medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2020-21-218-228medsovet-5987Research ArticleИНФЕКЦИИINFECTIONSВитамин D – стратегический удар по коронавирусной инфекцииVitamin D is a strategic blow to coronavirus infectionhttps://orcid.org/0000-0003-1851-0941СалуховВ. В.SalukhovV. V.

д.м.н., начальник 1-й кафедры и клиники (терапии усовершенствования врачей),

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Dr. of Sci. (Med.), Head at the 1st Department of Internal Medicine Postgraduate Training, 

6, Akademik Lebedev St., St Petersburg, 194044

vlasaluk@yandex.ruhttps://orcid.org/0000-0002-3784-8473КовалевскаяЕ. А.KovalevskayaE. A.

к.м.н., старший преподаватель 1-й кафедры и клиники (терапии усовершенствования врачей), 

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Cand. of Sci. (Med.), Senior Lecturer of the 1st Clinic of therapy for postgraduate education, 

6, Akademik Lebedev St., St Petersburg, 194044

fiil-elena@yandex.ruВоенно-медицинская академия им. С.М. КироваРоссияKirov Military Medical AcademyRussian Federation202015012021021218228Copyright © Салухов В.В., Ковалевская Е.А., 20212021Салухов В.В., Ковалевская Е.А.Salukhov V.V., Kovalevskaya E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/5987

Мир находится во власти пандемии новой вирусной инфекции COVID-19. В настоящее время количество пациентов во всем мире не только не снижается, а, наоборот, прогрессивно нарастает. Лечение и профилактика SARS-CoV-2 являются главной задачей мирового здравоохранения. Крайне необходимы эффективные и безопасные методы терапии и профилактики, которые могут снизить риск заражения, уменьшить тяжесть течения инфекционного процесса и смертность от этого тяжелого заболевания. Витамин D известен своей классической ролью в поддержании минеральной плотности костной ткани. В настоящее время все более выявляются его внескелетные эффекты. Например, отмечено его существенное влияние на иммунную систему организма и модуляцию как врожденного, так и адаптивного иммунитета с регуляцией воспалительного каскада. В данном обзоре рассмотрены известные механизмы воздействия витамина D на клеточный и гуморальный иммунитет и прямую противовирусную защиту организма и его потенциальную модулирующую роль в вакцинной иммуногенности. Представлены данные проведенных обсервационных и рандомизированных клинических исследований, доказывающих позитивное влияние колекальциферола на частоту и тяжесть сезонных вирусных респираторных заболеваний. Описан механизм проникновения и развития коронавируса в организм человека, изменения иммунной системы и гуморальных факторов защиты организма на фоне SARS-CoV-2. Уточнены группы пациентов, имеющие наибольший риск заражения коронавирусом и более тяжелого протекания инфекционного процесса в зависимости от возраста и сопутствующих заболеваний. Также проанализированы и обобщены данные современных исследований, убедительно продемонстрировавших, что оптимальный уровень витамина D в крови оказывает благотворное влияние на снижение риска заражения и тяжесть течения инфекций дыхательных путей, включая COVID-19. Приведены дозы и схемы терапии витамином D на фоне вирусных инфекций, включая COVID-19, опираясь на опыт предыдущих и текущих исследований и положения существующих руководств.

The world is in the grip of the pandemic of the new viral infection COVID-19. The number of patients around the world is not only not decreasing, but also progressively increasing. Treatment and prevention of SARS-CoV-2 is a major global healthcare challenge. Effective and safe methods of treatment and prevention are urgently needed that can reduce the risk of infection, reduce the risk of developing the infectious process and mortality from this serious disease in addition to quarantine. Vitamin D is known for its classic role in maintaining bone mineral density. Currently, his contribution has been more and more studied. For example, the immune system is important, as well as adaptive immunity and regulation of the inflammatory cascade. In these reviews, the mechanisms of the effect of vitamin D on cellular and humoral immunity and direct antiviral defense of the body were discovered, and its potential modules – the role in vaccine immunogenicity. The data of observational and randomized clinical trials proving the positive effect of colecalciferol on the frequency and severity of seasonal viral respiratory diseases are presented. The mechanism of penetration and development of coronavirus in the human body, changes in the immune system and humoral factors of the body’s defense against the background of the course of SARS-CoV-2. Coronavirus and more severe course is an infectious process depending on age and associated diseases. In this article, we analyze and summarize the data of modern studies, in which it is proved that the level of vitamin D in the blood has a beneficial effect on the content of vitamins D in the body’s immune and antiviral defense and its role in reducing the risk of infection and the severity of pathological diseases, including COVID-19. Discussion of the doses and regimens of vitamin D therapy against viral infections, including COVID-19, is based on the experience of previous and ongoing studies and guidelines.

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The authors declare that there are no conflicts of interest present.