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Vitamin D and coronavirus disease 2019 (COVID-19): rapid evidence review.

Vitamin D and coronavirus disease 2019 (COVID-19): rapid evidence review.
Vitamin D and coronavirus disease 2019 (COVID-19): rapid evidence review.

Background: The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has re-ignited interest in the possible role of vitamin D in modulation of host responses to respiratory pathogens. Indeed, vitamin D supplementation has been proposed as a potential preventative or therapeutic strategy. Recommendations for any intervention, particularly in the context of a potentially fatal pandemic infection, should be strictly based on clinically informed appraisal of the evidence base. In this narrative review, we examine current evidence relating to vitamin D and COVID-19 and consider the most appropriate practical recommendations. Observations: Although there are a growing number of studies investigating the links between vitamin D and COVID-19, they are mostly small and observational with high risk of bias, residual confounding, and reverse causality. Extrapolation of molecular actions of 1,25(OH) 2-vitamin D to an effect of increased 25(OH)-vitamin D as a result of vitamin D supplementation is generally unfounded, as is the automatic conclusion of causal mechanisms from observational studies linking low 25(OH)-vitamin D to incident disease. Efficacy is ideally demonstrated in the context of adequately powered randomised intervention studies, although such approaches may not always be feasible. Conclusions: At present, evidence to support vitamin D supplementation for the prevention or treatment of COVID-19 is inconclusive. In the absence of any further compelling data, adherence to existing national guidance on vitamin D supplementation to prevent vitamin D deficiency, predicated principally on maintaining musculoskeletal health, appears appropriate.

Coronavirus disease 2019 (COVID-19), Musculoskeletal health, Osteoporosis, Respiratory infection, Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), Vitamin D, Vitamin D deficiency
1594-0667
2031-2041
Raisi-Estabragh, Zahra
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Martineau, Adrian R.
066af71a-aee9-4312-ae6a-7decb7e764ef
Curtis, Elizabeth
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Moon, Rebecca
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Darling, Andrea
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Lanham-New, Susan
41a76d28-ab9a-43d5-929b-0c4c7030db8e
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Munroe, Patricia B.
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Petersen, Steffen E.
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Harvey, Nicholas
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Raisi-Estabragh, Zahra
43c85c5e-4574-476b-80d6-8fb1cdb3df0a
Martineau, Adrian R.
066af71a-aee9-4312-ae6a-7decb7e764ef
Curtis, Elizabeth
12aba0c3-1e9e-49ef-a7e9-3247e649cdd6
Moon, Rebecca
954fb3ed-9934-4649-886d-f65944985a6b
Darling, Andrea
3e123add-8f91-42b5-9aec-ac8153a68ed5
Lanham-New, Susan
41a76d28-ab9a-43d5-929b-0c4c7030db8e
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Munroe, Patricia B.
44d23746-20cd-4572-860e-7350424cc031
Petersen, Steffen E.
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Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145

Raisi-Estabragh, Zahra, Martineau, Adrian R., Curtis, Elizabeth, Moon, Rebecca, Darling, Andrea, Lanham-New, Susan, Ward, Kate, Cooper, Cyrus, Munroe, Patricia B., Petersen, Steffen E. and Harvey, Nicholas (2021) Vitamin D and coronavirus disease 2019 (COVID-19): rapid evidence review. Aging Clinical and Experimental Research, 33 (7), 2031-2041. (doi:10.1007/s40520-021-01894-z).

Record type: Review

Abstract

Background: The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has re-ignited interest in the possible role of vitamin D in modulation of host responses to respiratory pathogens. Indeed, vitamin D supplementation has been proposed as a potential preventative or therapeutic strategy. Recommendations for any intervention, particularly in the context of a potentially fatal pandemic infection, should be strictly based on clinically informed appraisal of the evidence base. In this narrative review, we examine current evidence relating to vitamin D and COVID-19 and consider the most appropriate practical recommendations. Observations: Although there are a growing number of studies investigating the links between vitamin D and COVID-19, they are mostly small and observational with high risk of bias, residual confounding, and reverse causality. Extrapolation of molecular actions of 1,25(OH) 2-vitamin D to an effect of increased 25(OH)-vitamin D as a result of vitamin D supplementation is generally unfounded, as is the automatic conclusion of causal mechanisms from observational studies linking low 25(OH)-vitamin D to incident disease. Efficacy is ideally demonstrated in the context of adequately powered randomised intervention studies, although such approaches may not always be feasible. Conclusions: At present, evidence to support vitamin D supplementation for the prevention or treatment of COVID-19 is inconclusive. In the absence of any further compelling data, adherence to existing national guidance on vitamin D supplementation to prevent vitamin D deficiency, predicated principally on maintaining musculoskeletal health, appears appropriate.

Text
zre nch covid_vitD_review R1 2021_05_18 clean - Accepted Manuscript
Restricted to Repository staff only until 21 May 2022.
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Accepted/In Press date: 21 May 2021
Published date: 12 June 2021
Additional Information: Funding Information: We would like to thank the Medical Research Council (UK), National Institute for Health Research (NIHR), Wellcome Trust, Versus Arthritis, Royal Osteoporosis Society Osteoporosis and Bone Research Academy and International Osteoporosis Foundation for supporting this work. SEP and PBM acknowledges support from the NIHR Barts Biomedical Research Centre. ZRE was supported by British Heart Foundation Clinical Research Training Fellowship No. FS/17/81/33318. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: Coronavirus disease 2019 (COVID-19), Musculoskeletal health, Osteoporosis, Respiratory infection, Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), Vitamin D, Vitamin D deficiency

Identifiers

Local EPrints ID: 449629
URI: http://eprints.soton.ac.uk/id/eprint/449629
ISSN: 1594-0667
PURE UUID: 13a98a2c-84c8-4b1a-b2c7-44c80247378b
ORCID for Elizabeth Curtis: ORCID iD orcid.org/0000-0002-5147-0550
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 09 Jun 2021 16:31
Last modified: 26 Nov 2021 03:09

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Contributors

Author: Zahra Raisi-Estabragh
Author: Adrian R. Martineau
Author: Rebecca Moon
Author: Andrea Darling
Author: Susan Lanham-New
Author: Kate Ward ORCID iD
Author: Cyrus Cooper ORCID iD
Author: Patricia B. Munroe
Author: Steffen E. Petersen
Author: Nicholas Harvey ORCID iD

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