Background The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has re-ignited interest in the possible role of vitamin D in modulation of host responses to respiratory pathogens. Indeed, vitamin D supplementation has been proposed as a potential preventative or therapeutic strategy. Recommendations for any intervention, particularly in the context of a potentially fatal pandemic infection, should be strictly based on clinically informed appraisal of the evidence base. In this narrative review, we examine current evidence relating to vitamin D and COVID-19 and consider the most appropriate practical recommendations. Observations Although there are a growing number of studies investigating the links between vitamin D and COVID-19, they are mostly small and observational with high risk of bias, residual confounding, and reverse causality. Extrapolation of molecular actions of 1,25(OH) 2 -vitamin D to an effect of increased 25(OH)-vitamin D as a result of vitamin D supplementation is generally unfounded, as is the automatic conclusion of causal mechanisms from observational studies linking low 25(OH)-vitamin D to incident disease. Efficacy is ideally demonstrated in the context of adequately powered randomised intervention studies, although such approaches may not always be feasible. Conclusions At present, evidence to support vitamin D supplementation for the prevention or treatment of COVID-19 is inconclusive. In the absence of any further compelling data, adherence to existing national guidance on vitamin D supplementation to prevent vitamin D deficiency, predicated principally on maintaining musculoskeletal health, appears appropriate.
【저자키워드】 Vitamin D, vitamin D deficiency, Coronavirus disease 2019 (COVID-19), Osteoporosis, respiratory infection, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), Musculoskeletal health, 【초록키워드】 COVID-19, Treatment, coronavirus disease, SARS-CoV-2, coronavirus, pandemic, randomised, Infection, Intervention, host response, virus, observational study, Spread, Respiratory pathogens, molecular, disease, Guidance, mechanism, therapeutic strategy, recommendations, Evidence, high risk, Support, observation, deficiency, Vitamin D supplementation, acute respiratory syndrome, modulation, National, extrapolation, intervention studies, Inconclusive, approach, Prevent, clinically, appear, absence, demonstrated, cause, feasible, residual confounding, 【제목키워드】 coronavirus disease, Evidence,