Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1

Nutrients. 2021 Nov 12;13(11):4047. doi: 10.3390/nu13114047.

Abstract

Background: We aimed to establish an acute treatment protocol to increase serum vitamin D, evaluate the effectiveness of vitamin D3 supplementation, and reveal the potential mechanisms in COVID-19.

Methods: We retrospectively analyzed the data of 867 COVID-19 cases. Then, a prospective study was conducted, including 23 healthy individuals and 210 cases. A total of 163 cases had vitamin D supplementation, and 95 were followed for 14 days. Clinical outcomes, routine blood biomarkers, serum levels of vitamin D metabolism, and action mechanism-related parameters were evaluated.

Results: Our treatment protocol increased the serum 25OHD levels significantly to above 30 ng/mL within two weeks. COVID-19 cases (no comorbidities, no vitamin D treatment, 25OHD <30 ng/mL) had 1.9-fold increased risk of having hospitalization longer than 8 days compared with the cases with comorbidities and vitamin D treatment. Having vitamin D treatment decreased the mortality rate by 2.14 times. The correlation analysis of specific serum biomarkers with 25OHD indicated that the vitamin D action in COVID-19 might involve regulation of INOS1, IL1B, IFNg, cathelicidin-LL37, and ICAM1.

Conclusions: Vitamin D treatment shortened hospital stay and decreased mortality in COVID-19 cases, even in the existence of comorbidities. Vitamin D supplementation is effective on various target parameters; therefore, it is essential for COVID-19 treatment.

Keywords: COVID-19; SARS-CoV-2; acute respiratory failure; cathelicidin-LL37; cytokine; vitamin D.

MeSH terms

  • Antimicrobial Cationic Peptides / blood
  • Antimicrobial Cationic Peptides / genetics
  • Antimicrobial Cationic Peptides / metabolism
  • COVID-19 / complications
  • COVID-19 / drug therapy*
  • COVID-19 / mortality
  • Dietary Supplements
  • Gene Expression Regulation / drug effects
  • Humans
  • Intercellular Adhesion Molecule-1 / blood
  • Intercellular Adhesion Molecule-1 / genetics
  • Intercellular Adhesion Molecule-1 / metabolism
  • Interferon-gamma / blood
  • Interferon-gamma / genetics
  • Interferon-gamma / metabolism
  • Interleukin-1beta / blood
  • Interleukin-1beta / genetics
  • Interleukin-1beta / metabolism
  • Nitric Oxide Synthase Type II / blood
  • Nitric Oxide Synthase Type II / genetics
  • Nitric Oxide Synthase Type II / metabolism
  • Prospective Studies
  • Retrospective Studies
  • SARS-CoV-2*
  • Vitamin D / administration & dosage*
  • Vitamin D / blood
  • Vitamin D / pharmacology
  • Vitamins / administration & dosage
  • Vitamins / pharmacology

Substances

  • Antimicrobial Cationic Peptides
  • ICAM1 protein, human
  • Interleukin-1beta
  • Vitamins
  • Intercellular Adhesion Molecule-1
  • Vitamin D
  • ropocamptide
  • Interferon-gamma
  • Nitric Oxide Synthase Type II