維生素D 降低新冠肺炎的相關併發症

Vitamin D Reduces the Related Complications of COVID-19

新型冠狀病毒感染可引起嚴重新冠肺炎及相關併發症，包括急性呼吸窘迫症候群、肺高壓、肺纖維化、栓塞、器官損傷、胃腸道症狀、疼痛、憂鬱等。不活性的維生素D在大多細胞內轉化為活性代謝物，與其受體結合後，可調控數千個基因的轉錄，進而影響生理功能。補充巨量維生素D以快速地矯正維生素D缺乏症，並維持維生素D狀態指標—血中25(OH)D在有效濃度，則可發揮多種藥理作用，包括促進抗微生物胜肽LL37產生以對抗病毒、調控適應性免疫系統以緩解細胞激素風暴、抑制腎素基因表現以緩解高度活化的「腎素-血管收縮素-醛固酮系統」、促進粒線體產生以提升能量等。目前尚未有藥物能有效地防治新冠肺炎的所有併發症；而以維生素D與藥物並用，可輔助改善相關併發症。

Infection with the severe acute respiratory syndrome coronavirus (SARS-CoV-2) could result in severe pneumonia and other complications such as acute respiratory distress syndrome (ARDS), pulmonary hypertension, pulmonary fibrosis, thrombosis, organ damage, gastrointestinal symptoms, pain, and depression. In most cells, the active metabolites of vitamin D act as ligands of vitamin D receptor to regulate the expression of thousands of genes, thus affecting many physiological functions. Rapid correction of vitamin D deficiency with mega doses of vitamin D3 and maintenance of optimal serum levels of 25(OH)D, a biomarker of vitamin D status, could confer pleiotropic pharmacological effects. These effects include antiviral activity of cathelicidin peptide LL37, reduction of cytokine storms, alleviation of hyperactive renin-angiotensin-aldosterone system (RAAS), and enhancement of mitochondrial biogenesis. Therefore, vitamin D can be used as an adjuvant treatment in combination with appropriate drugs to mitigate some COVID-19-related complications.