Department of Biosciences, Federal University of São Paulo (UNIFESP), Santos11015-020, São Paulo, Brazil.
Department of Physiology and Pharmacology, Federal University of Ceará (UFC), Fortaleza60430-275, Ceará, Brazil.
Rev Neurosci. 2020 Nov 12;32(2):235-247. doi: 10.1515/revneuro-2020-0074. Print 2021 Feb 23.
The coronavirus disease (COVID-19), identified in Wuhan, China, on December 2019, was declared a pandemic by the World Health Organization, on March, 2020. Since then, efforts have been gathered to describe its clinical course and to determine preventive measures and treatment strategies. Adults older than 65 years of age are more susceptible to serious clinical symptoms and present higher mortality rates. Angiotensin-converting enzyme 2 (ACE2) is a major receptor for some coronavirus infection, including SARS-COV-2, but is also a crucial determinant in anti-inflammation processes during the renin-angiotensin system (RAS) functioning - converting angiotensin II to angiotensin 1-7. The decline in ACE2 expression that occurs with aging has been associated to the higher morbidity and mortality rates in older adults. These observations highlight the importance of investigating the association between COVID-19 and age-related neurodegenerative disorders, i.e., Parkinson's and Alzheimer's diseases. A possible option to reduce the risk of COVID-19 is vitamin D supplementation, due to its anti-inflammatory and immune-system-modulating effects. It has also been suggested that vitamin D supplementation plays a role in slowing progression of Parkinson and Alzheimer. The present study is a literature review of articles published on the theme COVID-19, Parkinson and Alzheimer's diseases, and the role played by vitamin D. PUBMED, MEDLINE, and EMBASE databases were consulted. Results confirm neurodegenerative and neuroinflammatory effects of COVID-19, aggravated in Parkinson's and Alzheimer's patients, and the important role of vitamin D as a possible therapeutic strategy. Nevertheless, randomized controlled trials and large population studies are still warranted.
2019 年 12 月在中国武汉发现的冠状病毒病（COVID-19），于 2020 年 3 月被世界卫生组织宣布为大流行。从那时起，人们一直在努力描述其临床过程，并确定预防措施和治疗策略。65 岁以上的成年人更容易出现严重的临床症状，并呈现出更高的死亡率。血管紧张素转换酶 2（ACE2）是一些冠状病毒感染的主要受体，包括 SARS-COV-2，但也是肾素-血管紧张素系统（RAS）功能中抗炎过程的关键决定因素——将血管紧张素 II 转化为血管紧张素 1-7。随着年龄的增长，ACE2 表达的下降与老年人更高的发病率和死亡率有关。这些观察结果强调了研究 COVID-19 与年龄相关的神经退行性疾病（即帕金森病和阿尔茨海默病）之间的关联的重要性。减少 COVID-19 风险的一种可能方法是补充维生素 D，因为它具有抗炎和调节免疫系统的作用。也有人认为，维生素 D 补充剂在减缓帕金森病和阿尔茨海默病的进展方面发挥作用。本研究是对关于 COVID-19、帕金森病和阿尔茨海默病以及维生素 D 作用的主题文章的文献综述。查阅了 PUBMED、MEDLINE 和 EMBASE 数据库。结果证实了 COVID-19 的神经退行性和神经炎症作用，在帕金森病和阿尔茨海默病患者中更为严重，以及维生素 D 作为一种可能的治疗策略的重要作用。然而，仍需要随机对照试验和大型人群研究。
