Various studies have shown that Vitamin D can work wonders for COVID-19 patients- both in managing the symptoms as well as in preventing the infection.
Among the hospitalised COVID patients, 20 people develop Acute Respiratory Distress Syndrome (ARDS) and need ICU admission. ARDS is a condition when the fluid gets collected in the lungs. It is associated with either a cytokine storm or a bradykinin storm.What are cytokines?
Cytokines are proteins that send signals to the cells and puts the body's immune system in action. Bradykinins are proteins that lead to inflammation. Overexpression of these proteins, called cytokine storm or bradykinin storm can lead to multiple organ failure.
How Vitamin D can help?
Vitamin D acts as an immunomodulatory agent that can have protective effects against these severe outcomes in COVID-19 patients.
Here is how Vitamin D helps prevent multiple organ failure:
Cytokine stormVitamin D plays a crucial role in the activation and functioning of the immune system. Vitamin D inhibits the function of T helper cell type 1 (Th1), which is involved in cell-mediated inflammation.
Studies have found that an activated form of vitamin D is directly associated with the inhibition of two cytokines - gamma interferon and IL-2 that can lead to organ failure.
Protects against lung damage
During the viral infection, the inactive vitamin D is converted to the active form by the cells in the alveoli - tiny air sacs in our lungs and leads to an increased expression of another compound named cathelicidin. Cathelicidins have shown to reduce lung injury caused by hyperoxia or excessive oxygen supply.
Prevents kidney disease in diabetics
Studies in patients with kidney disease and in mice with diabetes have demonstrated increased angiotensin-converting enzyme 2 (ACE2) expression. ACE2 is known to facilitate the entry of SARS-CoV-2 virus into host cells.
A 2018 study found that vitamin D supplements can inhibit ACE2 expression in the kidney. Thus, vitamin D can reduce ACE2 expression in the kidney tubule cells, thereby preventing the entry of the virus into the cell and protecting the kidney of patients with diabetes.
Preventing ARDS and heart injury
Angiotensin II (Ang II) is a natural hormone that increases blood pressure. ACE2 helps in breaking down Ang II and thereby lowers its levels.
COVID-19 infection can lower the ACE2 level, which leads to excessive accumulation of Ang II. High levels of Ang II can cause ARDS and cardiac injuries. Renin, a protein released by the kidney can boost Ang II accumulation.
A 2015 study found that mice that do not have Vitamin D receptors have increased levels of Renin and Ang II. Thus, vitamin D supplement can prevent inflammatory activity of Ang II by suppressing the release of Renin in COVID-19 patients and decreasing the risk of ARDS and cardiac issues.
Thus, vitamin D can play a role in increasing the risk of developing COVID 19 infection, mortality and severity.