Cardiovascular Division, University of Minnesota, Minneapolis, USA
Cardiovascular Division, University of Minnesota, Minneapolis, USA.
Clin Med (Lond). 2020 Jul;20(4):e107-e108. doi: 10.7861/clinmed.2020-0301. Epub 2020 Jun 5.
The severity of coronavirus 2019 infection (COVID-19) is determined by the presence of pneumonia, severe acute respiratory distress syndrome (SARS-CoV-2), myocarditis, microvascular thrombosis and/or cytokine storms, all of which involve underlying inflammation. A principal defence against uncontrolled inflammation, and against viral infection in general, is provided by T regulatory lymphocytes (Tregs). Treg levels have been reported to be low in many COVID-19 patients and can be increased by vitamin D supplementation. Low vitamin D levels have been associated with an increase in inflammatory cytokines and a significantly increased risk of pneumonia and viral upper respiratory tract infections. Vitamin D deficiency is associated with an increase in thrombotic episodes, which are frequently observed in COVID-19. Vitamin D deficiency has been found to occur more frequently in patients with obesity and diabetes. These conditions are reported to carry a higher mortality in COVID-19. If vitamin D does in fact reduce the severity of COVID-19 in regard to pneumonia/ARDS, inflammation, inflammatory cytokines and thrombosis, it is our opinion that supplements would offer a relatively easy option to decrease the impact of the pandemic.
2019 年冠状病毒感染（COVID-19）的严重程度取决于肺炎、严重急性呼吸窘迫综合征（SARS-CoV-2）、心肌炎、微血管血栓形成和/或细胞因子风暴的存在，所有这些都涉及潜在的炎症。调节性 T 淋巴细胞（Treg）是对抗失控性炎症和一般病毒感染的主要防御机制。据报道，许多 COVID-19 患者的 Treg 水平较低，维生素 D 补充可以增加 Treg 水平。维生素 D 水平低与炎症细胞因子的增加以及肺炎和病毒性上呼吸道感染风险的显著增加有关。维生素 D 缺乏与血栓形成事件的增加有关，而 COVID-19 中经常观察到这种情况。维生素 D 缺乏在肥胖和糖尿病患者中更为常见。据报道，这些情况在 COVID-19 中死亡率更高。如果维生素 D 确实可以降低 COVID-19 肺炎/ARDS、炎症、炎症细胞因子和血栓形成的严重程度，我们认为补充剂是减少大流行影响的相对简单的选择。
