Role of vitamin D in treating COVID-19-associated coagulopathy: problems and perspectives

Mol Cell Biochem. 2021 Jun;476(6):2421-2427. doi: 10.1007/s11010-021-04093-6. Epub 2021 Feb 18.

Abstract

Aggressive inflammatory response leading to hypercoagulability has been found to be associated with disease severity in COVID-19 patients and portends bad treatment outcome. A state of acute disseminated intravascular coagulation (DIC), along with pulmonary embolism and/or deep vein thrombosis, has been observed in critically ill ICU patients. Autopsy reports of COVID-19 patients demonstrated microthrombi in lungs and in other organs, as well as marked inflammatory changes, characteristic clinicopathological features that exacerbate disease severity. Vitamin D supplementation was recommended by many clinicians across the globe to improve clinical symptoms of COVID-19 patients, mainly because of its immunomodulatory roles on immune cells. Furthermore, vitamin D and its associated molecules are also known to directly or indirectly regulate various thrombotic pathways. We propose that vitamin D supplementation not only attenuates the risk of Acute Respiratory Disease Syndrome (ARDS) but it also may have a role in reducing coagulation abnormalities in critically ill COVID-19 patients. The overarching goal of this review is to discuss the effects of vitamin D on coagulation pathways and other intertwined processes leading to thrombosis. Many clinical trials are currently investigating the efficacy of vitamin D supplementation in reducing the risk of COVID-19 infection. However, randomized placebo control clinical trials are also necessary to ascertain the effect of vitamin D supplementation on reducing the risk of coagulopathy in COVID-19 patients.

Keywords: COVID-19; Coagulation; Hypercoagulability; Inflammation; Thromboinflammation; Thrombosis; Venous thromboembolism (VTE); Vitamin D.

Publication types

  • Review

MeSH terms

  • Blood Coagulation Disorders / virology
  • COVID-19 / complications
  • COVID-19 / drug therapy*
  • COVID-19 / etiology*
  • Humans
  • Urachal Cyst / etiology
  • Vitamin D / pharmacology*
  • Vitamin D / physiology*
  • Vitamin D Deficiency / virology

Substances

  • Vitamin D

Supplementary concepts

  • Benign non-infected urachal cyst
  • COVID-19 drug treatment