Vitamin D supplementation enters the home care protocol for Covid-19 patients residing in Piedmont. Thus, the hypothesis that has emerged in the scientific literature that adequate serum levels of 25-hydroxyvitamin D [25(OH)D] are useful in preventing and treating the virus infection that triggered the still ongoing SARS-CoV-2 pandemic finds concrete application.
Vitamin D in the Covid-19 protocol
The call to include vitamin D in Covid-19 therapy and prevention was made to health care institutions and the scientific community just over three months ago. The request was conveyed in an open letter, signed by 61 Italian healthcare professionals (the Group of 61).
Spearheaded by two physicians from the Turin Academy of Medicine, Giancarlo Isaia and Enzo Medico, professors of geriatrics and histology, respectively, who first sensed and described in a paper in March 2020 the possible beneficial role of vitamin D in preventing and treating infections. (1)
The benefits of vitamin D
The utility of vitamin D against Covid-19, as documented by Isaiah and Medico, manifests itself in protection from infection and a less severe course of disease, with reduced mortality, among infected individuals.
The thesis is confirmed by several hundred scientific studies, as mentioned in the aforementioned Open Letter of the Group of 61. And just reaffirmed by work conducted by a team at Tor Vergata University Polyclinic in Rome, published in the Journal of The American College of Nutrition. (2)
The Piedmont Protocol
In light of so much evidence, the Piedmont Region included vitamin D supplementation among the recommended therapeutic measures for the treatment of Covid-19 patients. Specifying that in individual cases the prescription would be an off-label use, i.e., not included in the drug’s indications.
‘Although vitamin D supplementation is already part of the medical work, particularly in the groups most often in deficiency, reporting on it is justified because of some clinical-scientific findings about the Vitamin D deficiency measured in patients with COVID-19, especially the elderly, and in whom the desirability of correcting their levels through supplementation’ was circumstantially emphasized. (3)
The hostility of the Ministry of Health
Indifferent to the cited evidence, also shared by researchers from ISS, Istituto superiore di sanità, the Italian government confirms hostility to vitamin D supplementation. (4)
On the Ministry of Health website, the usefulness of vitamin D still features among the fake news on Covid-19. (5) While note 96/19 from Aifa, the Italian Medicines Agency, remains in effect, which-as we have seen-from the end of 2019 denies NHS coverage to the prescription of vitamin D for people with serum levels of not less than 20 ng/mL.
The price of saving
Beyond the promising correlations in anti Covid, vitamin D is essential to the maintenance of bone and muscle health. The main source is direct exposure to sunlight for 10-15 minutes a day (without protective creams). A ‘dose’ drastically reduced by the prolonged seclusion inside homes imposed on the population by anti-infection measures.
Not surprisingly, the Scottish government is distributing free vitamin D supplements. To avoid, at the very least, admitting severely ill patients with vitamin D levels as low as 4 (four) ng/mL into Covid wards, as documented in the aforementioned study by Tor Vergata researchers.
Insights
Insights into the correlations between diet, the immune system, inflammation and viral infections are available in the first volume of the trilogy ‘Covid-19, the ABC‘s’ at https://www.greatitalianfoodtrade.it/covid-19-abc-volume-i-persone_1
Marta Strinati
Notes
1) Giancarlo Isaia and Enzo Medico, Possible preventive and therapeutic role of vitamin D in the management of COVID-19 pandemic. University of Turin, paper 25.3.20 https://www.unitonews.it/storage/2515/8522/3585/Ipovitaminosi_D_e_Coronavirus_25_marzo_2020.pdf
2) Infante M, Buoso A, Pieri M, Lupisella S, Nuccetelli M, Bernardini S, Fabbri A, Iannetta M, Andreoni M, Colizzi V, Morello M. Low Vitamin D Status at Admission as a Risk Factor for Poor Survival in Hospitalized Patients With COVID-19: An Italian Retrospective Study. J Am Coll Nutr. 2021 Feb 18:1-16. Epub ahead of print. https://doi.org/10.1080/07315724.2021.1877580
3) Protocol for taking care of covid patients at home by special units of continuity of care, general practitioners and pediatricians of free choice: revision. Version March 4, 2021. Functional inter-agency department with regional significance ‘infectious diseases and emergencies’. V. ANNEX
4) V. https://www. iss.it/coronavirus/-/asset_publisher/1SRKHcCJJQ7E/content/covid-19-la-vitamina-d-potrebbe-cooperare-con-l-interferone-nella-risposta-antivirale
5) V. http://www. salute.gov.it/portale/nuovocoronavirus/archivioFakeNewsNuovoCoronavirus.jsp?lingua=italiano&tagId=1314
6) See the Scottish government website https://www.gov.scot/publications/coronavirus-covid-19-vitamin-d-take-up-by-the-shielding-group/
Professional journalist since January 1995, he has worked for newspapers (Il Messaggero, Paese Sera, La Stampa) and periodicals (NumeroUno, Il Salvagente). She is the author of journalistic surveys on food, she has published the book "Reading labels to know what we eat".
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