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Vitamin D and its protective effect against COVID-19: why low levels predispose to disease?

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A recent Boston University study focused on people who are having low levels of vitamin d associated its deficiency with an increased risk of suffering from coronavirus.

The global pandemic caused by SARS-CoV-2 virus infection has affected people from all walks of life since its emergence in China in December 2019. Around the world, millions of people became infected with the virus and died, and specialists noted, the spread of COVID-19 infection was especially high among African Americans, who tend to live in dense, low-income communities and work in occupations where they are most likely to be exposed to the virus.

Now, several recent studies have examined the role of vitamin D levels in relation to COVID-19 infection. And some of them found a higher incidence of infection in those individuals with lower levels of vitamin D.

Vitamin D is a naturally occurring hormone that regulates mineral and skeletal homeostasis and modulates the innate immune system. In humans, vitamin D is obtained from the diet as ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) derived from plants, yeasts and fungi, or through dietary supplements. Another important source is exposure to ultraviolet B radiation, which is involved in the conversion of 7-dehydrocholesterol into vitamin D3 by the liver.

The nutrient is essential for bone health in all stages of life, from fetal development to old age due to the role it plays in calcium homeostasis (skeletal or classical actions). In recent years, it has been reported that vitamin D also participates in the regulation of numerous tissues and organs through what is known as the extra-skeletal or non-classical actions of vitamin D.

Due to its immunomodulatory, anti-inflammatory, antimicrobial, regulatory actions of the renin-angiotensin-aldosterone system, favoring the indemnity of the respiratory epithelium and cellular redox homeostasis, vitamin D could have a protective effect on COVID-19 infection.

Precisely, among the risk groups for COVID-19 are the elderly, obese, diabetic, hypertensive, with cardiovascular diseases, pathologies with greater incidence in individuals with hypovitaminosis D. D supplementation, to achieve optimal 25OHD levels of 40-60 ng/ml, could reduce the incidence, severity and risk of death in the current COVID-19 pandemic, as a complementary measure while developing the vaccine and other specific medications.

Now, in addition, a recent Boston University study showed that Black Americans often experience (25(OH)D) insufficiency (20 to 29 ng/mL; 50–72.5 nmol/l) or deficiency (<20 ng/mL; <50 nmol/l), largely because darker skin pigmentation results in lower penetration of sunlight and subsequent production of vitamin D3.

Once infected with COVID-19, Black women are at an increased risk of developing severe disease, in part because they have a higher prevalence of predisposing conditions such as hypertension, type 2 diabetes, and obesity.

Given the disproportionate number of COVID-19 cases and deaths among Black women and the high prevalence of 25(OH)D deficiency among Black women, it is critical to evaluate the relationship between serum 25(OH)D concentrations and risk of COVID-19 infection in this population group.

This was done among participants in the Black Women’s Health Study (BWHS), a large national follow-up study of African-American women in the United States. Black women, after adjusting for potential confounding factors such as the higher levels of COVID-19 exposure experienced by U.S. Blacks.

The results: “Among 5,081 eligible participants whose blood sample had been assayed for 25(OH)D, 1,974 reported having had a COVID-19 test in 2020. Relative to women with 25(OH)D levels of 30 ng/mL (75 nmol/l) or more, multivariable-adjusted ORs for COVID-19 infection in women with levels of 20–29 ng/mL (50–72.5 nmol/l) and <20 ng/mL (<50 nmol/l) were, respectively, 1.48 (95% CI 0.95–2.30) and 1.69 (95% CI 1.04–2.72) (p trend 0.02).”

The current findings indicate that the American Black women with low levels of 25(OH)D are more likely to contract COVID-19. Additional research is required to confirm these findings and to determine the optimal level of 25(OH)D required to have a beneficial effect.

Image Credit: Getty

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