The role of vitamin D and cardiovascular risk in COVID-19 patients

Vitamin D deficiency has long been associated with the incidence of cardiovascular disease. It also thought to play a role in the severity of COVID-19 patients. A serum concentration of 25(OH) D < 50 nmol/L (vitamin D deficiency) is found in patient with severe COVID-19 manifestation requiring intensive care. These patients are thought to stem from an uncontrolled complex immune response. The role of vitamin D in the COVID-19 infection reaction is by supporting antimicrobial peptides response in the respiratory epithelium and reducing inflammatory reactions to SARS-CoV-2 infection. Therefore, it can reduce the severity of COVID-19 infection. Vitamin D has also involved in several cardiovascular diseases that could increase the severity of COVID-19 infection; i.e., hypertension, lipid metabolism, atherosclerosis, and heart failure. Vitamin D affects endothelial cell function, thus regulating vasodilatation of dependent endothelial cells. It can prevent atherosclerosis and vascular calcification, which COVID-19 patients are at an increased risk. It also reduces pro-inflammatory cytokines, which has an anti-remodelling effect to reducing the fatality risk of obesity and heart failure among COVID-19 patients. Understanding the importance of avoiding vitamin D deficiency, the fulfilment of daily intake should be taken into account. The recommended daily dose of vitamin D is 200 IU per day for those aged < 50 years, 400 IU per day for those aged 50-70 years and 600 IU for individuals aged > 70 years. It is estimated that for every 100 IU of vitamin D, the 25(OH)D level increases by 2.5 nmol/L.