The role of Vit D in COVID infection

This week’s expert:
Prof Peter Ebeling AO, Endocrinologist, Head of the Department of Medicine, Monash Health

Drawn from an interview with Prof Ebeling by Dr Harry Nespolon on the Healthed podcast Going Viral.

• It has been suggested that Vit D supplementation could help prevent and reduce the impact of COVID-19

• A meta-analysis published in the BMJ in 2017 showed that Vit D supplementation reduced the incidence of viral respiratory tract infections

• In the current pandemic, COVID-19 has been associated with a lower mortality in populations closer to the equator compared to those populations further away from the equator where Vit D deficiency is more likely

• To date there are no randomised controlled trials to determine if intervention with Vit D affects COVID-19 infection. However, such studies are currently underway

• Lab studies have shown that Vit D has antiviral, anti-inflammatory and lung protective properties

• Mechanisms by which Vit D could influence COVID-19 include:

o The conversion of the inactive form of Vit D to the active form not only takes place in the kidney, but can also occur in cells in the lung and in lymphocytes with the overall effect being anti-inflammatory
o The SARS-Cov-2 enters cells in the respiratory system via ACE2 receptors. Vit D can also activate these receptors and thereby inhibit the coronavirus entering the cells
o Vit D can inhibit one of the specific proteins that is important in the viral replication of COVID-19

• While yet to be proven, it would be prudent to consider Vit D supplementation particularly in the southern states of Australia where Vit D deficiency is more likely, as a means of protecting against COVID-19

• It is known that 23% of Australia’s population is Vit D deficient (<50nmol/L), the prevalence is higher in the southern states especially in the winter months

• The daily requirement for Vit D is 600-800U. Diet usually accounts for 110U a day with the balance being made up by UVB

• Daily or weekly supplementation with Vit D can be safely recommended at doses of 1000U/day. Severe deficiency and people who are obese warrant higher doses for supplementation

• Vit D is a fat-soluble vitamin and will be better absorbed if taken with a fatty meal

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