The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19
Yi Xu, David J Baylink, Chien-Shing Chen, Mark E Reeves, Jeffrey Xiao, Curtis Lacy, Eric Lau, Huynh Cao
Journal of Translational Medicine, doi:10.1186/s12967-020-02488-5
The coronavirus disease 2019 pandemic has led to a declaration of a Public Health Emergency of International Concern by the World Health Organization. As of May 18, 2020, there have been more than 4.7 million cases and over 316,000 deaths worldwide. COVID-19 is caused by a highly infectious novel coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), leading to an acute infectious disease with mild-to-severe clinical symptoms such as flu-like symptoms, fever, headache, dry cough, muscle pain, loss of smell and taste, increased shortness of breath, bilateral viral pneumonia, conjunctivitis, acute respiratory distress syndromes, respiratory failure, cytokine release syndrome (CRS), sepsis, etc. While physicians and scientists have yet to discover a treatment, it is imperative that we urgently address 2 questions: how to prevent infection in immunologically naive individuals and how to treat severe symptoms such as CRS, acute respiratory failure, and the loss of somatosensation. Previous studies from the 1918 influenza pandemic have suggested vitamin D's non-classical role in reducing lethal pneumonia and case fatality rates. Recent clinical trials also reported that vitamin D supplementation can reduce incidence of acute respiratory infection and the severity of respiratory tract diseases in adults and children. According to our literature search, there are no similar findings of clinical trials that have been published as of July 1st, 2020, in relation to the supplementation of vitamin D in the potential prevention and treatment for COVID-19. In this review, we summarize the potential role of vitamin D extra-renal metabolism in the prevention and treatment of the SARS-CoV-2 infection, helping to bring us slightly closer to fulfilling that goal. We will focus on 3 major topics here: 1. Vitamin D might aid in preventing SARS-CoV-2 infection: • Vitamin D: Overview of Renal and Extra-renal metabolism and regulation. • Vitamin D: Overview of molecular mechanism and multifaceted functions beyond skeletal homeostasis. • Vitamin D: Overview of local immunomodulation in human infectious diseases. -Anti-viral infection. -Anti-malaria and anti-systemic lupus erythematosus (SLE).
Supplementary information Supplementary information accompanies this paper at https ://doi. org/10.1186/s1296 7-020-02488 -5. Additional file 1: Table S1 . Ongoing Clinical Trials as of July 2nd, 2020, of vitamin D in the Prevention and Treatment of COVID-19.
Abbreviations
Authors' contributions YX conceived the study and drafted the manuscript. All authors revised the manuscript. All authors read and approved the final manuscript.
Funding This study is supported by Loma Linda University Research Innovation Grant (to H.C.) and LLU GRASP (to Y.X.) These funding bodies had no role in the design or performance of the study nor in the writing or interpretation thereof.
Ethics approval and consent to participate Not applicable.
Consent for publication Not applicable.
Competing interests The authors have declared that no competing interests exist.
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