SEARCHNARRATIVE_REVIEWimmunology, infectious disease

narrative_review·immunology, infectious disease, hematology, cardiology, nutrition·PMC10089932

The interplay between hypovitaminosis D and the immune dysfunction in the arteriovenous thrombotic complications of the sever coronavirus disease 2019 (COVID-19) infection

Blood Coagulation & Fibrinolysis · 2 authors, 2 centres

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This narrative review discusses how vitamin D deficiency may contribute to the immune dysfunction and thrombotic complications seen in severe COVID-19.

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This is a narrative review summarizing the proposed pathophysiological links between hypovitaminosis D and thrombotic complications in COVID-19. The review details vitamin D's established roles in modulating hemostasis, including effects on platelets, coagulation factors, and endothelial repair via the vitamin D receptor. The review also connects vitamin D to the renin-angiotensin system, which is disrupted by SARS-CoV-2.

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narrative_review

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immunology

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ORIGINAL PAPER

PMC10089932

The interplay between hypovitaminosis D and the immune dysfunction in the arteriovenous thrombotic complications of the sever coronavirus disease 2019 (COVID-19) infection

Blood Coagulation & Fibrinolysis

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ABSTRACT

Abstract Thromboembolic complications including cerebrovascular accidents, pulmonary embolism, myocardial infarction, deep vein thrombosis and disseminating intravascular coagulopathy are serious encounters in sever coronavirus disease 2019 (COVID-19) infected patients. This worsens the prognosis and may lead to death or life long morbidities. The laboratory finding of the disturbed haemostasias and the hyperinflammatory response are almost invariably present in COVID-19 patients. Multiple treatment modalities are utilized by the healthcare professionals to overcome the cytokine storm, oxidative stress, endothelial dysfunction, and coagulopathy in these patients. The combined actions of vitamin D (VitD) as a steroid hormone with anti-inflammatory, immunomodulatory, and antithrombotic properties increase the potential of the possible involvement of hypovitaminosis D in the thromboembolic complications of COVID-19 infection, and stimulated researchers and physicians to administer VitD therapy to prevent the infection and/or overcome the disease complications. The current review highlighted the immunomodulatory, anti-inflammatory, antioxidative and hemostatic functions of VitD and its interrelation with the renin–angiotensin–aldosterone system (RAAS) pathway and the complement system. Additionally, the association of VitD deficiency with the incidence and progression of COVID-19 infection and the associated cytokine storm, oxidative stress, hypercoagulability, and endothelial dysfunction were emphasized. Normalizing VitD levels by daily low dose therapy in patients with hypovitaminosis D below (25 nmol/l) is essential for a balanced immune response and maintaining the health of the pulmonary epithelium. It protects against upper respiratory tract infections and decreases the complications of COVID-19 infections. Understanding the role of VitD and its associated molecules in the protection against the coagulopathy, vasculopathy, inflammation, oxidative stress and endothelial dysfunction in COVID-19 infection could lead to new therapeutic strategies to prevent, treat, and limit the complications of this deadly virus infection. Keywords: coronavirus disease 2019 (COVID-19), cytokine storm, infection, inflammation, thrombosis, vitamin D

CITATION EXPORT

Haifa M AlNafea, Aida A Korish. The interplay between hypovitaminosis D and the immune dysfunction in the arteriovenous thrombotic complications of the sever coronavirus disease 2019 (COVID-19) infection. Blood Coagulation & Fibrinolysis. (2023). https://doi.org/10.1097/MBC.0000000000001212

AUTHORS

2 · 2 CENTRES

Haifa M AlNafea, Aida A Korish

aClinical Laboratory Sciences Department, College of Applied Medical Sciences, King Saud University
bPhysiology Department (29), College of Medicine, King Saud University Medical City (KSUMC), King Saud university, Riyadh, Saudi Arabia