Vitamin D and acute and severe illness – a mechanistic and pharmacokinetic perspective

Schoenmakers, Inez, Fraser, William D. and Forbes, Alastair ORCID: (2023) Vitamin D and acute and severe illness – a mechanistic and pharmacokinetic perspective. Nutrition Research Reviews, 36 (1). pp. 23-38. ISSN 0954-4224

[thumbnail of Accepted_Manuscript]
PDF (Accepted_Manuscript) - Accepted Version
Download (439kB) | Preview
[thumbnail of Published_Version]
PDF (Published_Version) - Published Version
Available under License Creative Commons Attribution.

Download (703kB) | Preview


The coronavirus disease 2019 (COVID-19) pandemic has generated high interest in factors modulating risk of infection, disease severity and recovery. Vitamin D has garnered interest since it is known to modulate immune function and vitamin D deficiency is associated with increased risk of respiratory infections and adverse health outcomes in severely ill patients. There are no population representative data on the direct relationship between vitamin D status and severe acute respiratory syndrome coronavirus 2 infection risk and severity of COVID-19. Data from intervention studies are limited to four studies. Here we summarise findings regarding vitamin D status and metabolism and their alterations during severe illness, relevant to COVID-19 patients. Further, we summarise vitamin D intervention studies with respiratory disease outcomes and in critically ill patients and provide an overview of relevant patient and population guidelines. Vitamin D deficiency is highly prevalent in hospitalised patients, particularly when critically ill, including those with COVID-19. Acute and critical illness leads to pronounced changes in vitamin D metabolism and status, suggestive of increased requirements. This needs to be considered in the interpretation of potential links between vitamin D status and disease risk and severity and for patient management. There is some evidence that vitamin D supplementation decreases the risk of respiratory tract infections, while supplementation of intensive care unit patients has shown little effect on disease severity or length of treatment. Considering the high prevalence of deficiency and low risks associated with supplementation, pro-actively applying current population and patient management guidelines to prevent, monitor and correct vitamin D deficiency is appropriate.

Item Type: Article
Additional Information: Funding Information: This work was supported by The Academy of Medical Sciences [SBF002\1097] and the University of East Anglia Health and Social Care Partners, UK.
Uncontrolled Keywords: covid-19,critical illness,respiratory disease,vitamin d,medicine (miscellaneous),nutrition and dietetics ,/dk/atira/pure/subjectarea/asjc/2700/2701
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine
Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine
Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Groups > Gastroenterology and Gut Biology
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 07 Oct 2021 01:33
Last Modified: 19 Jun 2023 08:30
DOI: 10.1017/S0954422421000251

Actions (login required)

View Item View Item