COVID-19: Lack of vitamin D in seniors is linked to complications and death

Vitamin D is important for a swift and effective immune response. Once COVID-19 infections become complicated and life-threatening, it is not the virus that is the threat but the fact that the immune defense reacts too slowly and then causes hyperinflammation that damages healthy tissues in the respiratory system and circulatory system. French scientists have made a meta-analysis where they looked at the relation between vitamin D levels in the elderly and COVID-19. Their review revealed that lack of vitamin D increases the infection risk and makes it more likely that the infections become complicated and life-threatening. Vitamin D deficiency is common among older people and for that reason, the researchers recommend vitamin D supplements as an inexpensive strategy for prevention and as a supplementary source of treatment.

The majority of cells in the body have vitamin D receptors. The nutrient is known to regulate around 10 percent of our genes by way of certain on-off mechanisms. Vitamin D is also vital for our innate immune system that serves as storm troops by destroying most germs without us noticing. Vitamin D is also important for the adaptive immune defense that has the ability to specialize and form immunity. Furthermore, vitamin D makes sure a certain type of white blood cells known as T cells are activated so that they are able to replicate exponentially in order to carry out frontal attacks on virus and bacteria. However, if the T cells are unable to absorb sufficient amounts of vitamin D from the blood, they will not be able to collaborate, attack, or develop immunity. Vitamin D even helps regulate a variety of proinflammatory cytokines such as IL-2, IL-6, IL-8, IL-12, IL-17, TNF-alpha, IFN-gamma, and NFkBA. These help the immune defense reach swiftly and appropriately. The body normally fights an infection by launching an acute inflammation, and it is important that the process is controlled carefully. If you lack vitamin D, there is an increased risk of both infection and uncontrolled inflammatory response that can harm healthy tissue.

Complicated COVID-19 infections are a result of an uncontrolled immune response

A COVID-19 infection normally starts when the virus infects nasal cells. From here, the infection spreads to the lower respiratory system. Most people are able to ward off the infection or at least get away with a mild or moderate infection. However, if the immune defense is unable to function optimally, acute respiratory distress syndrome also known as ARDS may develop in the lower respiratory tract in severe cases. A major cause is cytokine storm and hyperinflammation in the epithelial cells of the lungs. Hyperinflammation may also occur in the epithelial cells of the blood vessels and in other organs. This may result in circulatory failure and death.
Acute respiratory failure normally occurs more than seven days after the initial symptoms of a COVID-19 infection. The condition is primarily seen in older individuals. Multiple studies have revealed that after a week or so, there are abnormally high levels of proinflammatory cytokines in patients that develop life-threatening complications. The so-called cytokine storm is not caused by a virus but by a poorly regulated immune system. A simple strategy would therefore be to regulate the immune defense with vitamin D, which is a nutrient that older people typically lack.

Vitamin D’s role in the prevention of COVID-19 and other respiratory infections

It is hardly a coincidence that virus infections typically circulate during the winter period where vitamin D deficiencies are widespread. In comparison, the scientists behind the French meta-analysis refer to the Spanish flu, a pandemic that lasted from 1918 to 1920. It occurred in waves and lack of vitamin D most likely had a role in all of this.
It is commonly known that pneumonia follows in the wake of typical winter infections such as cold and flu in cases where the immune system is weak. The French scientists report that the risk of being admitted to the intensive care unit and dying of pneumonia is increased if you have a vitamin D deficiency.
The whole purpose of the new meta-analysis was to look closer at the relation between vitamin D levels and the severity of COVID-19 in patients older than 60 years of age and also to see if vitamin D supplementation could possibly have a positive effect.

 The meta-analysis

The scientists found 707 studies that had been published during the COVID-19 pandemic prior to March 15. Eleven suited observational studies were included in the final meta-analysis. Four of the studies compared COVID-19 patients who received vitamin D supplements with non-supplemented COVID-19 patients. All four studies showed that the supplemented patients had fewer complications, were in less need of ventilators, and had lower mortality, compared with the patients that did not get supplements.
Seven of the studies compared COVID-19 patients who had low vitamin D levels in their blood with patients who had adequate levels of the nutrient. The patients with sufficient amounts of vitamin D in their blood fared better and had fewer complications, they were in less need of ventilators, and they had lower mortality.
Based on their findings, the scientists conclude that lack of vitamin D in older people increases the risk of being infected with COVID-19 and it also increases the risk of complications and death. The greater the deficiency, the greater the risk of complications and death. It is therefore obvious to include vitamin D supplementation in the prevention in COVID-19 and as part of the early treatment.

The authorities recommend vitamin D supplements but many people are unaware of this

The Danish Veterinary and Food Administration advises everybody to take a vitamin D supplement during the winter period. Those who get too little sun, are advised to take a supplement all year round. The same goes for people aged 70 and older, nursing home residents, and people receiving homecare. Unfortunately, many older people are not aware of this. Furthermore, the practice of encouraging vitamin D supplements in the same way as prescription drugs has not yet been implemented. There are different supplements on the market with vitamin D doses in the range between 20 and 80 micrograms. A person’s actual need for vitamin D hinges on factors such as sun exposure, age, skin type, BMI, and chronic diseases. EU’s Scientific Committee on Food has established a safe upper level for daily intake of vitamin D, which is 100 micrograms for adults.
Vitamin D is lipid-soluble vitamin so the best way to absorb and utilize the nutrient is if you take it in oil-filled capsules.

References:

Moustapha Dramé et al. Relation between Vitamin D and COVID-19 in Aged People: A Systematic Review. Nutrients. 2021 April 17

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

Ali Daneshkhah et al. The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. medRxiv April 30, 2020

José L Hernandez et al. Vitamin D Status in Hospitalized Patients with SARS-CoV2- Infection. The Journal of Clinical Endocrinology & Metabolism. 27 October 2020

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