. Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study. SSRN Electron J [Internet]. 2020 [cited 2020 Jun 5]; Available from: https://www.ssrn.com/abstract=3585561
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