COVID-19: Fast and effective therapy with vitamin D can shorten hospital stays and safe lives

It has already been documented that the widespread problems with vitamin D deficiency increase the risk of being infected with COVID-19 and developing life-threatening complications. In a new study, a team of Turkish scientists has demonstrated that swift treatment with vitamin D can shorten the length of hospital stays plus reduce mortality risk by 50 percent. What’s more, it even has a positive effect on comorbidity. Vitamin D deficiencies are especially common during the winter period and among seniors, people of color, overweight individuals, diabetics, and other vulnerable groups. This makes the study results very relevant, especially when you consider the fact that vaccines only have a limited effect.

Since December 2019, the world has been haunted by a COVID-19 pandemic that has involved different variants of the virus. Normally, a virus starts by infecting cells in the nose after which it spreads to the lower respiratory tract. Some people are able to avoid the infection, while the majority develops mild to moderate symptoms. If the immune defense is derailed, however, ARDS (acute respiratory distress syndrome) may develop in rare cases. A major cause is something known as cytokine storm combined with hyperinflammation in the epithelial cells of the lungs. Cytokine storm and hyperinflammation can also occur in the epithelial cells of the blood vessels and in the organs and this can result in circulatory failure and death. It has been observed that COVID-19 patients in intensive care units have elevated plasma levels of cytokines such as IL-2, IL-7, IL-10, and TNFα. It is the capacity of our immune defense that determines how well we are able to ward off an infection, and the immune system is unable to function normally if we lack nutrients such as vitamin D. That is why there has been a lot of focus on vitamin D and its therapeutic potential in connection with the coronavirus pandemic.

Vitamin D is of vital importance to the immune defense

Nearly all our cells have vitamin D receptors (VDR). Vitamin D is considered a steroid hormone. The type of vitamin D that we synthesize in our skin or get from supplements needs to be activated before the body can make use of it. This is a process that takes place in the liver, kidneys, white blood cells, and various other sites.
Vitamin D has many different functions in the immune system. We have in our airways a large number of white blood cells called macrophages that need vitamin D in order to kill off germs. The process is supported by antibiotic peptides in the airways that are also dependent on vitamin D. In addition to that, the immune defense’s “special troops” in the bloodstream, the T cells, need vitamin D to divide rapidly and to attack viruses and establish immunity. B cells that produce antibodies also need vitamin D.
A number of studies have shown that being vitamin D-deficient increases the rate and severity of different infections such as the cold, the flu, bronchitis, bacterial vaginosis, and HIV. In old days, doctors treated tuberculosis by placing patients in direct sunlight outdoors so they could produce vitamin D. This was a long time before the discovery of antibiotic remedies. Ever since, vitamin D supplements have turned out to have a positive effect on different types of respiratory infections and asthma. It is also believed that vitamin D supplements can ameliorate severe COVID-19 infections and lower mortality rates in intensive care units.

The Turkish study

The scientists analyzed data from 867 COVID-19 patients who were hospitalized at Istanbul University Hospital. All patients were already receiving antiretroviral therapy (hydroxychloroquine), while some got immunosuppressive therapy (tocilizumab) in accordance with national guidelines.
In the first stage of the study, the scientists evaluated how blood levels of vitamin D measured as 25(OH)D affected the severity of the COVID-19 infection. The second stage was designed as a prospective, randomized, controlled study that included patients who had been diagnosed with COVID-19. Also, there was a group of healthy controls.
It turned out that vitamin D levels in the blood of most participants were below 30 ng/mL, which is considered a deficiency. In the following three to 14 days, the patients received mega-doses of vitamin D, starting off the first few days with the highest doses. Doses of up to 2,500 micrograms daily (100,000 IU) were given to normalize blood levels of the nutrient as fast as possible. Patients in intensive care and those with the lowest vitamin D levels at baseline were given the highest dose for a period of five days. The control group got regular therapy and no extra vitamin D.

Conclusion: Lack of vitamin D can be life-threatening, whereas supplements can save lives.

The Turkish scientists concluded that comorbidities represent the single greatest factor in terms of length of hospital stay and ICU admission due to COVID-19. Moreover, the researchers observed that patients without comorbidities but with very low vitamin D levels (under 12 ng/mL) spent longer time in intensive care compared with patients that suffered from comorbidities.
Put differently, severe vitamin D deficiency apparently makes people more vulnerable towards COVID-19 infections and more vulnerable than patients with comorbidities.
The study also showed that vitamin D supplements could mitigate and shorten the length of the patients’ hospital stay, even among patients with comorbidities. Vitamin D therapy was shown to lower the mortality rate by a factor of 2.14.
Vitamin D has been shown to effectively affect different parameters and is therefore relevant for patients with COVID-19. The scientists call for additional studies that look at the long-term effect of using vitamin D supplements against the chronic characteristics of COVID-19 infections. This includes studying patients that have completely recovered and looking at possible delayed effects of organ damage. The scientists also call for studies based on healthy individuals that are given supplements of vitamin D. The Turkish study is published in Nutrients and supports earlier research.

References:

Gönen M.S. et al. Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 Patients. Nutrients 2021

Nihayet Bayraktar et al. Analysis of serum cytokine and protective vitamin D-levels in severe cases of COVID-19. Journal of Medical Virology 2021

Ariel Israel, Assi Circurel et al. The link between vitamin D deficiency and COVID-19 in a large population. Department of Research and Data, Division of Planning and Strategy. September 2020

Northwestern University. Vitamin D levels appear to play role in COVID-19 mortality rates. Science Daily. May 2020

Hutchings, N. et al. Patients hospitalized with COVID-19 have low levels of 25-hydroxyvitamin D. Endocrine. February 2021

José L Hernandez et al. Vitamin D Status in Hospitalized Patients with SARS-CoV2- Infection. The Journal of Clinical Endocrinology & Metabolism. October 2020

Cutolo M et al. Vitamin D and Lung Outcomes in Elderly COVID-19 Patients. Nutrients. February 2021

Moustapha Dramé et al. Relation between Vitamin D and COVID-19 in Aged People: A Systematic Review. Nutrients. April 2021

Marta Entrenas Castillo et al. Effect of calciferol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study. The Journal of Steroid Biochemistry and Molecular Biology. October 2020

David O. Meltzer et al. Association of Vitamin D Levels, Race/Ethnicity, and Clinical Characteristics With COVID-19 Test Results. JAMA Network Open. March 2021

Nikki Hancocks. Diet and supplements: Swiss panel publishes COVID-19 recommendations. NUTRAingredients.com October 2020