Owner, Natural Health Partners, LLC, 125 SW 3rd Place, Cape Coral, FL 33991, USA.
Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA.
Nutrients. 2020 Oct 31;12(11):3361. doi: 10.3390/nu12113361.
Vitamin D deficiency co-exists in patients with COVID-19. At this time, dark skin color, increased age, the presence of pre-existing illnesses and vitamin D deficiency are features of severe COVID disease. Of these, only vitamin D deficiency is modifiable. Through its interactions with a multitude of cells, vitamin D may have several ways to reduce the risk of acute respiratory tract infections and COVID-19: reducing the survival and replication of viruses, reducing risk of inflammatory cytokine production, increasing angiotensin-converting enzyme 2 concentrations, and maintaining endothelial integrity. Fourteen observational studies offer evidence that serum 25-hydroxyvitamin D concentrations are inversely correlated with the incidence or severity of COVID-19. The evidence to date generally satisfies Hill's criteria for causality in a biological system, namely, strength of association, consistency, temporality, biological gradient, plausibility (e.g., mechanisms), and coherence, although experimental verification is lacking. Thus, the evidence seems strong enough that people and physicians can use or recommend vitamin D supplements to prevent or treat COVID-19 in light of their safety and wide therapeutic window. In view of public health policy, however, results of large-scale vitamin D randomized controlled trials are required and are currently in progress.
维生素 D 缺乏症与 COVID-19 患者共存。此时，肤色较深、年龄较大、存在既往疾病和维生素 D 缺乏是 COVID 疾病严重程度的特征。在这些特征中，只有维生素 D 缺乏是可以改变的。通过与多种细胞相互作用，维生素 D 可能有多种方式降低急性呼吸道感染和 COVID-19 的风险：降低病毒的存活和复制、降低炎症细胞因子产生的风险、增加血管紧张素转换酶 2 浓度、并维持内皮完整性。14 项观察性研究提供的证据表明，血清 25-羟维生素 D 浓度与 COVID-19 的发病率或严重程度呈负相关。迄今为止的证据在生物学系统中通常满足希尔因果关系的标准，即关联强度、一致性、时间性、生物学梯度、合理性（例如，机制）和一致性，尽管缺乏实验验证。因此，鉴于其安全性和广泛的治疗窗，证据似乎足够有力，人们和医生可以使用或推荐维生素 D 补充剂来预防或治疗 COVID-19。然而，鉴于公共卫生政策，需要并正在进行大规模维生素 D 随机对照试验的结果。
