Rodrigo Nolasco dos Santos1
Sergio Setsuo Maeda1
José Roberto Jardim2
Marise Lazaretti-Castro1
1 Disciplina de Endocrinologia,
Departamento de Medicina,
Universidade Federal de São Paulo
(Unifesp), São Paulo, SP, Brasil
2 Disciplina de Pneumologia,
Departamento de Medicina,
Universidade Federal de São Paulo
(Unifesp), São Paulo, SP, Brasil
ABSTRACT
The effects of vitamin D on the musculoskeletal system are well established. Its deficiency causes
osteomalacia, secondary hyperparathyroidism, and an increased risk for fractures and falls. However,
clinical and experimental evidence points to extra-skeletal actions of vitamin D, including on immune
and respiratory systems. Thus, during this COVID-19 pandemic, a possible deleterious role of vitamin D
deficiency has been questioned. This paper aims to present a brief review of the literature and discuss,
based on evidence, the role of vitamin D in the lung function and in the prevention of respiratory
infections. Relevant articles were searched in the databases MEDLINE/PubMed and SciELO/LILACS.
The mechanisms of vitamin D action in the immune system response will be discussed. Clinical data
from systematic reviews and meta-analyses show benefits in the prevention of respiratory infections
and improvement of pulmonary function when vitamin D-deficient patients are supplemented. At the
time of writing this paper, no published data on vitamin D supplementation for patients with COVID-19
have been found. Vitamin D supplementation is recommended during this period of social isolation
to avoid any deficiency, especially in the context of bone outcomes, aiming to achieve normal values
of 25(OH)D. The prevention of respiratory infections and improvement of pulmonary function are
additional benefits observed when vitamin D deficiency is treated. Thus far, any protective effect of
vitamin D specifically against severe COVID-19 remains unclear. We also emphasize avoiding bolus
or extremely high doses of vitamin D, which can increase the risk of intoxication without evidence
of benefits.
Keywords
Coronavirus; vitamin D; respiratory infections; immune system
https://www.aem-sbem.com/media/uploads/2020-0179_WnpWema.pdf