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Vitamin D and COVID-19

Vitamin D can be introduced into the body in 2 ways. Either from foods such as egg yolks and milk or UV rays from the sun. It is a fat soluble hormone and is also known as cholecalciferol (CCF). Our skin stores a fat molecule called 7-dehydro-cholesterol converted into CCF through up rays from light.

CCF is then converted into its active form known as 1,25-DOH-CCF (1,25-dehydroxyl cholecalciferol). This increases calcium absorption in blood and also increases the absorption of macrophages to sites where there are high concentrations of virus.



Active CCF enters the immune cells such as macrophages and activates the DNA to make specific proteins which help to fend off viruses. One of which is called beta defensins. They punches holes in cell membrane in virus cells/ viral envelopes, causing the virus cells to die out.


There is a correlation between vitamin D deficiency and COVID-19 mortality rate. In liver failure or chronic kidney disease (renal failure) there is decreased vitamin D activation in the body. Vitamin D will not be converted into its active form to produce proteins (beta-defensins and cathelicidins) to carry out phagocytosis and chemotaxis. 


In other cases, obesity can also have a similar effect in its own ways. The inactive form of vitamin D (CCF) is fat soluble. Consequently, vitamin D is stored in the fat cells and is not being activated by enzymes to circulate into the bloodstream. Hence, this also decreases the body’s ability to fend off viruses such as COVID-19. 


In elderly individuals, those typically in their 70s-80s, also have lower vitamin D production. They have found to have a higher mortality rate to COVID-19. Although logically sound, further research is required to conclude any correlation.


A low vitamin D level is approximately less than 30 nanomoles per litre. The recommended level the average human should have is 75 nanomoles per litre of vitamin D.


A patient can either opt for bolus doses (large) or (sufficient) prophylaxis doses, with the latter shown to be more effective. The daily recommended amount of vitamin D for an average adult is approximately 2000-4000 international units. For pediatric patients, the number is 1000. 


For obese patients (BMI>30), they require 3 times the daily recommended intake because vitamin D is a fat soluble hormone, and most of it will be stored in the fat cells of these individuals.


If taken in excess, one may contract vitamin D toxicity. However, it is extremely rare for a patient to suffer from vitamin D toxicity and only primarily occurs in patients suffering from sarcoidosis, a condition which raises the levels of vitamin D in the blood. Patients who do not suffer from sarcoidosis will not contract vitamin D toxicity even if they take 4-5 times the daily recommended intake.



https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468980/

https://www.nature.com/articles/s41586-020-2521-4

https://www.youtube.com/watch?v=cT1CaTv5-e4

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6532760/


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