Scoping review.
DATA SOURCES: Ovid MEDLINE (1946 to 24 of April 2020) and PubMed (2020 to 17 of September 2020).
ELIGIBILITY CRITERIA FOR SELECTING STUDIES: 91 studies were identified as being concerned with Acute Respiratory
Infection (ARI)/
Acute Respiratory Distress Syndrome (ARDS) and
vitamin D, and 25 publications specifically explored the role of
vitamin D deficiency in the development and progression of SARS-CoV-2/
COVID-19 related ARDS. Search "A" identified three main themes of indirect evidence supporting such an association. Consistent epidemiological evidence exists linking low
vitamin D levels to increased risk and severity of
respiratory tract infections. We also report on plausible biological processes supporting such an association; and present weaker evidence supporting the benefit of
vitamin D supplementation in reducing the risk and severity of ARIs. Uncertainty remains about what constitutes an appropriate dosing regimen in relation to reducing risk/severity of ARI/ARDS. More recent evidence (Search B) provided new insights into some direct links between
vitamin D and
COVID-19; with a number of cohort and ecological studies supporting an association with PCR-positivity for SARS-CoV-2 and
vitamin D deficiency. The exact efficacy of the
vitamin D supplementation for prevention of, or as an adjunct treatment for
COVID-19 remains to be determined; but a number of randomized control trials (RCTs) currently underway are actively investigating these potential benefits.
CONCLUSION: Our rapid review of literature supports the need for observational studies with
COVID-19 infected populations to measure and assess
vitamin D levels in relation to risk/severity and outcomes; alongside RCTs designed to evaluate the efficacy of supplementation both in preventive and therapeutic contexts. The overlap in the
vitamin D associated
biological pathways with the dysregulation reported to drive
COVID-19 outcomes warrants further investigation.