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JCST

Journal of Current Science and Technology

ISSN 2630-0656 (Online)

COVID-19 pandemic and vitamin D deficiency: a different approach with an analysis of the findings and a complimentary proposal

  • Virna M. Martín Giménez, Instituto de Investigaciones en Ciencias Químicas, Facultad de Ciencias Químicas y Tecnológicas, Universidad Católica de Cuyo, San Juan, Argentina.
  • Ivana Bergam, Croatia osiguranje, Pension Company for voluntary pension fund management, Vatroslava Jagića 33, 10000 Zagreb, Croatia.
  • Felipe Inserra, Universidad Maimónides, Buenos Aires, Argentina
  • Russel J. Reiter, Department of Cell Systems and Anatomy, UT Health San Antonio Long School of Medicine, San Antonio, TX, USA.
  • Walter Manucha, Área de Farmacología, Departamento de Patología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina. & Instituto de Medicina y Biología Experimental de Cuyo (IMBEC, Corresponding author; E-mail: wmanucha@yahoo.com.ar

Abstract

Vitamin D is an essential immune-modulator with receptors widely distributed throughout the body, and its serum levels fluctuate significantly in individuals between winter and summer months.  This study examines the association between low vitamin D status and prevalence of COVID-19 cases around the world and proposes a relationship with the seasonal character of the human immune system strength rather than to the seasonal infectivity of viruses.  Also, this review suggests that the observed geographical disparities in COVID-19 cases are due to differences in vitamin D levels.  On the international scale, serum vitamin D levels are reportedly lowest in China, the Middle East, and South Europe; these populations also had the largest outbreaks of COVID-19 cases.  In addition to the geographical differences in vitamin D status, there are known risk groups (ethnic, age-related, pregnancies).  In contrast, some countries including Canada, Finland, and North Europe incorporate increased amounts of vitamin D through fortified foods, vitamin D supplements, and sunbathing.  These countries show the lowest morbidity and mortality rates by COVID-19 infection and demonstrate that lower ambient temperatures do not contribute to a higher number of COVID-19 cases.  COVID-19 has spread around the globe almost simultaneously in both warm and cold areas.  Given this information, vitamin D measurement should become an essential component of public health monitoring as a biomarker of immunity status.  Clinical trials should be conducted to confirm this hypothesis.  COVID-19 tests should be performed together with vitamin D status tests to verify this proposed relationship.

Keywords: COVID-19; geographical differences; seasonal immune system; vitamin D deficiency; vitamin D status

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DOI: 10.14456/jcst.2021.16

References

Adams, J. S., & Hewison, M. (2012). Extrarenal expression of the 25-hydroxyvitamin D-1-hydroxylase. Archives of Biochemistry and Biophysics, 523(1), 95-102. DOI: https://doi.org/10.1016/j.abb.2012.02.016

Alshahrani, F., & Aljohani, N. (2013). Vitamin D: deficiency, sufficiency and toxicity. Nutrients, 5(9), 3605-3616. DOI: https://doi.org/10.3390/nu5093605

Alvarez-Artime, A., Cernuda-Cernuda, R., Artime-Naveda, F., Cepas, V., Gonzalez-Menendez, P., Fernadez-Vega, S., Quiros-Gonzalez, I., Sainz, R. M., & Mayo, J. C. (2020). Melatonin-Induced Cytoskeleton Reorganization Leads to Inhibition of Melanoma Cancer Cell Proliferation. International Journal of Molecular Sciences, 21(2), 548. DOI: https://doi.org/10.3390/ijms21020548

Aranow, C. (2011). Vitamin D and the immune system. Journal of Investigative Medicine, 59(6), 881-886. DOI: https://doi.org/10.2310/JIM.0b013e31821b8755

Arnljots, R., Snaebjörnsson Arnljots, E., Thorn, J., Elm, M., Moore, M., & Sundvall, P. D. (2019). Bacteriuria and vitamin D deficiency: a cross sectional study of 385 nursing home residents. BMC Geriatrics, 19(1), 381. DOI: https://doi.org/10.1186/s12877-019-1400-z

Barnard, K., & Colón-Emeric, C. (2010). Extraskeletal effects of vitamin D in older adults: cardiovascular disease, mortality, mood, and cognition. The American Journal of Geriatric Pharmacotherapy, 8(1), 4-33. DOI: https://doi.org/10.1016/j.amjopharm.2010.02.004

Bassil, D., Rahme, M., Hoteit, M., & Fuleihan, G. E.-H. (2013). Hypovitaminosis D in the Middle East and North Africa: Prevalence, risk factors and impact on outcomes. Dermatoendocrinology, 5(2), 274-298. DOI: https://doi.org/10.4161/derm.25111

Beard, J. A., Bearden, A., & Striker, R. (2011). Vitamin D and the anti-viral state. Journal of Clinical Virology, 50(3), 194-200. DOI: https://doi.org/10.1016/j.jcv.2010.12.006

Bikle, D. D. (2009). Vitamin D and immune function: understanding common pathways. Current Osteoporosis Reports, 7(2), 58-63. DOI: https://doi.org/10.1007/s11914-009-0011-6

Cannell, J. J., Vieth, R., Umhau, J. C., Holick, M. F., Grant, W. B., Madronich, S., Garland, C. F., & Giovannucci, E. (2006). Epidemic influenza and vitamin D. Epidemiology and Infection, 134, 1129-1140. DOI: https://doi.org/10.1017/S0950268806007175

Chakhtoura, M., Rahme, M., Chamoun, N., & Fuleihan, G. E.-H. (2018). Vitamin D in the Middle East and North Africa. Bone Reports, 8, 135-146. DOI: https://doi.org/10.1016/j.bonr.2018.03.004

Cinar, N., Harmanci, A., Yildiz, B. O., & Bayraktar, M. (2014). Vitamin D status and seasonal changes in plasma concentrations of 25-hydroxyvitamin D in office workers in Ankara, Turkey. European Journal of Internal Medicine, 25(2), 197-201. DOI: https://doi.org/10.1016/j.ejim.2013.11.004

D'Avolio, A., Avataneo, V., Manca, A., Cusato, J., De Nicolò, A., Lucchini, R., Keller, F., & Cantù, M. (2020). 25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2. Nutrients, 12(5), 1359. DOI: https://doi.org/10.3390/nu12051359

Dobson, R. (2007). Many young south Asian women in UK lack vitamin D, study finds. British Medical Journal, 334(7590), 389. DOI: https://doi.org/10.1136/bmj.39132.351516.DB

Ferder, M., Inserra, F., Manucha, W., & Ferder, L. (2013). The world pandemic of vitamin D deficiency could possibly be explained by cellular inflammatory response activity induced by the renin-angiotensin system. American Journal of Physiology Cell Physiology, 304(1), C1027-39. DOI: https://doi.org/10.1152/ajpcell.00403.2011

Gavigan, P., & McCullers, J. A. (2019). Influenza: annual seasonal severity. Current Opinion in Pediatrics, 31(1), 112-118. DOI: https://doi.org/10.1097/MOP.0000000000000712

Giménez, V. M. M., Sanz, R. L., Marón, F. J. M., Ferder, L., & Manucha, W. (2020). Vitamin D-RAAS connection: An Integrative Standpoint into Cardiovascular and Neuroinflammatory Disorders. Current Protein and Peptide Sciences, 2020, 10.2174/1389203721666200606220719. DOI: https://doi.org/10.2174/1389203721666200606220719

Grant, W. B. (2011). An estimate of the global reduction in mortality rates through doubling vitamin D levels. European Journal of Clinical Nutrition, 65(9), 1016-1026. DOI: https://doi.org/10.1038/ejcn.2011.68

Grant, W. B., Bhattoa, H. P., & Boucher, B. J. (2017). Seasonal variations of U.S. mortality rates: Roles of solar ultraviolet-B doses, vitamin D, gene exp ression, and infections. The Jounal of Steroid Biochemistry and Molecular Biology, 173, 5-12. DOI: https://doi.org/10.1016/j.jsbmb.2017.01.003

Grant, W. B., & Giovannucci, E. (2009). The possible roles of solar ultraviolet-B radiation and vitamin D in reducing case-fatality rates from the 1918-1919 influenza pandemic in the United States. Dermatoendocrinology, 1(4), 215-9. DOI: https://doi.org/10.4161/derm.1.4.9063

Grant, W. B., Schwalfenberg, G. K., Genuis, S. J., & Whiting, S. J. (2010). An estimate of the economic burden and premature deaths due to vitamin D deficiency in Canada. Molecular Nutrition and Food Research, 54(8), 1172-1181. DOI: https://doi.org/10.1002/mnfr.200900420

Kim; H. J., Jang, J. G., Hong, K. S., Park, J. K., & Choi, E. Y. (2015). Relationship between serum vitamin D concentrations and clinical outcome of community-acquired pneumonia. International Journal of Tuberculosis and Lung Disease, 19(6), 729-734. DOI: https://doi.org/10.5588/ijtld.14.0696

Lips, P. (2010). Worldwide status of vitamin D nutrition. The Journal of Steroid Biochemistry and Molecular Biology, 121(1-2), 297-300. DOI: https://doi.org/10.1016/j.jsbmb.2010.02.021

Lips, P., Cashman, K. D., Lamberg-Allardt, C., Bischoff-Ferrari, H. A., Obermayer-Pietsch, B., Bianchi, M. L., Stepan, J., Fuleihan, G. E.-H., & Bouillon, R. (2019). Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. European Journal of Endocrinology, 180(4), P23-P54. DOI: https://doi.org/10.1530/EJE-18-0736

Martín Giménez, V. M., Inserra, F., Ferder, L., García, J., & Manucha, W. (2020a). Vitamin D deficiency in African Americans is associated with a high risk of severe disease and mortality by SARS-CoV-2. Journal of Human Hypertension, 2020, 1-3. DOI: https://doi.org/10.1038/s41371-020-00398-z

Martín Giménez, V. M., Inserra, F., Tajer, C. D., Mariani, J., Ferder, L., Reiter, R .J., & Manucha, W. (2020b). Lungs as target of COVID-19 infection: Protective common molecular mechanisms of vitamin D and melatonin as a new potential synergistic treatment. Life Sciences, 254, 117808. DOI: https://doi.org/10.1016/j.lfs.2020.117808

Martineau, A. R., Jolliffe, D. A., Hooper, R. L., Greenberg, L., Aloia, J. F., Bergman, P., Dubnov-Raz, G., Esposito, S., Ganmaa, D., Ginde, A. A., Goodall, E. C., Grant, C. C., Janssens, W., Jensen, M. E., Kerley, C. P., Laaksi, I., Manaseki-Holland, S., Mauger, D., Murdoch, D. R., Neale, R., Rees, J. R., Simpson, S., Stelmach, I., Trilok Kumar, G., Urashima, M., Camargo, C.A., Griffiths, C. J., & Hooper, R. L. (2019). Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis. Health Technology Assessment, 23(2), 1-44. DOI: https://doi.org/10.3310/hta23020

Mead, M. N. (2008). Benefits of sunlight: a bright spot for human health. Environmental Health Perspectives, 116(4), A197. DOI: https://doi.org/10.1289/ehp.116-a160

Meltzer, D. O., Best, T. J., Zhang, H., Vokes, T., Arora, V., & Solway, J. (2020). Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results. JAMA Network Open, 3(9), e2019722. DOI:  https://doi.org/10.1001/jamanetworkopen.2020.19722

Merzon, E., Tworowski, D., Gorohovski, A., Vinker, S., Golan Cohen, A., Green, I., & Frenkel-Morgenstern, M. (2020). Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study. FEBS Journal, 10.1111/febs.15495. DOI: https://doi.org/10.1111/febs.15495

Mocayar Marón, F. J., Ferder, L., Reiter, R. J., & Manucha, W. (2020. Daily and seasonal mitochondrial protection: Unraveling common possible mechanisms involving vitamin D and melatonin. The Journal of Steroid Biochemistry and Molecular Biology, 199, 105595. DOI: https://doi.org/10.1016/j.jsbmb.2020.105595

Panula, J., Pihlajamäki, H., Mattila, V. M., Jaatinen, P., Vahlberg, T., Aarnio, P., & Kivelä, S. L. (2011). Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. BMC Musculoskelet. Disorders, 12, 105. DOI: https://doi.org/10.1186/1471-2474-12-105

Raoult, D.; Zumla, A., Locatelli, F., Ippolito, G., & Kroemer, G. (2020). Coronavirus infections: Epidemiological, clinical and immunological features and hypotheses. Cell Stress, 4(4), 66-75. DOI: https://doi.org/10.15698/cst2020.04.216

Reiter, R. J., Sharma, R., Ma, Q., Liu, C., Manucha, W., Abreu- González, P., & Domínguez- Rodríguez, A. (2020). Plasticity of glucose metabolism in activated immune cells: advantages for melatonin inhibition of COVID-19 disease. Melatonin Research, 3, 346-361. DOI: https://doi.org/10.32794/mr11250068

Rondanelli, M., Miccono, A., Lamburghini, S., Avanzato, I., Riva, A., Allegrini, P., Faliva, M.A., Peroni, G., Nichetti, M., & Perna, S. (2018). Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. Evidence-Based Complementary and Alternative Medicne, 2018, 5813095. DOI: https://doi.org/10.1155/2018/5813095

Rosano, A., Bella, A., Gesualdo, F., Acampora, A., Pezzotti, P., Marchetti, S., Ricciardi, W., & Rizzo, C. (2019). Investigating the impact of influenza on excess mortality in all ages in Italy during recent seasons (2013/14-2016/17 seasons). International Journal of Infectious Diseases, 88, 127-134. DOI: https://doi.org/10.1016/j.ijid.2019.08.003

Rosen, C.J., Adams, J.S., Bikle, D.D., Black, D.M., Demay, M.B., Manson, J.E., Murad, M.H., Kovacs, C.S. (2012) The nonskeletal effects of vitamin D: an Endocrine Society scientific statement. Endocrine Reviews, 33(3), 456-92. DOI: https://doi.org/10.1210/er.2012-1000

Ross, A. C., Taylor, C. L., Yaktine, A. L., & Del Valle, H. B. (2011). Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. The national academies collection: Reports funded by national institutes of health. Dietary reference intakes for calcium and vitamin D. Washington (DC): National Academies Press (US). National Academy of Sciences.

Sabetta, J. R., DePetrillo, P., Cipriani, R. J., Smardin, J., Burns, L. A., & Landry, M. L. (2010). Serum 25-hydroxyvitamin d and the incidence of acute viral respiratory tract infections in healthy adults. PLoS One, 5(6), e11088. DOI: https://doi.org/10.1371/journal.pone.0011088

Scholtens, R. M., van Munster, B. C., van Kempen, M. F., & de Rooij, S. E. (2016). Physiological melatonin levels in healthy older people: A systematic review. Journal of Psychosomatic Research, 86, 20-27. DOI: https://doi.org/10.1016/j.jpsychores.2016.05.005

Shaman, J., Pitzer, V. E., Viboud, C., Grenfell, B. T., Lipsitch, M. (2010). Absolute humidity and the seasonal onset of influenza in the continental United States. PLoS Biol, 8(2), e1000316. DOI: 10.1371/journal.pbio.1000316

Spiro, A., & Buttriss, J. L. (2014). Vitamin D: An overview of vitamin D status and intake in Europe. Nutrition Bulletin, 39(4), 322-350. DOI: https://doi.org/10.1111/nbu.12108

Teymoori-Rad, M., Shokri, F., Salimi, V., & Marashi, S. M. (2019). The interplay between vitamin D and viral infections. Reviews in Medical Virology, 29(2), e2032. DOI: https://doi.org/10.1002/rmv.2032

Treanor, J. J., Talbot, H. K., Ohmit, S. E., Coleman, L. A., Thompson, M. G., Cheng, P. Y., Petrie, J. G., Lofthus, G., Meece, J. K., Williams, J. V., Berman, L., Breese Hall, C., Monto, A. S., Griffin, M. R., Belongia, E., Shay, D. K., & Network, U. S. (2012). Flu-VE. Effectiveness of seasonal influenza vaccines in the United States during a season with circulation of all three vaccine strains. Clinical Infectious Diseases, 55(7), 951-959. DOI: https://doi.org/10.1093/cid/cis574

Van Schoor, N., & Lips, P. (2011). Worldwide Vitamin D Status. Best Practice and Research: Clinical Endocrinology and Metabolism, Best Practice and Research: Clinical Endocrinology and Metabolism, 25(4), 671-680. DOI:  https://doi.org/10.1016/j.beem.2011.06.007

Xie, J., & Zhu, Y. (2020). Association between ambient temperature and COVID-19 infection in 122 cities from China. Science of the Total Environment, 724, 138201. DOI: https://doi.org/10.1016/j.scitotenv.2020.138201

Zehnder, D., Bland, R., Williams, M. C., McNinch, R. W., Howie, A. J., Stewart, P. M., & Hewison, M. (2001). Extrarenal expression of 25-hydroxyvitamin d(3)-1 alpha-hydroxylase. The Journal of Clinical Endocrinology and Metabolism, 86(2), 888-894. DOI: https://doi.org/10.1210/jcem.86.2.7220

Zimmerman, S., & Reiter, R. (2019). Melatonin and the Optics of the Human Body. Melatonin Research, 2(1), 138-160. DOI: https://doi.org/https://doi.org/10.32794/mr11250016

Zisi, D., Challa, A., & Makis, A. (2019). The association between vitamin D status and infectious diseases of the respiratory system in infancy and childhood. Hormones (Athens), 18(4), 353-363. DOI: https://doi.org/10.1007/s42000-019-0015

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