Hali inayoweza kusahihishwa kwa urahisi Upungufu wa Vitamini D (VDI) has very severe implications for COVID-19. In countries worst affected by COVID-19 such as Italy, Spain and Greece, Vitamini D insufficiency (VDI) rates were high in the range of 70-90%.; on the other hand, in Norway and Denmark, where COVID-19 was less severe, VDI rates were 15-30% suggesting strong correlation between VDI and COVID-19. It is hypothesized that VDI aggravates COVID-19 severity by its prothrombic effects and deregulation of immune response. Furthermore, in Wuhan, COVID-19 Associated Coagulopathy (CAC) was present in 71.4% of non-survivors vs. 0.6% in survivors. Patients with VDI having severe COVID-19 symptoms also had CAC, viz. blood clotting in micro vessels that was associated with high mortality.
The Covid-19 janga ambalo limeambukiza watu milioni 6.4 duniani kote na kusababisha vifo vya watu ~380,000 limesababisha dunia nzima kupiga magoti kuhusiana na hali ya uchumi. Huku chanjo ikiwa bado iko mbali, kuna haja ya uelewa wa kina wa ugonjwa huo ili tahadhari za kutosha zichukuliwe ili kuepuka kuambukizwa na ugonjwa huo. Msemo wa zamani, "Kinga ni bora kuliko tiba", inafaa sana katika kesi ya ugonjwa wa COVID-19 kwani ulimwengu wote wa kisayansi unatatizika kuelewa asili na utata wa ugonjwa huu ili kupata hatua za kuzuia kudhibiti kuenea kwake.
Tafiti kadhaa zimefanywa ili kuelewa mzunguko wa maisha wa virusi vya SARS-CoV-2, ukatili wake kwa watu wa rika tofauti na kasi ya kupona watu walioambukizwa virusi hivyo.1,2. One of the factors that could have been overlooked is the Vitamini D status of the populations that could influence the severity of COVID-19 disease as more people are advised to stay indoors. In studies across Europe, it has been observed that COVID-19 had been severe in Italy, Spain and Greece which had vitamini D viwango vya upungufu (VDI) vya 70-90% ikilinganishwa na VDI ya 15-30% nchini Norway na Denmark ambapo ugonjwa wa COVID-19 haukuwa kama kali 3. Mlo wa watu katika nchi za Scandinavia ni matajiri katika Vitamini D kwa sababu ya ulaji mwingi wa samaki wenye mafuta mengi na virutubisho vya maziwa ambavyo vimeimarishwa na Vitamini D3.
Katika utafiti wa hivi majuzi uliofanywa katika kituo kimoja cha matibabu cha elimu ya juu kuhusu masomo 20, uwiano wa moja kwa moja ulipatikana kati ya viwango vya Vitamini D na ukali wa ugonjwa wa COVID-19. Wagonjwa 11 kati ya hawa walilazwa ICU na walikuwa na VDI, 7 kati yao walikuwa na viwango vya chini ya 20ng/mL wakati wengine walikuwa na viwango vya chini zaidi. Kati ya wagonjwa 11 katika ICU, 62.5% walikuwa na CAC (COVID-19 Associated Coagulopathy) huku 92.5% walikuwa na lymphopenia ikipendekeza kuwa VDI inazidisha ukali wa COVID-19 kwa athari zake za prothrombic na kupunguza mwitikio wa kinga.4. Huko Wuhan, CAC ilikuwepo katika 71.4% ya watu ambao hawakunusurika dhidi ya 0.6% ya walionusurika.5. Vitamini D has been shown to play an essential role in modulating both the innate and adaptive immune response6, 7 wakati VDI inahusishwa na kuongezeka kwa hatari ya CVD na kifo8.
Katika uchunguzi mwingine wa nyuma wa vituo vingi vya kesi 212 zilizo na maambukizo yaliyothibitishwa na maabara ya SARS-CoV-2, seramu. vitamini D viwango vilikuwa vya chini zaidi katika visa muhimu, lakini vya juu zaidi katika visa vidogo9. Uchambuzi wa data umebaini kuwa kwa kila kupotoka kwa kiwango kunaongezeka kwa seramu vitamini D, uwezekano wa kuwa na matokeo madogo ya kiafya badala ya kuwa makali uliongezeka ~ mara 7.94, ilhali jambo la kushangaza ni kwamba uwezekano wa kupata matokeo madogo ya kiafya badala ya matokeo muhimu uliongezeka ~ mara 19.61.9. This suggests that an increase in vitamin D levels in the body could either improve clinical outcomes, while a decrease in vitamini D levels in the body could intensify the clinical outcomes in COVID-19 patients.
These studies showing a positive/improved clinical response in COVID-19 patients with increased levels of vitamini D and a negative/poor clinical response with low vitamini D levels warrant further investigation on the role of vitamini D in COVID-19 disease and provides a way forward for clinicians and policy makers to undertake large population trials to evaluate this as a preventive measure to fight against COVID-19.
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Marejeo:
1. Weiss SR na Navas-Martin S. 2005. Ugonjwa wa Virusi vya Korona na pathojeni inayoibuka ugonjwa mkali wa kupumua kwa papo hapo. Microbiol. Mol. Bioli. Rev. 2005 Des;69(4):635-64. DOI: https://doi.org/10.1128/MMBR.69.4.635-664.2005
2. Soni R., 2020. Utafiti wa ISARIC Unaonyesha Jinsi Umbali wa Kijamii Unavyoweza Kurekebishwa Katika Karibuni Ili Kuboresha 'Kulinda Maisha' na 'Uchumi wa Kitaifa wa Kickstart'. Iliyotumwa Mei 01, 2020. Sayansi ya Ulaya. Inapatikana mtandaoni kwa https://www.scientificeuropean.co.uk/isaric4c-study-indicates-how-social-distancing-could-be-fine-tuned-in-near-future-to-optimise-protecting-lives-and-kickstart-national-economy Ilifikiwa tarehe 30 Mei 2020.
3. Scharla SH., 1998. Kuenea kwa upungufu mdogo wa vitamini D katika nchi tofauti za Ulaya. Osteoporosis Int. 8 Suppl 2, S7-12 (1998). DOI: https://doi.org/10.1007/PL00022726
4. Lau, FH., Majumder, R., et al 2020. Upungufu wa Vitamini D umeenea katika hali mbaya ya COVID-19. Chapisha mapema medRxiv. Ilichapishwa tarehe 28 Aprili 2020. DOI: https://doi.org/10.1101/2020.04.24.20075838 or https://www.medrxiv.org/content/10.1101/2020.04.24.20075838v1
5. Tang N, Li D, et al 2020. Vigezo visivyo vya kawaida vya kuganda vinahusishwa na ubashiri mbaya kwa wagonjwa walio na nimonia mpya ya coronavirus. Jarida la Thrombosis na Haemostasis 18, 844–847 (2020). Ilichapishwa mara ya kwanza:19 Februari 2020. DOI: https://doi.org/10.1111/jth.14768
6. Liu PT., Stenger S., et al. 2006. Uanzishaji wa kipokezi cha kulipia cha mwitikio wa antimicrobial wa binadamu unaopatana na vitamini D. Sayansi 311, 1770-1773 (2006). DOI: https://doi.org/10.1126/science.1123933
7. Edfeldt K., Liu PT., et al 2010. Sitokini za seli za T-kiini hudhibiti kwa njia tofauti majibu ya antimicrobial ya monocyte ya binadamu kwa kudhibiti kimetaboliki ya vitamini D. Proc. Natl. Acad. Sayansi. USA 107, 22593–22598 (2010). DOI: https://doi.org/10.1073/pnas.1011624108
8. Forrest KYZ na Stuhldreher WL 2011. Kuenea na uwiano wa upungufu wa vitamini D kwa watu wazima wa Marekani. Utafiti wa Lishe 31, 48–54 (2011). DOI: https://doi.org/10.1016/j.nutres.2010.12.001
9. Nyongeza ya Alipio M. Vitamini D Inaweza Kuboresha Matokeo ya Kitabibu ya Wagonjwa Walioambukizwa Virusi vya Korona-2019 (COVID-19) (Aprili 9, 2020). Inapatikana kwa SSRN: https://ssrn.com/abstract=3571484 or http://dx.doi.org/10.2139/ssrn.3571484
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