Abstract
Background: The immunomodulatory effects of vitamin D are known to be beneficial in viral infections; it is also known that its deficiency is associated with a prognosis more critical of Coronavirus Disease 2019. This study aimed to determine baseline vitamin D serum concentrations and the effects of its supplementation in asymptomatic or mildly symptomatic Coronavirus Disease 2019 outpatients. Methods: 42 outpatients were included, 22 of which received a supplement of 10,000 IU of vitamin D3 for 14 days; the remaining 20 outpatients were designated as a control group. Serum levels of transferrin, ferritin, vitamin D, and D-dimer were measured at baseline in both groups. After 14 days, serum levels of total vitamin D were determined in the supplemented group. Results: At baseline, only 19% of infected outpatients had vitamin D levels corresponding to sufficiency. All outpatients with vitamin D insufficiency had at least one symptom associated with the disease, while only 75% of patients with symptoms presented sufficiency. On the seventh and fourteenth day of follow-up, the supplemented group presented fewer symptoms with respect to those non-supplemented. A vitamin D3 dose of 10,000 IU/daily for 14 days was sufficient to raise vitamin D serum concentrations. Conclusions: Immunomodulatory effects of vitamin D appear to be linked to the development of symptoms in positive outpatients. Vitamin D supplementation could have significant benefits in the Western Mexican population.
Highlights
Coronavirus Disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome of Coronavirus 2 (SARS-CoV-2) [1]
The hallmark of COVID-19 pathogenesis is the excessive activity of immune cells, such as macrophages and T helper 1 cells (Th1), with the consequent release of pro-inflammatory cytokines, including interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, IL-6, and IL-8, that exacerbate the inflammatory response and mediate alveolar and endothelial damage [4,5]
Ferritin is supposed to be a cellular means of storing iron, not transporting it, yet serum ferritin levels are widely measured as indicators of iron status [34], while transferrin is a liver-derived protein able to bind up to two iron atoms in ferric form
Summary
Coronavirus Disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome of Coronavirus 2 (SARS-CoV-2) [1]. Concerning SARS-CoV-2 infection, it is known that the virus has a tropism for the upper and lower respiratory tracts. Once it infects and starts replicating, the course of the disease can be mild or moderate; in some cases, it can even progress to severe pneumonia and Acute Respiratory Distress Syndrome (ARDS) [4]. This study aimed to determine baseline vitamin D serum concentrations and the effects of its supplementation in asymptomatic or mildly symptomatic Coronavirus Disease 2019 outpatients. After 14 days, serum levels of total vitamin D were determined in the supplemented group. Results: At baseline, only 19% of infected outpatients had vitamin D levels corresponding to sufficiency. Vitamin D supplementation could have significant benefits in the Western Mexican population
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