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NEW DELHI: There is no clinical evidence to prove that low levels of vitamin D lead to severe symptoms of COVID-19, but there is a clear link between the ‘sunshine vitamin’ and immune responses to disease, say experts as the pandemic spreads across the world and concerns rise over a new mutant strain.
Stressing that vitamin D is inexpensive and poses a negligible risk compared to the considerable risk of COVID-19, global researchers on the disease have called on governments to integrate it into their strategy against the novel coronavirus.
Many factors such as age, being male, and co-morbidities are known to predispose individuals to a higher risk of exposure to SARS-CoV-2, but an inadequate vitamin D is by far the most important. most easily and quickly modifiable risk factor with abundant evidence to support great benefit. indeed, said Prof Afrozul Haq, former dean of the School of Interdisciplinary Sciences and Technology (SIST) at Jamia Hamdard University in New Delhi.
He is one of 170 experts who wrote an open letter on the subject earlier this month.
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Calling for an immediate and widespread increase in vitamin D intake, the letter posted on the vitamindforall.org website states that “research shows that low levels of vitamin D almost certainly promote infections, hospitalizations and deaths in the world. COVID-19 ”.
“This campaign group of vitamin D and COVID-19 researchers, including myself, began the process of writing this letter with the goal of educating everyone about the benefits of vitamin D supplementation at home. patients infected with COVID-19 and send this letter to everyone. ministries, health workers, government agencies and NGOs, ”Haq told PTI.
According to the letter, which had 171 signatories on Wednesday, evidence suggests the possibility that the COVID-19 pandemic will be sustained in large part thanks to the infection of people with low vitamin D and deaths are mostly concentrated in those deficient. .
“The mere possibility that this is so should force the urgent gathering of more data on vitamin D. Even without more data, the preponderance of evidence indicates that increasing vitamin D would help reduce infections,” hospitalizations, ICU admissions and deaths, ”he said.
As debate on the issue intensified, immunologist Vineeta Bal added a note of skepticism, noting that most experts are based in developed countries where daily vitamin D supplementation may be feasible, convenient, and affordable.
“But this is not the case with India. Vitamin D deficiency is extremely common in India. Regular supplementation is not a standard recommendation, not even for pregnant women, ”Bal, visiting professor at the Indian Institute of Scientific Education and Research in Pune, told PTI.
“If the individuals are severely deficient, supplementation as recommended in the letter will likely take weeks or months to reach desirable levels of vitamin D in serum,” she said.
The scientist added that this cannot be considered an emergency measure, when the country lacks manpower and facilities, even for the vaccination program.
In her opinion, vitamin D supplementation should be a long-term, non-urgent measure that could also be helpful in the COVID-19 scenario.
“Not only vitamin D, other vitamins and micronutrients like zinc have also shown beneficial effects,” she explained.
According to Professor Srijit Mishra, another signatory of the letter, the recommendation is vitamin D intake for adults of up to 4,000 international units (IU) or 100 micrograms (mcg) per day. People at increased risk of deficiency due to being overweight, dark skinned, or living in nursing homes may need a higher intake.
“Current evidence suggests that serum 25-hydroxyvitamin D levels exceed 30 nanograms per milliliter (ng / ml), a test to measure vitamin D level is a widely approved minimum for reducing the risk of COVID-19,” Mishra , from the Indira Gandhi Institute of Mumbai of Development Research (IGIDR), told PTI.
Bal said vitamin D is generally known to have many beneficial contributions to immune responses, and added, “There are no reports, to my knowledge, where there are dramatic improvements from supplementation. vitamin D in normal individuals.
In his opinion, vitamin D may have an additional role to play with other drugs, but not a primary role. The link between vitamin D and improved immune competence exists based on experimental data, and patient data is almost invariably associative and does not prove a cause and effect relationship, she said.
Although no clinical trial has tested the effectiveness of vitamin D as a treatment or preventive measure, several studies have found an association between low levels of vitamin D and COVID-19.
However, a review of five of these studies by the National Institute for Health and Care Excellence (NICE) in the UK concludes that the studies provide no evidence that vitamin D levels influence the risk of contracting COVID-19 or die as a result.
“There is no evidence to support taking vitamin D supplements to specifically prevent or treat COVID-19,” the study authors wrote.
Mishra also noted that the evidence so far on risk factors for COVID-19 with low vitamin D levels is associative, with some studies pointing out that low vitamin levels have a higher risk of infection and higher rates. of positivity.
He said a paper from the UK-based NNEdPro Global Center for Nutrition and Health released a 10-point summary on diet, nutrition and the role of micronutrients in the fight against COVID-19.
“The memo identifies the suitability of various micronutrients, including vitamin D. However, as the editorial staff of NNEdPro makes clear, this advice on nutritional adequacy should not be seen as a substitute for key public health advice and medical on prevention, ”Mishra told me.
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