Interaction of Vitamin D and Corticosteroid Use in Hospitalized COVID-19 Patients: A Potential Explanation for Inconsistent Findings in the Literature

Jimmy T Efird; Ethan J Anderson; Charulata Jindal; Ayako Suzuki

doi:10.2174/1381612828666220418132847

Interaction of Vitamin D and Corticosteroid Use in Hospitalized COVID-19 Patients: A Potential Explanation for Inconsistent Findings in the Literature

Curr Pharm Des. 2022;28(21):1695-1702. doi: 10.2174/1381612828666220418132847.

Authors

Jimmy T Efird^{1

2}, Ethan J Anderson³, Charulata Jindal⁴, Ayako Suzuki^{5

6}

Affiliations

¹ VA Cooperative Studies Program Coordinating Center, Boston, MA 02130, USA.
² Department of Radiation Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH 44105, USA.
³ Department of Pharmaceutical Sciences and Experimental Therapeutics, Fraternal Order of Eagles Diabetes Research Center, Abboud Cardiovascular Research Center, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA.
⁴ Harvard Medical School, Harvard University, Boston, MA 02115, USA.
⁵ Division of Gastroenterology, Duke University, Durham, NC 27710, USA.
⁶ VA Cooperative Studies Program Epidemiology Center, Durham, NC 27705, USA.

PMID: 35440302
DOI: 10.2174/1381612828666220418132847

Abstract

Vitamin D is an important immune-modulator with anti-inflammatory properties. While this prohormone has been studied extensively in the prevention and treatment of COVID-19, findings have been inconsistent regarding its overall benefit in patients hospitalized with COVID-19. Most studies to date have been observational in nature, not accounting for the use of corticosteroids. Furthermore, the few randomized clinical trials designed to examine the effect of vitamin D supplementation on COVID-19 outcomes have been relatively small and thus insufficiently powered to assure a balance of corticosteroid use between study arms. The current perspective addresses the interaction of vitamin D and corticosteroids as a potential explanation for the divergent results reported in the literature. Future research on vitamin D and COVID-19 will benefit by considering this interaction, especially among hospitalized patients requiring oxygen and mechanical ventilation.

Keywords: Anti-inflammatory; COVID-19; SARS-CoV-2; corticosteroids; cytokine storm; vitamin D.

Publication types

Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adrenal Cortex Hormones / therapeutic use
COVID-19 Drug Treatment*
Humans
SARS-CoV-2
Vitamin D / therapeutic use
Vitamins

Substances

Adrenal Cortex Hormones
Vitamins
Vitamin D