Vitamin D to reduce risk of COVID-19

Authors

• Prab R. Tumpati, MD, editor in chief and founder, WikiMD
• Bhanu Gadde, PharmD

Is lack of vitamin in the population making the ongoing Coronavirus disease 2019 pandemic unstoppable?

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Vitamin D

Physical barriers are good, but the way this is spreading, it is a foregone conclusion that most of us will be infected by it. According to the throat swabs of corona positive non-symptomatic patients, the viral counts were 4 orders of magnitude higher than those observed in SARS or MERS patients.

The mortality rates with this are ranging from 0.5% to 8% among various populations and coupled with the virulence, these numbers can mean staggeringly high deaths compared to the previous outbreaks that happened within the last 2 decades. Some people recover from this without showing any symptoms. Hence, it is not only important to focus on physical barriers, but on physiological barriers as well.

The trial of Hydroxychloroquine/Azithromycin along with antiviral drug combinations proved effective in a recent French study. Hydroxychloroquine and chloroquine are zinc ionophores and bring zinc into the cell which can inhibit viral replication. Zinc was found to reduce the viral counts in RSV infections by a 1000 to 1,000,000 fold.1

Based on this information one can conclude that, as much as the Chloroquine and Hydroxychloroquine seem to work, zinc supplementation along with this therapy could only enhance the therapeutic outcomes.

Not only the modulation of RAS (Renin-Angiotensin System) by vitamin D is known but also the modulation of the immune responses to respiratory viruses can also be seen in the literature2

Vitamin D deficit is also implicated in activating the RAS3

• SARS-COV2 seems to bind to the ACE2 receptor to gain access into the cell and reduce the ACE2 activity leading to a further imbalance of the RAS system4

• Normalization of vitamin D levels can reduce the RAS activity and can prevent acute lung injury in ARDS5

(Acute respiratory Distress Syndrome).

The role of vitamin D in suppressing viral replication in various viral infections is also extensively documented in the literature. There is evidence that low levels of circulating vitamin D resulting in impaired innate immune function6

Vitamin D receptor plays an important role in vitamin D mediated transcription in the nucleus. For the virus to replicate, it must use the transcription mechanisms of the cell by hijacking the processes.

The suppression of viral replication in people with normal vitamin D levels in viral anthologies associated with various viral diseases may indicate the unavailability of the VDR (vitamin D receptor) to the virus to facilitate its replication. Irrespective of the mechanism, evidence points to suppressed replication of virus in people with normal vitamin D levels.

Vitamin D appears to play a very important role in addressing the covid-19 disease progression in multiple ways including modulating the innate and adaptive immunity, modulating the RAS system and preventing the replication by vitamin D mediated transcription mechanisms.

Based on this evidence, the population that has nutritional deficiencies (Vitamin D, and minerals - zinc) can be a perfect target for the ravaging effects of the SARS-COV2 virus. Supplementation with zinc and high levels of vitamin D3 (proven to be safe up to 50,000 iu/day7) can prove to be an effective physiological barrier in combating this pandemic.

In light of this evidence and given that the majority of the population is chronically deficient in vitamin D, and that the cost of vitamin D3 is extremely low, it would be utterly irresponsible to not recommend this to everyone.

Our proposal - recommendation for Vitamin D

• Every adult in the COVID affected areas must consider starting on at least 20,000 iu/day of vitamin D3 (not D2, which is a vitamin D analog; the same beneficial effects of D3 were not seen in D2 supplementation) whether symptomatic or asymptomatic in consultation with a licensed physician^ for a duration of 4-8 weeks, should be recommended by all physicians during the ongoing Coronavirus disease 2019 outbreak.
• Also consider 50 to 100 mg of zinc daily^.

Recent studies

According to an article published on The SUN, a popular daily in the United Kingdom, the death rate with normal vitamin D and COVID 19 is about 4% while the death rate in those that are deficient in vitamin D is a staggering 98.9%! Based on this analysis and study, with a mortality difference that is so high, not supplementing vitamin D is suicidal.

* Terrifying graph shows the correlation on vitamin D and COVID

Also see

• COVID-19 prophylaxis proposal

References

1. . Antimicrob Agents Chemother . 2004 Mar; 48(3): 783–790.
2. . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488782/
3. . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331620/
4. . https://www.bmj.com/content/368/bmj.m810
5. . https://thorax.bmj.com/content/70/7/617
6. . https://jlb.onlinelibrary.wiley.com/doi/pdf/10.1189/jlb.1011523
7. . https://www.ncbi.nlm.nih.gov/pubmed/30611908

^Disclaimer:: Please do not take any medication including, but not limited to, any of the above medications, without first consulting with a licensed physician. This proposal is intended as a suggestion for the government and other policy makers to come up with a plan of action. This article, by no means, should be taken as providing medical advise.

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