Nutritional Perspectives to Coronavirus Disease 2019 (COVID-19) Susceptibility and Severity: a review of the roles of vitamin D and C
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Abstract
Background: Coronavirus disease 2019 (COVID-19) which was declared a global pandemic on March 11, 2020 is known to have affected more than 108 million people with more than 2 million deaths worldwide as at February 2021. The pathophysiology of disease severity is governed by a cytokine storm which could potentially be modulated by certain vitamins such as vitamins D and C with immunomodulatory and anti-inflammatory properties. The mechanisms underpinning the susceptibility to and severity of the disease when these nutrients that have shown anti-inflammatory properties are deficient is yet to be fully elucidated.
Objectives: The aim of this review was to explore the plausible mechanisms through which vitamin D and C can influence risk of SARS-CoV-2 infection and progression to severe symptomatic form of COVID-19.
Method: We performed a literature search to review the pathophysiology of COVID-19 as well as effects of supplemental vitamin D and C on risk of infection, disease progression and severity.
Results: Randomised control trials which administered high doses of vitamin D and C, have shown demonstrable beneficial effects in COVID-19 patients. Although there is no recommended dose of vitamin D and C for COVID-19, maintaining optimum plasma concentration of vitamin D (100-150 nmol/L) and vitamin C (60-80 μmol/L) may prove beneficial. Doses of 50-125μg/day of vitamin D3 and 2-3g/day of vitamin C have proven effective in maintaining this optimum plasma concentration in COVID-19.
Conclusions: Together these studies suggest that high dose supplementation of vitamin D and C to maintain optimum plasma concentration have shown better outcome, reduced risk of progression and fatality even in severe cases of COVID-19.
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