Vitamin D supplementation as a prophylactic measure to COVID-19: a risk and benefit approach
INTRODUCTION: The pandemic caused by the novel coronavirus (SARS-CoV-2) presented itself as a global threat. The uncertainties regarding effective therapies linked to the small number of studies that concretely prove the performance of the virus brought a collection of doubts regarding the proper way to conduct new cases. However, studies show that vitamin D, if administered at adequate levels, has a prophylactic and controlling role in infectious diseases of the respiratory system. AIM Address the evidence on vitamin D supplementation in the population as a prophylactic measure for Covid-19, with an emphasis on the associated risks and benefits. MATERIAL AND METHODS: A systematic review based on articles published in journals indexed in the PUBMED and Biblioteca Virtual em Saúde (BVS) databases from 2015 to 2020. We used the following keywords: “Vitamin D”, “Prophylaxis”, “SARS-CoV-2", and “Respiratory infection". Among the 16 articles found, we selected 10 based on the following inclusion criteria: articles in Portuguese and English in their full version. RESULTS: Studies have shown punctual divergences since the absence of complete proof of efficacy has raised concerns about the indiscriminate use of high supplemental doses of vitamin D, which can trigger intoxication. However, observational studies and a meta-analysis with clinical trials on the association between vitamin D supplementation and prevention of acute viral respiratory infection (ARI) have shown moderate protective effects. Other studies suggest the relationship between low levels of vitamin D and increased risk of severity of respiratory infections, considering the activity of this vitamin in modulating the immune system. CONCLUSION: Given the urgent scenario regarding the treatment of Covid-19, there is a need for additional studies to establish the real effectiveness of vitamin D supplementation in preventing Covid-19 and how the deficit of this nutrient can aggravate the infection. Once the prophylactic activity of vitamin D and its protective effects are proven, we can use the vitamin D as a possible adjuvant therapy. The health professional must warn about the lack of proven benefits to limit the misuse of vitamin D supplementation by the population.
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