Vitamin D: A simpler alternative to tocilizumab for trial in COVID-19?

Morry Silberstein, Morry Silberstein

Abstract

There is anecdotal evidence that tocilizumab, an immunosuppressant drug, may be a potential therapeutic option for patients with severe manifestations of coronavirus disease 2019 (COVID-19). Like tocilizumab, Vitamin D appears to modulate the activity of an interleukin (IL-6), which may explain the seasonal variation in prevalence of influenza. While most cases of COVID-19 have, thus far, occurred in the Northern Hemisphere winter, limiting the ability to assess seasonal variation, there remains substantial variation in the severity of this condition that has yet to be explained. A retrospective comparison of Vitamin D levels in previously obtained blood samples between survivors and confirmed fatalities could establish a rationale for implementation of widespread Vitamin D supplementation. This would be far cheaper and simpler than tocilizumab as a therapeutic option to trial.

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Crown Copyright © 2020 Published by Elsevier Ltd. All rights reserved.

References

    1. WHO Coronavirus disease 2019 (COVID-19) situation report – 66. . Published March 26, 2020. Accessed March 27, 2020.
    1. Gianotti G. I'm a doctor at Italy’s hardest-hit hospital. I had to decide who got a ventilator and who didn’t. March 27, 2020. Accessed March 27, 2020.
    1. Chinese Clinical Trial Registry: A multicenter, randomized controlled trial for the efficacy and safety of tocilizumab in the treatment of new coronavirus pneumonia (COVID-19). .
    1. : Tocilizumab in COVID-19 Pneumonia (TOCIVID-19). .
    1. Conti P, Ronconi G, Caraffa A, et al. Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies. J Biol Regul Homeost Agents. 2020 Mar 14;34(2). pii: 1. doi: 10.23812/CONTI-E. [Epub ahead of print].
    1. Tanaka T, Narazaki M, Kishimoto T. IL-6 in inflammation, immunity, and disease. Cold Spring Harb Perspect Biol. 2014;6(10):a016295. Published 2014 Sep 4. doi: 10.1101/cshperspect.a016295.
    1. Tanaka T., Narazaki M., Ogata A., Kishimoto T. A new era for the treatment of inflammatory autoimmune diseases by interleukin-6 blockade strategy. Semin Immunol. 2014;26(1):88–96. doi: 10.1016/j.smim.2014.01.009. Epub 2014 Mar 1.
    1. Hope-Simpson R.E. The role of season in the epidemiology of influenza. J Hyg (Lond) 1981;86:35–47. doi: 10.1017/s0022172400068728.
    1. Urashima M., Segawa T., Okazaki M., Kurihara M., Wada Y., Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010;91:1255–1260. doi: 10.3945/ajcn.2009.29094.
    1. Manion M., Hullsiek K.H., Wilson E.M.P. Vitamin D deficiency is associated with IL-6 levels and monocyte activation in HIV-infected persons. PLoS One. 2017;12(5):e0175517. doi: 10.1371/journal.pone.0175517. Published 2017 May 2.
    1. Liu Q., Zhou Y.H., Yang Z.Q. The cytokine storm of severe influenza and development of immunomodulatory therapy. Cell Mol Immunol. 2016;13(1):3–10. doi: 10.1038/cmi.2015.74.
    1. Labudzynskyi D., Shymanskyy M., Veliky I. Role of vitamin D3 in regulation of interleukin-6 and osteopontin expression in liver of diabetic mice. Eur Rev Med Pharmacol Sci. 2016;20(13):2916–2919.
    1. Guan W.J., Ni Z.Y., Hu Y. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 doi: 10.1056/NEJMoa2002032. [Epub ahead of print]
    1. Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med. 2020 pii: S2213-2600(20)30117-X. doi: 10.1016/S2213-2600(20)30117-X. [Epub ahead of print]
    1. Yu H.J., Kwon M.J., Woo H.Y., Park H. Analysis of 25-hydroxyvitamin D status according to age, gender, and seasonal variation. J Clin Lab Anal. 2016;30:905–911. doi: 10.1002/jcla.21955.
    1. Xie Z., Xia W., Zhang Z. Prevalence of vitamin D inadequacy among Chinese postmenopausal women: a nationwide, multicenter, cross-sectional study. Front Endocrinol (Lausanne) 2019;9:782. Published 2019 Jan 7. doi:10.3389/fendo.2018.00782.

Source: PubMed

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