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. 2020 Nov 26:11:564387.
doi: 10.3389/fphys.2020.564387. eCollection 2020.

Association Between Vitamin D and Novel SARS-CoV-2 Respiratory Dysfunction - A Scoping Review of Current Evidence and Its Implication for COVID-19 Pandemic

Aida Santaolalla  1 , Kerri Beckmann  1   2 , Joyce Kibaru  1 , Debra Josephs  1   3 , Mieke Van Hemelrijck  1 , Sheeba Irshad  3   4
Affiliations

Association Between Vitamin D and Novel SARS-CoV-2 Respiratory Dysfunction - A Scoping Review of Current Evidence and Its Implication for COVID-19 Pandemic

Aida Santaolalla et al. Front Physiol. .

Abstract

Objectives: To assess the association between vitamin D deficiency and increased morbidity/mortality with COVID-19 respiratory dysfunction.

Design: Scoping review.

Data sources: Ovid MEDLINE (1946 to 24 of April 2020) and PubMed (2020 to 17 of September 2020).

Eligibility criteria for selecting studies: A search using the search terms: [(cholecalciferol or ergocalciferol or vitamin D2 or vitamin D3 or vitamin D or 25OHD) and (SARS-CoV-2 or coronavirus or COVID or betacoronavirus or MERS-CoV or SARS-CoV or respiratory infection or acute respiratory distress syndrome or ARDS)]m.p. was conducted on the 24/04/2020 (Search A) and 17/09/2020 (Search B).

Results: 91 studies were identified as being concerned with Acute Respiratory Infection (ARI)/Acute Respiratory Distress Syndrome (ARDS) and vitamin D, and 25 publications specifically explored the role of vitamin D deficiency in the development and progression of SARS-CoV-2/COVID-19 related ARDS. Search "A" identified three main themes of indirect evidence supporting such an association. Consistent epidemiological evidence exists linking low vitamin D levels to increased risk and severity of respiratory tract infections. We also report on plausible biological processes supporting such an association; and present weaker evidence supporting the benefit of vitamin D supplementation in reducing the risk and severity of ARIs. Uncertainty remains about what constitutes an appropriate dosing regimen in relation to reducing risk/severity of ARI/ARDS. More recent evidence (Search B) provided new insights into some direct links between vitamin D and COVID-19; with a number of cohort and ecological studies supporting an association with PCR-positivity for SARS-CoV-2 and vitamin D deficiency. The exact efficacy of the vitamin D supplementation for prevention of, or as an adjunct treatment for COVID-19 remains to be determined; but a number of randomized control trials (RCTs) currently underway are actively investigating these potential benefits.

Conclusion: Our rapid review of literature supports the need for observational studies with COVID-19 infected populations to measure and assess vitamin D levels in relation to risk/severity and outcomes; alongside RCTs designed to evaluate the efficacy of supplementation both in preventive and therapeutic contexts. The overlap in the vitamin D associated biological pathways with the dysregulation reported to drive COVID-19 outcomes warrants further investigation.

Keywords: COVID-19; COVID-19 risk/severity; SARS-CoV-2; association; respiratory dysfunction; scoping review; vitamin D; vitamin D prophylaxis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA diagram presenting the review strategy “A”.
FIGURE 2
FIGURE 2
PRISMA diagram presenting the review strategy “B”.
See this image and copyright information in PMC

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