Vitamin D may actually protect against Covid-19 due to its immunomodulatory role and antiviral effects. The scientific evidence is reviewed in a paper authored by Giancarlo Isaia and Enzo Medico, president of the Turin Academy of Medicine the former and both professors at the University of Turin. Who, back in March, after the pandemic was declared, had associated hypovitaminosis D with the new coronavirus. (1)
The insight of researchers in Turin
The two professors from Turin-as we reported at the time-had reported a correlation between the new coronavirus and vitamin D deficiency (serum levels <20 ng/ml). But as is often the case with pioneers, their idea had been rejected by institutions with unfounded arrogance. ISS and the Ministry of Health had even dismissed the researchers’ insight as fake news.
The National Institute of Health has since revised its position, reaffirming its role as an independent scientific authority. Therefore, ISS concurred that adequate vitamin D intakes are useful both in the prevention of acute respiratory disease and in treating two typical symptoms of Covid-19 (loss of sense of smell and taste).
Ministry of Health, true to the line (of apparent savings)
The Ministry of Health, however, stuck to the line. The list of fake news about Covid-19 still includes thewarning no. 39:
‘Vitamin D protects against new coronavirus infection. FALSE. There is currently no scientific evidence that vitamin D plays a role in protecting against new coronavirus infection’.
The ministry’s line-communicated by Italian Medicines Agency (AIFA)-has only one certain assumption. The recent decision to ban the prescription of vitamin D within the National Health System under the banner of saving money at all costs. Only apparent savings in the era of preventive medicine that the entire scientific community-not even the public administration-claims to yearn for.
As of the end of 2019-just as Covid-19 was beginning to propagate-a ban on prescribing vitamin D supplementation drugs in the absence of manifest disease has been triggered for family physicians. Mere deficiency (serum levels below 20 ng/ml) is therefore not sufficient for prescription. Instead, symptoms such as asthenia, myalgia, widespread or localized pain, and frequent unmotivated falls are needed. Should we then wait for fractures and traumas (resulting in hospitalizations, surgeries, hospitalizations and therapies, possible disability and death in older patients), to save on vitamins?
That’s right, prevention and science have given way to cash requirements and convenient opinions. In a health care system that responds to an ‘economistic’ logic and was in fact unable to deal with the albeit predictable ‘gray swan’ Covid-19, as noted above.
The Latium Region-led by the national secretary of a ruling party already known in the news for the 16 hospitals closed in Italy’s second most populous region-has offered evidence of this ‘bursar’ approach. In a measure that reads, literally:
‘The exorbitant costs of prescribing vitamin D (cholecalciferol) are derived, most likely, from an erroneous assessment of normal serum vitamin levels and an incongruous evaluation of this DATE in individuals who are not at risk.’ (2)
Vitamin D and Covid-19, the scientific studies
Isaiah and Medico’s work recalls a number of studies-published in international peer-reviewed scientific journals-that assume relevance in addressing the coronavirus threat. Several studies observe the correlation between deficient serum levels of vitamin D and vulnerability to coronavirus. Noting the high probability of an inverse correlation, sis also pending a demonstration of etiological link (cause-and-effect relationship).
Moreover, the scientific literature is solid on certain virtues of vitamin D that have clear relevance to the prevention of virosis and the treatment of certain symptoms characteristic of, among others, Covid-19. Refers to immune system boosting and antiviral properties, as well as possible roles in mitigating pneumonia and hyperinflammation.
Vitamin D, in particular, has shown:
– A protective role for many infectious diseases. Infections of the respiratory, enteric, and urinary tracts. Vaginosis, sepsis, influenza syndrome, dengue, hepatitis,
– effectiveness in supporting innate immunity and counteracting all factors of potential relevance to acute pneumonia and hyperinflammation, already observed in COVID-19 patients,
– protection in patients with inflammatory bowel disease, which causes vitamin D malabsorption. Administration of vitamin D3 (500 U/d) reduced the incidence of respiratory infections by two-thirds in patients with serum levels below 20 ng/mL. In the same cohort, a serum concentration above 38 ng/mL was associated with a 50 percent reduction in the risk of respiratory infection.
A meta-analysis involving 25 randomized interventional trials and more than 11,000 patients also showed that vitamin D supplementation reduced the incidence of acute respiratory infections by two-thirds in patients with serum levels below 16 ng/mL.
Finally, preclinical (animal) evidence demonstrates a protective effect of vitamin D (calcitriol) on acute lung damage and on the effects – devastating to lung structures – of chronic deficiency of the same vitamin.
The appeal to policymakers
In light of the recalled scientific literature, in arguing for further research, the authors urge policymakers to secure the population.
‘We believe that governments of all countries, especially where, as in Italy, there is a high prevalence of vitamin D insufficiency or deficiency, should promote public health campaigns to increase the consumption of vitamin D-rich foods and promote adequate exposure to sunlight or, when this is not possible, properly controlled pharmaceutical supplementation.
In line with this approach, the British Dietetic Association and the Scottish government recently published recommendations to ensure, particularly during this critical period, normal levels of vitamin D in the general population’.
Attached is the text of the editorial by the two researchers with the bibliography of the cited studies.
Marta Strinati and Dario Dongo
Notes
(1) Giancarlo Isaia, Enzo Medico. Associations between hypovitaminosis D and COVID-19: a narrative review, to be published in August 2020 in the international journalAging in Clinical and Experimental Research. ANNEX
(2) See Lazio Region Determination 28.1.2020 no. G00683
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".
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
