Estudio sugiere que la deficiencia de vitamina D podría aumentar las posibilidades de contraer coronavirus

Investigadores enfatizan la importancia de los estudios experimentales para determinar si la suplementación con vitamina D puede reducir el riesgo y potencialmente la gravedad del covid-19.

[#9 Cuchipanda]

#5 esos tienen una placa solar generadora de vitamina D en todo el cogote, cráneos previlegiados.

[#10 Desactivado]

No de contraer...de sufrir consecuencias severas.

[#20 Arzak_]

#19 Así es en la mayoría de casos. Nuestros hábitos de trabajo o vida con la mayoría de tiempo encerrados dentro de un edificio, ya no hacemos oficios al sol. Tomar el sol el fin de semana o sólo en verano no es suficiente, se recomienda al menos 20 diarios todo el año recibir sol en en cara, brazos y piernas. Por otro lado el aporte de esta vitamina procedente de los alimentos tiene un aporte bajo para cumplir la dosis diaria recomendada.

[#1 Desactivado]

Por tanto es mala idea confinar a la gente sin que pueda salir a la calle y no pueda tomar el sol.

[#3 podremos]

#1 Pero no el obligar a las empresas y a los ciudadanos a tomar medidas de seguridad para no facilitar la expansión del virus.

[#18 Desactivado]

#3 qué virus? Si no lo han aislado ni purificado

[#21 podremos]

#18 Sabes bien que hablo del coronavirus, si no se hace nada multiplicaría el número de víctimas mortales, hay que tomar medidas y el no dejar salir de casa para nada no es la solución, pero el dejar a los ciudadanos el que tomen las precauciones por si mismos, cuando hay un número importante de personas que se oponen a ello no soluciona nada y no dificulta su expansión.

[#23 angelitoMagno]

#18 ¿Estás siendo irónico?

[#6 Cuchipanda]

#1 imagina vivir en un mundo donde las casas tuvieran ventanas, o donde, excepto que tengas que hacer cuarentena por ser positivo o por haber estado en contacto con uno que ha pitado, pudieras salir a la calle sin que nadie te dijera nada siempre y cuando mantengas las medidas mínimas de seguridad.

Ahora estoy pensando algo muy loco... ¿y si alguien inventara suplementos de vitamina D? Bufff... uno se pone a imaginar mundos posibles y de verdad que es todo un despropósito.

[#16 Desactivado]

#6 ¿Y si alguien inventara un suero con todos los nutrientes y se nos inyectara de forma intravenosa?, no tendríamos que comer ni beber.

[#17 Cuchipanda]

#16 espero que no te lea Soros, tú ves dando ideas.

[#22 angelitoMagno]

#1 No, porque confinar disminuye en mayor medida la posibilidad de contraer Covid19.

Es lo que tienen los problemas complejos, que no tienen soluciones únicas.

[#2 Desactivado]

Vamos que los morenitos estáis mas jodidos ,,

[#4 Cuchipanda]

#2 y los adultos, los ancianos, los gordos, los que están jodidos de los riñones, los que no llevan una buena alimentación y también los niños rata.

[#5 Desactivado]

#4 y no te olvides de los calvos ,,

[#7 podremos]

#2 Este estudio sugiere y por lo tanto no está demostrado, por lo que no se puede afirmar que sea cierto del todo o si a la vez se debe haber otro factor para que así sea.

[#8 tranki]

No cuadra. En Spain tenemos vitamina D para dar y vender.
Otro estudio de las tres y cuarto.

[#11 Desactivado]

#8 precisamente por eso la gente busca más la sombra

[#15 Desactivado]

#11 pues oye, igual has dado con el problema. El covid de pilla en la sombra.

Piénsalo.

[#12 Cuchipanda]

#8 De momento todo se queda en un sugiere o puede, que hay cosas más determinantes que eso, y que dosis bajas no son perjudiciales. Pero aquí a la hora de presentar los estudios lo normal es que le das la mano al periodista y el periodista se la mete en el culo. A ver si me cabe el texto entero:

Vitamin D is produced in the skin under the influence of UVB-light from the sun or obtained via the diet by eating fatty fish, enriched dairy products or supplements. Vitamin D is known to support a healthy bone and severe deficiency may lead to osteomalacia or the rickets, which still occur in poor areas of the world. In addition, vitamin D support key functions in many organs, including the brain, muscle and the immune systems (Holick, 2007). In fact, the vitamin D receptor (VDR) is expressed in most cell types and may activate somewhere between 200-500 genes, many related to the immune system. Thus, the role of This article is protected by copyright. All rights reservedvitamin D in human immunity has been studied intensly during the past 20 years (Hewison, 2011). For example, it has been hypothesized that vitamin D supplementation may prevent acute respiratory infections (ARI), which is based on the fact that these infections are much more common during the winter, which coincides with lower vitamin D levels in the population (Hypponen and Power, 2007). Moreover, experimental evidence showed that vitamin D can activate antimicrobial peptides, which are secreted at mucosal surfaces and have the capacity to kill bacteria and viruses (Hewison, 2011). These observations spurred several randomized controlled trials (RCT) testing the hypothesis. The results from these trials were not conclusive, with some showing beneficial effects and some not (Bergman et al., 2012;Murdoch et al., 2012). However, a large individual patient data meta-analysis compiled individual data for almost 11.000 patients from 25 RCTs (Martineau et al., 2017). A general preventive effect of vitamin D supplementation against ARI was observed. The effect was greater in those with vitamin D deficiency (< 25 nmol/L) and if the supplement was given daily or weekly but not if given as large bolus doses

A recent narrative review explains the rationale for further studies of vitamin D and Covid-19

Given data supporting that vitamin D could prevent ARI, it was natural to ask the question whether vitamin D could prevent Covid-19. This was addressed in a narrative review by Rhodes et al, published in JIM (Rhodes, 2020). The authors first present a clear link between vitamin D levels and Covid-19 by comparing the mortality of Covid-19 in relation to the latitude of different countries. They observed a 4.4% increase in mortality for each degree latitude north of 28 degrees north, a link that remained after adjustment for age. This observation suggests that UV-light, and thus indirectly Vitamin D, may be involved in the protection against Covid-19. However, it should be noted that UV-light also has a number of vitamin D independent effects on immunity, such as suppression of T-cell activation in the skin, which may explain this observation (Bernard et al., 2019). In addition, the link between UV-exposure and Covid-19 mortality on a nation-wide level is complex and may be severely hampered by inherent bias.

Further, they point out the fact that factors associated with death from Covid-19 (old age, ethnicity, male sex, obesity, diabetes, hypertension) overlap with risk for vitamin D deficiency. Although this is striking and something that deserves further studies, it may be fully explained by the “healthy user effect”, i.e. that healthier people simply spend more time outdoor and eat healthier, compared to less healthy individuals, thereby explaining this overlap.

Rhodes et al also refer to the fact that vitamin D deficiency is a general risk-factor for ARI and that supplementation may prevent ARI. This is clearly shown in associative studies but also in some interventional randomized and placebo-controlled trials as well as in one large individual patient data meta-analysis (Martineau et al., 2017). Notably, some recent associative data on the link between Vitamin D and Covid-19 is presented in this narrative review. One questionnaire-based study of Italian patients (n=1486) with Parkinson disease reported that those taking vitamin D supplements were less likely to have Covid-19 (Fasano et al., 2020). Another small Italian study (n=107) reported that serum-levels of vitamin D was lower in patients who were PCR-positive for SARS-CoV-2 (D'Avolio et al., 2020). A third study from the US is mentioned (n=4314) where low vitamin D levels increased the risk to test positive for Covid-19 (Meltzer et al., 2020). However, this study is published at a pre-print server and therefore not properly peer-reviewed, which is a common problem in these pandemic days where quick publication is of paramount importance. There are also studies – also published as pre-print publications - that failed to find a link between low vitamin D levels and increased risk of Covid-19 infections (medRxiv 2020.04.29.20084277; medRxiv 2020.06.01.20118943). Importantly, there is no data from interventional trials showing that vitamin D supplementation may prevent against Covid-19, although such trials are under way.

Finally, Rhodes et al present arguments that vitamin D increases the conversion of ACE2 to ACE, which potentially may protect against Covid-19. Again, this is an interesting hypothesis but only shown in experimental settings so far and thus lacking clinical validation

What are the implications for the Vitamin D research field?

To conclude, the implications for the Vitamin D research fieldthere is a strong rationale to study whether vitamin D may prevent Covid-19, given previous publications in the field. Future studies should involve experimental models to assess whether vitamin D can impair viral replication, block proinflammatory cytokines or have other effects related to SARS-CoV-2 pathogenesis. Here it is crucial to select the best model system where vitamin D responsive host factors are active. For example, the virus grows well in VeroE6-cells, but these cells are of primate origin and may not represent the best model. The virus is significantly more difficult to grow in human cells, but it is possible (Banerjee et al., 2020). Further, large epidemiological studies can be employed to assess whether vitamin D levels correlate with the risk to get infected by the virus and also if vitamin D levels are associated with the severity of disease. Importantly blood levels should not be too old, but rather obtained within a 6 month period prior to disease-onset to give a meaningful estimate of the impact of disease by vitamin D levels. Finally, and most important, is to perform randomized and placebo-controlled trials to test the hypothesis whether vitamin D can prevent Covid-19. Special consideration should be given to the inclusion criteria, where only those deficient in vitamin D should be included, to maximize the potential effect. Also, a daily dosing schedule may be superior to weekly or monthly dosing, as judged by previous data (Bergman et al., 2013;Martineau et al., 2017)

How should the clinician deal with this information about vitamin D and Covid-19?

It is not easy to fully understand the complex mechanistic underpinnings of vitamin D mediated effects on immunity and translate this into the clinical practice. A simple rule of thumb could be the following: 1. Vitamin D is safe. Recently, results from a large meta-analysis failed to find any evidence that vitamin D caused adverse events in previously healthy people (Martineau et al., 2017). Doses up to 10.000 IU/day is safe, although well above what is needed In fact, only 1000-2000 IU may be needed to obtain optimal effects on bone and immunity. Nevertheless, special attention should be paid in patients with certain rare diseases, such as tuberculosis and sarcoidosis, where ectopic activation of vitamin D may lead to hypercalcemia. 2. 1000-2000 IU/day is enough to keep the immune system healthy. No mega-doses are needed and may only lead to increased risk for adverse events. Small and daily doses are enough to boost immunity. 3. If possible, test your patients for 25OHD-levels in serum and provide only supplements to those below 50 nmol/L. This will protect the bone and be enough to enhance respiratory immunity against ARI. By adopting this limit, you will only supplement individuals that need extra vitamin D, avoid unnecessary costs and follow available guidelines for bone-health. 4. Be aware that the beneficial effect is small and may take some time (months) to develop. However, given the common problem with ARI and especially now in the corona-epidemic, a small vitamin D supplement may be beneficial, and definitely not harmful. Risk-groups (dark skin, the elderly, patients with chronic diseases and obese patients, to mention a few) should have first priority for supplementation.

Finally, the field of vitamin D and Covid-19 is very active and several trials are under way. Thus, new data will come, which may change these conclusions. However, in the meantime the conclusions above can be followed and we have massive data to say that vitamin D at low doses (1000-2000 IU/day) are safe and not harmful, which is in line with the historical proverb: primum non nocere (first, do no harm) – but potentially we may prevent a number of ARIs and perhaps also Covid-19.

[#13 Arzak_]

#8 Aunque en España se cuenta con muchas horas de sol al año, existe una carencia generalizada de vitamina D en toda la población:

https://www.agenciasinc.es/Noticias/El-deficit-de-vitamina-D-es-el-defecto-nutricional-mas-frecuente-en-los-espanoles

https://www.saludigestivo.es/la-deficiencia-de-vitamina-d-en-espana-es-similar-a-la-de-los-paises-de-europa-central/

[#19 Cehona]

#13 Llevo todo el verano siguiendo al sol como los girasoles y en la última analítica no pasé de 10 ng/mL (valores normales 20)

[#14 Nineok]

#8 También hay muchas iglesias y no va a misa ni Dios

[#24 angelitoMagno]

#8 Tu visión es muy simplista, no asumas un solo factor de contagio, o que esté sea el más importante.