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维生素 D 在预防 COVID-19 感染、进展和严重程度中的作用。

Role of vitamin D in preventing of COVID-19 infection, progression and severity.

机构信息

Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh.

出版信息

J Infect Public Health. 2020 Oct;13(10):1373-1380. doi: 10.1016/j.jiph.2020.06.021. Epub 2020 Jun 20.

Abstract

The outbreak of COVID-19 has created a global public health crisis. Little is known about the protective factors of this infection. Therefore, preventive health measures that can reduce the risk of infection, progression and severity are desperately needed. This review discussed the possible roles of vitamin D in reducing the risk of COVID-19 and other acute respiratory tract infections and severity. Moreover, this study determined the correlation of vitamin D levels with COVID-19 cases and deaths in 20 European countries as of 20 May 2020. A significant negative correlation (p=0.033) has been observed between mean vitamin D levels and COVID-19 cases per one million population in European countries. However, the correlation of vitamin D with COVID-19 deaths of these countries was not significant. Some retrospective studies demonstrated a correlation between vitamin D status and COVID-19 severity and mortality, while other studies did not find the correlation when confounding variables are adjusted. Several studies demonstrated the role of vitamin D in reducing the risk of acute viral respiratory tract infections and pneumonia. These include direct inhibition with viral replication or with anti-inflammatory or immunomodulatory ways. In the meta-analysis, vitamin D supplementation has been shown as safe and effective against acute respiratory tract infections. Thus, people who are at higher risk of vitamin D deficiency during this global pandemic should consider taking vitamin D supplements to maintain the circulating 25(OH)D in the optimal levels (75-125nmol/L). In conclusion, there is not enough evidence on the association between vitamin D levels and COVID-19 severity and mortality. Therefore, randomized control trials and cohort studies are necessary to test this hypothesis.

摘要

COVID-19 的爆发引发了全球公共卫生危机。目前人们对这种感染的保护因素知之甚少。因此,急需采取预防保健措施来降低感染、疾病进展和严重程度的风险。本综述讨论了维生素 D 减少 COVID-19 和其他急性呼吸道感染风险和严重程度的可能作用。此外,本研究还确定了截至 2020 年 5 月 20 日,20 个欧洲国家的维生素 D 水平与 COVID-19 病例和死亡之间的相关性。在欧洲国家,维生素 D 水平与每百万人 COVID-19 病例数呈显著负相关(p=0.033)。然而,维生素 D 与这些国家 COVID-19 死亡病例之间的相关性并不显著。一些回顾性研究表明维生素 D 状态与 COVID-19 的严重程度和死亡率之间存在相关性,而其他研究在调整混杂变量后并未发现相关性。一些研究表明维生素 D 在降低急性病毒性呼吸道感染和肺炎的风险方面发挥作用,包括通过直接抑制病毒复制或通过抗炎或免疫调节作用。荟萃分析表明,维生素 D 补充剂对急性呼吸道感染是安全有效的。因此,在全球大流行期间,那些维生素 D 缺乏风险较高的人应考虑服用维生素 D 补充剂,以将循环 25(OH)D 维持在最佳水平(75-125nmol/L)。总之,目前尚无足够证据表明维生素 D 水平与 COVID-19 严重程度和死亡率之间存在关联。因此,需要进行随机对照试验和队列研究来验证这一假设。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b74/7305922/6ff6c6de3400/gr1_lrg.jpg

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