Khan Aysha Habib, Nasir Noreen, Nasir Nosheen, Maha Quratulain, Rehman Rehana
Department of Pathology & Laboratory Medicine & Medicine, Aga Khan University, Karachi, Pakistan.
Department of Medicine, Aga Khan University, Karachi, Pakistan.
J Diabetes Metab Disord. 2021 Mar 29;20(1):931-938. doi: 10.1007/s40200-021-00775-6. eCollection 2021 Jun.
The COVID-19 pandemic requires a rapid understanding of the pathogenesis of the spectrum of the disease and factors associated with varied clinical presentations. Immune dysregulation with a cytokine storm (CS) progressing to ARDS with resemblance to sHLH is suggested as a main cause of tissue injury. Low levels of vitamin D were observed in COVID-19 cases with higher incidence of mortality in 20 European countries, increased risk of severity in COVID-19 contributing to ARDS or fulminant myocarditis and micro vascular thrombosis is proposed. Vitamin D may be protective against acute respiratory tract infections, as it regulates the inflammatory cytokine response of respiratory epithelial cells and macrophages, suppress CS and other manifestations seen in SARS-Cov-2. Hence, it is suggested as one of the therapies in SARS-CoV-2 infection. Major research gaps are identified globally in clinical management and this relationship. There is an imperative requisite to understand the interplay of markers in SARS-CoV-2, its risk factors and potential role of vitamin D to improve clinical outcome by pandemic of COVID-19. We therefore perform this review for understanding the pathophysiology of SARS-CoV-2 infections and the role of vitamin D in combating it.
新冠疫情需要我们迅速了解该疾病谱的发病机制以及与不同临床表现相关的因素。免疫失调伴细胞因子风暴（CS）进展为急性呼吸窘迫综合征（ARDS），且与噬血细胞性淋巴组织细胞增生症（sHLH）相似，这被认为是组织损伤的主要原因。在20个欧洲国家，新冠病例中观察到维生素D水平较低，死亡率较高，因此有人提出维生素D水平低会增加新冠病情严重程度的风险，进而导致ARDS或暴发性心肌炎以及微血管血栓形成。维生素D可能对急性呼吸道感染具有保护作用，因为它可调节呼吸道上皮细胞和巨噬细胞的炎性细胞因子反应，抑制细胞因子风暴以及新冠病毒（SARS-CoV-2）出现的其他表现。因此，它被建议作为新冠病毒感染的治疗方法之一。全球在临床管理以及这种关系方面都存在重大研究空白。迫切需要了解新冠病毒中各种标志物之间的相互作用、其风险因素以及维生素D的潜在作用，以通过应对新冠疫情改善临床结果。因此，我们进行本次综述以了解新冠病毒感染的病理生理学以及维生素D在对抗该病毒中的作用。
