Abstract
In recent years the immunomodulatory actions of vitamin D, a steroid hormone, have been extensively studied. In 2020, due to the COVID-19 pandemic, the question arose as to 25(OH)D status would be related to susceptibility to SARS-CoV-2 infection, since several studies pointed out a higher prevalence and severity of the disease in populations with low levels of 25(OH)D. Thus, we investigated the 25(OH)D levels in adults "Detected" positive for SARS CoV-2 by RT-PCR (reverse transcriptase polymerase chain reaction) test, and in negative controls, "not Detected", using the Fleury Group's examination database, in Sao Paulo, Brazil. Of a total of 14.692 people with recent assessments of 25(OH)D and RT-PCR tests for COVID-19, 2.345 were positive and 11.585 were negative for the infection. The groups did not differ in the percentage of men and women, or in the age distribution. There were no differences in the distribution of 25(OH)D between the two groups (p = 0.08); mean 25(OH)D of 28.8 ± 21.4 ng/mL and 29.6 ± 18.1 ng/mL, respectively. In the specific population studied, clinical, environmental, socioeconomic and cultural factors should have greater relevance than 25(OH)D in determining the susceptibility to COVID-19.
Highlights
The musculoskeletal effects of vitamin D are widely studied, as well as its endocrine actions in regulating the homeostasis of calcium and phosphorus
Informed consent was not required since the data were anonymized. This was a retrospective study that collected records from individuals of both genders, between 18 and 90 years old, with RT-PCR results for SARS CoV-2 and who simultaneously had their 25(OH)D measured over a period of 30 days before or after the collection of the sample for COVID-19 RT-PCR test
25OH vitamin D – Liason, CLIA, DiaSorin, Saluggia, Italy, reference range: 20-60 ng/mL, intra and interassay coefficient of variation are 6.0% and 8.0%, respectively; RT-PCR – molecular test developed entirely in house according to the Charité protocol and a confirmatory test by the CDC protocol when necessary for confirmation, using clinical samples from the respiratory tract
Summary
The musculoskeletal effects of vitamin D are widely studied, as well as its endocrine actions in regulating the homeostasis of calcium and phosphorus. The metabolite 25(OH)D is the major circulating form of vitamin D in humans, and it is used to reflect person’s vitamin D status. Vitamin D and COVID-19 infection functions in osteomineral metabolism, the extensive distribution of vitamin D (VDR) receptors in human tissues and the action of the active hormone, 1,25(OH)2D (calcitriol), in regulating the transcription and expression of countless genes, indicate the importance of nonskeletal actions of this hormone. Experimental and clinical studies have revealed the intracrine action of vitamin D in the immune system, in monocytes and macrophages, with a modulating role for both innate and adaptive immune responses against a number of microorganisms, including viruses [1,2]
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