Bouillon, RogerQuesada-Gomez, José Manuel2022-05-202022-05-202021-12Bouillon R, Quesada-Gomez JM. Vitamin D Endocrine System and COVID-19. JBMR Plus. 2021 Nov 17;5(12):e10576.http://hdl.handle.net/10668/3660Preclinical data strongly suggest that the vitamin D endocrine system (VDES) may have extraskeletal effects. Cells of the immune and cardiovascular systems and lungs can express the vitamin D receptor, and overall these cells respond in a coherent fashion when exposed to 1,25-dihydroxyvitamin D, the main metabolite of the VDES. Supplementation of vitamin D-deficient subjects may decrease the risk of upper respiratory infections. The VDES also has broad anti-inflammatory and anti-thrombotic effects, and other mechanisms argue for a potential beneficial effect of a good vitamin D status on acute respiratory distress syndrome, a major complication of this SARS-2/COVID-19 infection. Activation of the VDES may thus have beneficial effects on the severity of COVID-19. Meta-analysis of observational data show that a better vitamin D status decreased the requirement of intensive care treatment or decreased mortality. A pilot study in Cordoba indicated that admission to intensive care was drastically reduced by administration of a high dose of calcifediol early after hospital admission for COVID-19. A large observational study in Barcelona confirmed that such therapy significantly decreased the odds ratio (OR) of mortality (OR = 0.52). This was also the conclusion of a retrospective study in five hospitals of Southern Spain. A retrospective study on all Andalusian patients hospitalized because of COVID-19, based on real-world data from the health care system, concluded that prescription of calcifediol (hazard ratio [HR] = 0.67) or vitamin D (HR = 0.75), 15 days before hospital admission decreased mortality within the first month. In conclusion, a good vitamin D status may have beneficial effects on the course of COVID-19. This needs to be confirmed by large, randomized trials, but in the meantime, we recommend (rapid) correction of 25 hydroxyvitamin D (25OHD) deficiency in subjects exposed to this coronavirus. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Vitamin DCalcifediolCOVID-19MortalityAcute respiratory distress syndromeIntensive care treatmentVitamina DMortalidadSíndrome de dificultad respiratoriaMedical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Cholestanes::Cholestenes::Cholecalciferol::Hydroxycholecalciferols::CalcifediolMedical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Secosteroids::Vitamin DMedical Subject Headings::Technology and Food and Beverages::Food and Beverages::Food::Dietary SupplementsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Critical CareMedical Subject Headings::Anatomy::Endocrine SystemMedical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Respiratory Distress Syndrome, AdultMedical Subject Headings::Anatomy::Cardiovascular SystemMedical Subject Headings::Health Care::Health Services Administration::Patient Care Management::Delivery of Health CareMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Inflammatory AgentsMedical Subject Headings::Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus InfectionsMedical Subject Headings::Organisms::Viruses::RNA Viruses::Nidovirales::Coronaviridae::Coronavirus::SARS Virusresearch article34950831open access10.1002/jbm4.105762473-4039PMC8674769