Potential benefit of vitamin D supplementation in people with respiratory illnesses, during the COVID-19 pandemic

Interactive effect of booster vaccination and vitamin D status on antibody production of Omicron variant-infected adults: A real-world cohort study

INTRODUCTION

Effect of booster vaccination and vitamin D status on antibody production of Omicron variant-infected adults need to be further explored.

METHODS

A retrospective, longitudinal, real-world cohort study was performed. All included cases were divided into vitamin D deficiency (VDD) and non-VDD (control) groups according to baseline serum 25-hydroxyvitamin D [25(OH)D] concentration and then into unvaccinated, routinely vaccinated, and booster vaccinated VDD and control subgroups according to vaccination status. Antibody dynamics were observed within six time periods during hospitalization.

RESULTS

A total of 204 adult cases were included, of which 121 (59%) were males; 23 (11%), 31 (15%), and 26 (13%) or 50 (25%), 35 (17%), and 39 (19%) were unvaccinated, routinely vaccinated, and booster vaccinated VDD cases or controls, respectively. The median (interquartile range) for age and baseline 25(OH)D concentration was 42.5 (31-53.5) years and 21.5 (18-25.4) ng/mL, respectively. The IgM titers within 3 to 7 days and 7 to 14 days increased rapidly to 1.8-fold (P < 0.001) and 3.6-fold (P < 0.001) those within the first day; the IgG titers increased to 5.8-fold (P < 0.001) and 10.9-fold (P < 0.001). Booster vaccinated controls had higher first IgG titers compared with unvaccinated controls (3.1-fold; P = 0.001) or booster vaccinated VDD cases (2.1-fold; P = 0.02).

CONCLUSIONS

Booster vaccination and non-VDD status may have an interactive boosting effect on IgG production of Omicron variant-infected adults. Further randomized clinical trials may be needed to determine whether booster vaccination combined with VDD correction improves the humoral immunity to Omicron variants.

Latent TB Infection, Vitamin D Status and COVID-19 Severity in Mongolian Patients

We aimed to determine potential risk factors for COVID-19 severity including serum vitamin D levels and latent TB infection among Mongolian inpatients diagnosed with COVID-19, and to study the effects of disease complications and treatment outcomes. This study included patients admitted to the Mongolian National Center for Communicable Disease, a main referral center for infectious disease in Mongolia, with COVID-19 ascertained by a positive PCR test. Patients' demographic, clinical, and laboratory data were analyzed. Of the 270 patients enrolled, 125 (46%) had mild-to-moderate illness, 86 (32%) had severe illness, and 59 (22%) had critical illness. Ten (91%) of the 11 patients who had active TB were hospitalized with severe or critical COVID-19, suggesting that they had a higher risk of falling into the severe category (OR = 10.6 [1.2; 92.0] 95% CI). Severe vitamin D deficiency (25(OH)D < 10 ng/mL) was present in 32% of the patients, but was not significantly associated with the severity of illness (p = 0.65). Older age, being male, having active TB and/or COPD were associated with greater COVID-19 severity, whereas a history of COVID-19 vaccination and the presence of a BCG vaccination scar were protective in terms of disease severity.

Infections and Autoimmunity-The Immune System and Vitamin D: A Systematic Review

Both 25-autoimmunity and(25(OH)D: calcifediol) and its active form, 1,25-dihydroxyvitamin D (1,25(OH)2D: calcitriol), play critical roles in protecting humans from invasive pathogens, reducing risks of autoimmunity, and maintaining health. Conversely, low 25(OH)D status increases susceptibility to infections and developing autoimmunity. This systematic review examines vitamin D's mechanisms and effects on enhancing innate and acquired immunity against microbes and preventing autoimmunity. The study evaluated the quality of evidence regarding biology, physiology, and aspects of human health on vitamin D related to infections and autoimmunity in peer-reviewed journal articles published in English. The search and analyses followed PRISMA guidelines. Data strongly suggested that maintaining serum 25(OH)D concentrations of more than 50 ng/mL is associated with significant risk reduction from viral and bacterial infections, sepsis, and autoimmunity. Most adequately powered, well-designed, randomized controlled trials with sufficient duration supported substantial benefits of vitamin D. Virtually all studies that failed to conclude benefits or were ambiguous had major study design errors. Treatment of vitamin D deficiency costs less than 0.01% of the cost of investigation of worsening comorbidities associated with hypovitaminosis D. Despite cost-benefits, the prevalence of vitamin D deficiency remains high worldwide. This was clear among those who died from COVID-19 in 2020/21-most had severe vitamin D deficiency. Yet, the lack of direction from health agencies and insurance companies on using vitamin D as an adjunct therapy is astonishing. Data confirmed that keeping an individual's serum 25(OH)D concentrations above 50 ng/mL (125 nmol/L) (and above 40 ng/mL in the population) reduces risks from community outbreaks, sepsis, and autoimmune disorders. Maintaining such concentrations in 97.5% of people is achievable through daily safe sun exposure (except in countries far from the equator during winter) or taking between 5000 and 8000 IU vitamin D supplements daily (average dose, for non-obese adults, ~70 to 90 IU/kg body weight). Those with gastrointestinal malabsorption, obesity, or on medications that increase the catabolism of vitamin D and a few other specific disorders require much higher intake. This systematic review evaluates non-classical actions of vitamin D, with particular emphasis on infection and autoimmunity related to the immune system.

Controlling Chronic Diseases and Acute Infections with Vitamin D Sufficiency

Apart from developmental disabilities, the prevalence of chronic diseases increases with age especially in those with co-morbidities: vitamin D deficiency plays a major role in it. Whether vitamin D deficiency initiates and/or aggravates chronic diseases or vice versa is unclear. It adversely affects all body systems but can be eliminated using proper doses of vitamin D supplementation and/or safe daily sun exposure. Maintaining the population serum 25(OH)D concentration above 40 ng/mL (i.e., sufficiency) ensures a sound immune system, minimizing symptomatic diseases and reducing infections and the prevalence of chronic diseases. This is the most cost-effective way to keep a population healthy and reduce healthcare costs. Vitamin D facilitates physiological functions, overcoming pathologies such as chronic inflammation and oxidative stress and maintaining broader immune functions. These are vital to overcoming chronic diseases and infections. Therefore, in addition to following essential public health and nutritional guidance, maintaining vitamin D sufficiency should be an integral part of better health, preventing acute and chronic diseases and minimize their complications. Those with severe vitamin D deficiency have the highest burdens of co-morbidities and are more vulnerable to developing complications and untimely deaths. Vitamin D adequacy improves innate and adaptive immune systems. It controls excessive inflammation and oxidative stress, generates antimicrobial peptides, and neutralizes antibodies via immune cells. Consequently, vitamin D sufficiency reduces infections and associated complications and deaths. Maintaining vitamin D sufficiency reduces chronic disease burden, illnesses, hospitalizations, and all-cause mortality. Vulnerable communities, such as ethnic minorities living in temperate countries, older people, those with co-morbidities, routine night workers, and institutionalized persons, have the highest prevalence of vitamin D deficiency-they would significantly benefit from vitamin D and targeted micronutrient supplementation. At least now, health departments, authorities, and health insurance companies should start assessing, prioritizing, and encouraging this economical, non-prescription, safe micronutrient to prevent and treat acute and chronic diseases. This approach will significantly reduce morbidity, mortality, and healthcare costs and ensure healthy aging.

The Effect of Vitamin D Supplementation on the Length of Hospitalisation, Intensive Care Unit Admission, and Mortality in COVID-19-A Systematic Review and Meta-Analysis

The coronavirus disease 2019 (COVID-19) pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has become a global health crisis and pushed researchers and physicians to discover possible treatments to improve the outcome of their patients. Vitamin D, known for its role in immune system function, has been hypothesized to play a role in COVID-19 treatment. A systematic review and meta-analysis were conducted to evaluate the efficacy of vitamin D supplementation in COVID-19, focusing on length of hospital stay (LOS), admission to the intensive care unit (ICU), and mortality. Thirteen randomized controlled trials (RCTs) were included, and the meta-analysis revealed that high-dose vitamin D supplementation showed potential benefits in reducing the length of hospital stay and ICU admission rates for patients with COVID-19. However, the overall effect on mortality did not reach statistical significance. While this systematic review suggests the potential benefits of high-dose vitamin D supplementation in reducing hospital stays and ICU admission in COVID-19 patients, caution is warranted due to the high heterogeneity and limitations of the included studies. Further large-scale randomized controlled trials with consistent study characteristics are needed to provide more robust evidence regarding the therapeutic benefits of vitamin D supplementation in COVID-19 outcomes.

Impact of vitamin D3 supplementation on COVID-19 vaccine response and immunoglobulin G antibodies in deficient women: A randomized controlled trial

Background

Immune levels were observed by giving vitamin D supplements to vitamin D deficient women who received the COVID-19 vaccine.

Methods

In the research, there were volunteer women who had received two doses of the COVID-19 vaccine who participated for a mean of more than 65 days. Group D (n=14 Pfizer-BioNTech, 2 Sinovac) received 150,000 IU of vitamin D supplementation, but group C (n=14 Pfizer-BioNTech), 3 Sinovac) no support was provided.

Results

When the consumption of vitamin D ends (D group), serum 25-Hydroxy Vitamin D levels were found to increase regularly in the (W3) last measurements (p=0.001). There was no significant difference in immunoglobulin M levels between groups D and C (Control group) (p=0.063). It was observed that the immunoglobulin G levels reached the peak level between the W1 and W2 measurements of the D group (P<0.001) and there were significant differences between the three sizes. Also, no correlation was found between the D group's initial serum immunoglobulin G and 25-Hydroxy Vitamin D levels. However, when the final measurements were examined, a significant positive correlation was found between immunoglobulin G and 25-Hydroxy Vitamin D levels (r=0.558, p=0.031).

Conclusion

It was determined that serum IgG levels increased significantly depending on the duration between those who used vitamin D and those who did not and it was above the initial level for a long time. A positive and significant relationship was found between the last measured immunoglobulin G and 25(OH) D levels while vitamin D supplementation continued.

Trial Registration: This study registered under ClinicalTrials.gov (Identifier no. NCT05447065)

Relationship between Vitamin D Status and Antibody Response to COVID-19 mRNA Vaccination in Healthy Adults

The immune response to vaccination with SARS-CoV-2 vaccines varies greatly from person to person. In addition to age, there is evidence that certain micronutrients influence the immune system, particularly vitamin D. Here, we analysed SARS-CoV-2 IgG and neutralisation potency along with 25-hydroxy-cholecalciferol [25(OH)D] concentrations in a cohort of healthy German adults from the time of vaccination over 24 weeks. Contrary to our expectations, no significant differences were found in the dynamic increase or decrease of SARS-CoV-2 IgG as a function of the 25(OH)D status. Furthermore, the response to the first or second vaccination, the maximum SARS-CoV-2 IgG concentrations achieved, and the decline in SARS-CoV-2 IgG concentrations over time were not related to 25(OH)D status. We conclude that the vaccination response, measured as SARS-CoV-2 IgG concentration, does not depend on 25(OH)D status in healthy adults with moderate vitamin D status.

Vitamin D, Thyroid Hormones and Cardiovascular Risk: Exploring the Components of This Novel Disease Triangle

The role of thyroid hormones (THs) in the cardiovascular (CV) system, through several direct and indirect effects is recognized. Even very small modification in TH levels (as those observed in subclinical hypothyroidism or hyperthyroidism, and low triiodothyronine syndrome) may adversely affect the CV system, whereas thyroid hormones benefit the CV system and improve the prognosis. There is also evidence of vitamin D effects on cardiometabolic disease (e.g., through modulation of endothelial and smooth muscle cell activity, renin-angiotensin-aldosterone system, nitric oxide, oxidative stress, and inflammatory response), as well as an association between vitamin D [25(OH)D] deficiency and autoimmune thyroid diseases or cancer, and a relationship between vitamin D concentration and titers of antibodies and thyroid autoimmunity replacement. Interestingly, experimental data indicate a direct effect of vitamin D on Type 2 deiodinase expression causing subsequential peripheral conversion of T4 into T3. However, the functional links among THs, vitamin D and the cardiovascular system, and clinical effects of coexisting abnormalities in this new troublesome triad, have not yet been reviewed. The main aim of this review is to discuss pathophysiology of this relationship, proposing new mechanistic insights involving vitamin D in the modulation of cardiometabolic disease and thyroid profile.