Vitamin D and SARS-CoV-2 Infection—Evolution of Evidence Supporting Clinical Practice and Policy Development - a Position Statement from the Covit-D Consortium

Authors

Daniel McCartney, Technological University DublinFollow
Paula M. O'Shea, National University of Ireland, GalwayFollow
John L. Faul, Royal College of Surgeons in IrelandFollow
Martin J. Healy, St. James's Hospital, Dublin, IrelandFollow
Greg Byrne, Technological University DublinFollow
Tomas P. Griffin, National University of Ireland, GalwayFollow
James Bernard Walsh, Trinity College Dublin, IrelandFollow
Declan G. Byrne, Trinity College Dublin, IrelandFollow
Rose Anne Kenny, Trinity College Dublin, IrelandFollow

Document Type

Article

Rights

Available under a Creative Commons Attribution Non-Commercial Share Alike 4.0 International Licence

Disciplines

Immunology, Public and environmental health, Infectious diseases

Publication Details

Published in the Irish Journal of Medical Sciences (21st November 2020):

Abstract

Abstract

Observational ecological and epidemiological studies have suggested increased risks of SARS-CoV-2 infection and severity in groups with high prevalence of vitamin D deficiency (older adults, and those with obesity, pre-existing medical conditions or darker skin). Emerging observational clinical studies have confirmed these associations, reporting higher risk of SARS-CoV-2 infection, severe Covid-19 disease and mortality in those who are vitamin D deplete. Further experimental studies have described the immunological and metabolomic mechanisms by which vitamin D deficiency increases these risks, while recent prospective RCT data have shown reduced Covid-19 disease severity and mortality with vitamin D supplementation, further supporting a causal association.

Dietary vitamin D intakes are low (~3-6μg/d (120-240 IU/d)) and sunshine exposure inadequate to achieve optimal vitamin D status in Ireland. Consequently, vitamin D deficiency (serum 25(OH)D<50nmol/l) is common, with roughly half of the adult population, and an even greater proportion of older adults, affected. In Ireland, oral vitamin D intakes of 25-30μg/d (1000-1200 IU/d) are required to maintain serum 25(OH)D levels >50nmol/l on a year round basis. Supplementation with 20-25μg/d (800-1000 IU/d) is therefore required to avoid deficiency and meet the minimum 25(OH)D threshold of 50nmol/l for enhanced immunity to viral respiratory infection. For older adults, and those with obesity, underlying conditions or darker skin, supplementation at higher doses under medical supervision is indicated.

Practice and policy development are now required to ensure that Irish adults are supplemented with vitamin D3 at these safe and effective doses to reduce their risks of SARS-CoV-2 infection and severe disease.

DOI

https://doi.org/10.1007/s11845-020-02427-9

Recommended Citation

McCartney, D.M., O’Shea, P.M., Faul, J.L. et al. Vitamin D and SARS-CoV-2 infection—evolution of evidence supporting clinical practice and policy development. Ir J Med Sci (2020). doi :10.1007/s11845-020-02427-9