Laird E, Rhodes J, Kenny R A
The Irish Longitudinal Study on Ageing, School of Medicine, Trinity College Dublin, Ireland.
Institute of Translational Medicine, University of Liverpool.
Ir Med J. 2020 May 7;113(5):81.
Background Recent research has indicated that vitamin D may have immune supporting properties through modulation of both the adaptive and innate immune system through cytokines and regulation of cell signalling pathways. We hypothesize that vitamin D status may influence the severity of responses to Covid-19 and that the prevalence of vitamin D deficiency in Europe will be closely aligned to Covid-19 mortality. Methods We conducted a literature search on PubMed (no language restriction) of vitamin D status (for older adults) in countries/areas of Europe affected by Covid-19 infection. Countries were selected by severity of infection (high and low) and were limited to national surveys or where not available, to geographic areas within the country affected by infection. Covid-19 infection and mortality data was gathered from the World Health Organisation. Results Counter-intuitively, lower latitude and typically 'sunny' countries such as Spain and Italy (particularly Northern Italy), had low mean concentrations of 25(OH)D and high rates of vitamin D deficiency. These countries have also been experiencing the highest infection and death rates in Europe. The northern latitude countries (Norway, Finland, Sweden) which receive less UVB sunlight than Southern Europe, actually had much higher mean 25(OH)D concentrations, low levels of deficiency and for Norway and Finland, lower infection and death rates. The correlation between 25(OH)D concentration and mortality rate reached conventional significance (P=0.046) by Spearman's Rank Correlation. Conclusions Optimising vitamin D status to recommendations by national and international public health agencies will certainly have benefits for bone health and potential benefits for Covid-19. There is a strong plausible biological hypothesis and evolving epidemiological data supporting a role for vitamin D in Covid-19.
背景 近期研究表明，维生素D可能通过细胞因子对适应性和先天性免疫系统进行调节以及调控细胞信号通路，从而具有免疫支持特性。我们推测，维生素D状态可能会影响对新冠病毒病（Covid-19）反应的严重程度，并且欧洲维生素D缺乏症的患病率将与Covid-19死亡率密切相关。方法 我们在PubMed上进行了文献检索（无语言限制），以查找受Covid-19感染影响的欧洲国家/地区（针对老年人）的维生素D状态。根据感染严重程度（高和低）选择国家，并仅限于全国性调查，若无法获取全国性调查数据，则选择该国受感染影响的地理区域。Covid-19感染和死亡率数据来自世界卫生组织。结果 与直觉相反，纬度较低且通常阳光充足的国家，如西班牙和意大利（特别是意大利北部），25(OH)D的平均浓度较低，维生素D缺乏率较高。这些国家也是欧洲感染率和死亡率最高的国家。与南欧相比，接受紫外线B阳光较少的北纬国家（挪威、芬兰、瑞典）实际上25(OH)D的平均浓度要高得多，缺乏水平较低，而且挪威和芬兰的感染率和死亡率也较低。通过Spearman等级相关分析，25(OH)D浓度与死亡率之间的相关性达到了传统意义上的显著性（P = 0.046）。结论 将维生素D状态优化至国家和国际公共卫生机构的建议水平，肯定会对骨骼健康有益，对Covid-19也可能有益。有一个强有力且看似合理的生物学假说以及不断发展的流行病学数据支持维生素D在Covid-19中发挥作用。
