Department Nutrition, University Hohenheim, Stuttgart, Germany.
Curr Opin Clin Nutr Metab Care. 2021 Jan;24(1):18-24. doi: 10.1097/MCO.0000000000000700.
Old age, obesity and vitamin D deficiency are considered as independent risk factors for severe courses of COVID-19. The aim of the review is to discuss common features of these risk factors and the impact of vitamin D.
The recently discovered relationship between vitamin D and the infection pathway of the virus via the renin--angiotensin system (RAS) and the adipokines leptin and adiponectin play an important role. The frequency of studies showing a relationship between a low vitamin D status in comorbidities and severe COVID-19 courses makes an impact of vitamin D effects likely.
There is a direct relationship between vitamin D, body fat and age in COVID-19 courses. With age, the ability of the skin to synthesize vitamin D decreases, and leads to vitamin D-deficits. If the skin is insufficiently exposed to sunlight, severe deficits can develop. As vitamin D plays an important role not only in the immune system but also in the RAS, and thus at the point where the virus attacks, a good vitamin D supply is an important basis for reducing the risk of severe COVID-19 processes. Treatment with vitamin D supplements should be based on severity of the vitamin D deficiency.
老年、肥胖和维生素 D 缺乏被认为是 COVID-19 严重病程的独立危险因素。本综述的目的是讨论这些危险因素的共同特征以及维生素 D 的影响。
最近发现维生素 D 与病毒的感染途径通过肾素-血管紧张素系统（RAS）以及脂联素和瘦素等脂肪因子有关。越来越多的研究表明，合并症中维生素 D 状态低下与 COVID-19 严重病程之间存在关联，这表明维生素 D 的作用可能很重要。
在 COVID-19 病程中，维生素 D、体脂肪和年龄之间存在直接关系。随着年龄的增长，皮肤合成维生素 D 的能力下降，导致维生素 D 缺乏。如果皮肤不能充分暴露在阳光下，就会发生严重的缺乏。由于维生素 D 不仅在免疫系统中而且在 RAS 中都发挥着重要作用，因此在病毒攻击时，充足的维生素 D 供应是降低 COVID-19 严重病程风险的重要基础。维生素 D 补充剂的治疗应根据维生素 D 缺乏的严重程度而定。
