Laboratorio de Medicina Traslacional, Escuela Militar de Graduados de Sanidad, UDEFA, Mexico City, 11200, Mexico.
Division de Neurociencias, Instituto Nacional de Rehabilitación, Secretaría de Salud, Mexico City, 14389, Mexico.
Curr Top Med Chem. 2022;22(16):1346-1368. doi: 10.2174/1568026622666220401140737.
Vitamin D is a hormone involved in the regulation of important biological processes such as signal transduction, immune response, metabolic regulation and also in the nervous and vascular systems. To date, coronavirus disease 2019 (COVID-19) infection does not have a specific treatment. However, various drugs have been proposed, including those that attenuate the intense inflammatory response, and recently, the use of vitamin D, in clinical trials, as part of the treatment of COVID-19 has provided promising results. It has been observed in some clinical studies that the use of cholecalciferol (vitamin D3) and its two metabolites the circulating form, calcidiol or calcifediol (25-hydroxycalciferol, 25-(OH)-D), and the active form, calcitriol (1,25-(OH)2-D), in different doses, improve the clinical manifestations, prognosis, and survival of patients infected with COVID-19 probably because of its anti-inflammatory, antiviral and lung-protective action. In relation to the central nervous system (CNS) it has been shown, in clinical studies, that vitamin D is beneficial in some neurological and psychiatric conditions because of its anti-inflammatory and antioxidant properties, modulation of neurotransmitters actions, and regulation of calcium homeostasis between other mechanisms. It has been shown that COVID-19 infection induces CNS complications such as headache, anosmia, ageusia, neuropathy, encephalitis, stroke, thrombosis, cerebral hemorrhages, cytotoxic lesions, and psychiatric conditions and it has been proposed that the use of dietary supplements, as vitamin and minerals, can be adjuvants in this disease. In this review, the evidence of the possible role of vitamin D, and its metabolites, as a protector against the neurological manifestations of COVID-19 was summarized.
维生素 D 是一种参与调节重要生物过程的激素，如信号转导、免疫反应、代谢调节，以及神经系统和血管系统。迄今为止，2019 年冠状病毒病（COVID-19）感染没有特定的治疗方法。然而，已经提出了各种药物，包括那些能减弱强烈炎症反应的药物，最近，维生素 D 的使用，在临床试验中，作为 COVID-19 治疗的一部分，已经取得了有希望的结果。在一些临床研究中观察到，使用胆钙化醇（维生素 D3）及其两种代谢物，循环形式的 25-羟胆钙化醇或钙二醇（25-（OH）-D），以及活性形式的 1,25-二羟胆钙化醇（1,25-（OH）2-D），以不同剂量，可以改善 COVID-19 感染患者的临床表现、预后和生存率，这可能是因为它具有抗炎、抗病毒和肺保护作用。关于中枢神经系统（CNS），在临床研究中已经表明，维生素 D 因其抗炎和抗氧化特性、神经递质作用的调节以及钙稳态的调节等机制，对一些神经和精神疾病有益。已经表明，COVID-19 感染会引起 CNS 并发症，如头痛、嗅觉丧失、味觉丧失、神经病、脑炎、中风、血栓形成、脑出血、细胞毒性损伤和精神疾病，并且已经提出膳食补充剂，如维生素和矿物质的使用，可以作为这种疾病的辅助剂。在这篇综述中，总结了维生素 D 及其代谢物作为 COVID-19 神经表现的保护因子的可能作用的证据。
