Vitamin D Perspective in Front Line Healthcare Workers Amid COVID-19

Muhammad Waris Farooka,Afaq Ahmad,Mansoor Ahmed Tarar,Minhaj Rafi,Muhammad Bilal,Syeda Saba Aslam,Nouman Rafique

doi:10.24018/ejmed.2021.3.4.957

Abstract

Deficiency of Vitamin D is very common in Pakistan, even among healthy asymptomatic individuals [1], [2]. Recent studies have shown that the risk of contracting COVID-19 was increased to two-fold, and consequent mortality to 4-fold if the person is Vitamin D deficient [3]. Health care workers including the nursing and administration staff are at a high risk of contracting SARS-CoV2 due to increased regular exposure in a health care setting [4]. Consequently, a convergence of the COVID-19 pandemic, the deficiency of Vitamin D, and the increased exposure can render the health care workers at an additional risk to COVID-19 infection. Our objective was to determine the prevalence of vitamin D deficiency in healthy asymptomatic front-line health care workers and to analyze the change in serum level by loading oral dose of SunnyD STAT softgel capsules (200000 IU Vitamin D3). We followed single centered, cross-sectional, cohort study with subsequent randomized placebo-controlled design for supplementation and follow up. Serum level of 25-hydroxyvitamin D (25OHD) was the main outcome variable, with anthropometric data, nutritional intake, and lifestyle variables analyzed for potential association as risk factors for the outcome. Severe Vitamin D deficiency was found to be prevalent among front line health care workers in this urban hospital-based sample. Serum level of Vitamin D was found to be significantly associated with designation and presence of high blood pressure. The likelihood of increased serum Vitamin D levels was observed with increasing monthly income, higher designation, increasing age and supplementation intake. Mean increase in the serum 25(OH)D3 level after 2 doses of SunnyD STAT softgel capsule (200000 IU Vitamin D3) was 34.22 ng/ml. Public health interventions regarding Vitamin D supplementation and awareness are needed, especially amid COVID-19 pandemicDeficiency of Vitamin D is very common in Pakistan, even among healthy asymptomatic individuals [1], [2]. Recent studies have shown that the risk of contracting COVID-19 was increased to two-fold, and consequent mortality to 4-fold if the person is Vitamin D deficient [3]. Health care workers including the nursing and administration staff are at a high risk of contracting SARS-CoV2 due to increased regular exposure in a health care setting [4]. Consequently, a convergence of the COVID-19 pandemic, the deficiency of Vitamin D, and the increased exposure can render the health care workers at an additional risk to COVID-19 infection. Our objective was to determine the prevalence of vitamin D deficiency in healthy asymptomatic front-line health care workers and to analyze the change in serum level by loading oral dose of SunnyD STAT softgel capsules (200000 IU Vitamin D3). We followed single centered, cross-sectional, cohort study with subsequent randomized placebo-controlled design for supplementation and follow up. Serum level of 25-hydroxyvitamin D (25OHD) was the main outcome variable, with anthropometric data, nutritional intake, and lifestyle variables analyzed for potential association as risk factors for the outcome. Severe Vitamin D deficiency was found to be prevalent among front line health care workers in this urban hospital-based sample. Serum level of Vitamin D was found to be significantly associated with designation and presence of high blood pressure. The likelihood of increased serum Vitamin D levels was observed with increasing monthly income, higher designation, increasing age and supplementation intake. Mean increase in the serum 25(OH)D3 level after 2 doses of SunnyD STAT softgel capsule (200000 IU Vitamin D3) was 34.22 ng/ml. Public health interventions regarding Vitamin D supplementation and awareness are needed, especially amid COVID-19 pandemic.

Highlights

Vitamin D is a secosteroid that has a wide spectrum of immunomodulatory, anti-inflammatory, antifibrotic, and antioxidant actions [5]
Epidemiological studies have reported that vitamin D deficiency is associated with viral respiratory tract infections and acute lung injury [5]
Type-II pneumocytes are the primary target of coronaviruses and ACE2 receptors are highly expressed on these cells [9]

Summary

Introduction

Vitamin D is a secosteroid that has a wide spectrum of immunomodulatory, anti-inflammatory, antifibrotic, and antioxidant actions [5]. Epidemiological studies have reported that vitamin D deficiency is associated with viral respiratory tract infections and acute lung injury [5]. Vitamin D supplementation has exhibited protective effects against acute lung injury by modulating the expression of members of the renin–angiotensin system such as ACE2 in lung tissue [7], supporting the role of vitamin D deficiency as a pathogenic factor in COVID-19. Type-II pneumocytes are the primary target of coronaviruses and ACE2 receptors are highly expressed on these cells [9]. II pneumocytes decrease the surfactant level and increase surface tension in COVID-19 [9]. Recent studies have shown that the risk of contracting COVID-19 was increased to two-fold, and consequent mortality to 4-fold if the person is Vitamin D deficient [12]. Optimal levels of Vitamin D in the blood can reduce the risk of ICU admission to up to 97% [13]

Objectives

Methods

Results

Conclusion