Rapid and Effective Vitamin D Supplementation May Present Better Clinical Outcomes in COVID-19 (SARS-CoV-2) Patients by Altering Serum INOS1, IL1B, IFNg, Cathelicidin-LL37, and ICAM1.

Mustafa Sait Gönen,Emre Durcan,Duygu Gezen-Ak,Okan Kadir Nohut,Yusuf Özdemir,Berna Küçükece,Merve Alaylıoğlu,Yalım Dikmen,Seval Ürkmez,Şermin Börekçi,Erdinç Dursun,Serdar Şahin,H Volkan Kara,Yılmaz Keskindemirci,Hande Mefkure Özkaya ,Cédric Annweiler ,Díldar Konukoğlu ,Zekayі Kutlubay ,Spyridon Ν Karras ,İ̇lker İnanç Balkan

doi:10.3390/nu13114047

Abstract

Background: We aimed to establish an acute treatment protocol to increase serum vitamin D, evaluate the effectiveness of vitamin D3 supplementation, and reveal the potential mechanisms in COVID-19. Methods: We retrospectively analyzed the data of 867 COVID-19 cases. Then, a prospective study was conducted, including 23 healthy individuals and 210 cases. A total of 163 cases had vitamin D supplementation, and 95 were followed for 14 days. Clinical outcomes, routine blood biomarkers, serum levels of vitamin D metabolism, and action mechanism-related parameters were evaluated. Results: Our treatment protocol increased the serum 25OHD levels significantly to above 30 ng/mL within two weeks. COVID-19 cases (no comorbidities, no vitamin D treatment, 25OHD <30 ng/mL) had 1.9-fold increased risk of having hospitalization longer than 8 days compared with the cases with comorbidities and vitamin D treatment. Having vitamin D treatment decreased the mortality rate by 2.14 times. The correlation analysis of specific serum biomarkers with 25OHD indicated that the vitamin D action in COVID-19 might involve regulation of INOS1, IL1B, IFNg, cathelicidin-LL37, and ICAM1. Conclusions: Vitamin D treatment shortened hospital stay and decreased mortality in COVID-19 cases, even in the existence of comorbidities. Vitamin D supplementation is effective on various target parameters; therefore, it is essential for COVID-19 treatment.

Highlights

Since December 2019, the world has been experiencing one of the most striking outbreaks in human history—the COVID-19 pandemic
Mean intensive care units (ICU) stay in COVID-19 cases excluding those with co-existing diseases while having serum 25OHD levels lower than 12 ng/mL, was 17.80 ± 6.91, N:5
Our results indicated that vitamin D treatment shortened the hospitalization period, decreased the mortality rate, and that the effect of vitamin D in COVID-19 might involve regulation of INOS1, IL1B, IFNg, cathelicidin-LL37, and ICAM1

Summary

Introduction

Since December 2019, the world has been experiencing one of the most striking outbreaks in human history—the COVID-19 pandemic. Several classes of drugs and supplements, including vitamin D, are being evaluated for the treatment of COVID-19, based on the growing evidence regarding the natural history and evolution of the infection obtained from patients [4]. Vitamin D is a secosteroid hormone that has existed on the Earth’s surface for 750 million years and regulates many cellular mechanisms [5,6]. We aimed to establish an acute treatment protocol to increase serum vitamin. D, evaluate the effectiveness of vitamin D3 supplementation, and reveal the potential mechanisms in COVID-19. A total of 163 cases had vitamin D supplementation, and 95 were followed for 14 days. Routine blood biomarkers, serum levels of vitamin D metabolism, and action mechanism-related parameters were evaluated. Results: Our treatment protocol increased the serum 25OHD levels significantly to above

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