Recommendations for High Vitamin D Supplementation to help Fight the COVID-19 Pandemic and its Inclusion in National COVID-19 Management Guidelines

  • Jugal Kishore Director Professor & Head, Department of Community Medicine, VMMC & SJH, New Delhi, India
  • David S Grimes Retired Consultant Physician, East Lancashire
  • David C Anderson Retired Consultant Physician and Clinical Endocrinologist and former Professor of Medicine and Endocrinology, University of Manchester, Manchester, UK, and The Chinese University of Hong Kong
  • Omesh Kumar Bharti State Epidemiologist from Shimla, Himachal Pradesh, India
  • Blessy Joseph Senior Resident, Department of Community Medicine, VMMC & SJH, New Delhi, India
  • Glory Ghai Resident, Department of Community Medicine, VMMC & SJH, New Delhi, India
  • Monika Sahoo Senior Resident, Department of Obstetrics &Gynaecology, VMMC & SJH, New Delhi, India
Keywords: Vitamin D, COVID-19, National COVID-19 Management Guidelines


Vitamin D is a fat-soluble vitamin, formed in the skin under the action of UVB light and is known as sunshine vitamin with immunomodulatory as well as classical endocrine actions in calcium control. It has a role in both innate and adaptive immune responses. Intracellular synthesis of 1,25(OH)D in immunocytes promotes the production of cathelicidin and human b -defensin-2 which are …..antimicrobial peptides produced by neutrophils, macrophages, and epithelial cells that facilitate the killing of the pathogenic encapsulated viruses. Vitamin D also plays a role in inhibiting pro-inflammatory cytokines and activating anti-inflammatory cytokines. It provides antiviral immunity by promoting autophagy. Epidemiological studies have shown an association between low vitamin D levels and a variety of respiratory tract infections, both bacterial and viral. Global data correlates severe vitamin D deficiency with COVID-19 due to similar pathological processes being involved.


Dixit V, Garg B, Mehta N, Pegrum J, Dhanwal D. COVID-19 infection, inception and immunity: Observations and recommendations in the light of vitamin D? J Infect Public Health. 2021 Apr 1;14(4):444-5. [PubMed] [Google Scholar]

Bilezikian JP, Bikle D, Hewison M, Lazaretti-Castro M, Formenti AM, Gupta A, Madhavan MV, Nair N, Babalyan V, Hutchings N, Napoli N, Accili D, Binkley N, Landry DW, Giustina A. Mechanisms in endocrinology: vitamin D and COVID-19. Eur J Endocrinol. 2020 Nov 1;183(5):R133-47. [PubMed] [Google Scholar]

Vyas N, Kurian SJ, Bagchi D, Manu MK, Saravu K,Unnikrishnan MK, Mukhopadhyay C, Rao M, Miraj SS. Vitamin D in prevention and treatment of COVID-19: current perspective and future prospects. J Am Coll Nutr. 2020 Sep 1:1-14. [PubMed] [Google Scholar]

Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004 Dec;80(6):1678S-88S. [PubMed] [Google Scholar]

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30. [PubMed] [Google Scholar]

Ministry of Health and Family Welfare [Internet]. Home; [cited 2021 Jun 9]. Available from:

The Hindu BusinessLine [Internet]. At current rate, India will take 2.5 years to vaccinate 75% of its population; [cited 2021 Jun 9]. Available from:

Aparna P, Muthatal S, Nongkynrih B, Gupta SK. Vitamin D deficiency in India. J Family Med Prim Care. 2018 Mar-Apr;7(2):324-30. [PubMed] [Google Scholar]

Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. 2020 Jul;32(7):1195- 8. [PubMed] [Google Scholar]

Kaufman HW, Niles JK, Kroll MH, Bi C, Holick MF. SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PLoS One. 2020 Sep 17;15(9):e0239252. [PubMed] [Google Scholar]

Padhi S, Suvankar S, Panda VK, Pati A, Panda AK. Lower levels of vitamin D are associated with SARS-CoV-2 infection and mortality in the Indian population: An observational study. Int Immunopharmacol. 2020 Nov;88:107001 [PubMed] [Google Scholar]

Nogués X, Ovejero D, Pineda-Moncusi M, Bouillon R, Arenas D, Pascual J, Ribes A, Guerri-Fernandez R, Villar-Garcia J, Rial A, Gimenez-Argente C, Cos ML, Rodriguez-Morera J, Campodarve I, Quesada-Gomez JM, Garcia-Giralt N. Calcifediol treatment and COVID-19-related outcomes. J Clin Endocrinol Metab. 2021;dgab405. [PubMed] [Google Scholar]

Jayawardena R, Jeyakumar DT, Francis TV, Misra A. Impact of the vitamin D deficiency on COVID-19 infection and mortality in Asian countries. Diabetes Metab Syndr. 2021 May-Jun;15(3):757-64. [PubMed] [Google Scholar]

Rastogi A, Bhansali A, Khare N, Suri V, Yaddanapudi N, Sachdeva N, Puri GD, Malhotra P. Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study). Postgrad Med J. 2020 Nov 12. [PubMed] [Google Scholar]

Mudur G. Indian endocrinologists set guidance to combat vitamin D deficiency. BMJ. 2015 Nov 9;351:h5997. [PubMed] [Google Scholar]

Grimes DS. Covid-19 & Vitamin D – summaries of evidence [Internet]; 2020 Oct 9. Available from:

Purswani JM, Gala P, Dwarkanath P, Larkin HM, Kurpad A, Mehta S. The role of vitamin D in pre-eclampsia: a systematic review. BMC Pregnancy Childbirth. 2017 Jul;17(1):231. [PubMed] [Google Scholar]

Gallo S, McDermid JM, Al-Nimr RI, Hakeem R, Moreschi JM, Pari-Keener M, Stahnke B, Papoutsakis C, Handu D, Cheng FW. Vitamin D Supplementation during Pregnancy: An Evidence Analysis Center Systematic Review and Meta-Analysis. J Acad Nutr Diet. 2020 May;120(5):898-924.e4. [PubMed] [Google Scholar]

Bi WG, Nuyt AM, Weiler H, Leduc L, Santamaria C, Wei SQ. Association Between Vitamin D Supplementation During Pregnancy and Offspring Growth, Morbidity, and Mortality: A Systematic Review and Meta-analysis. JAMA Pediatr. 2018 Jul 1;172(7):635-45. [PubMed] [Google Scholar]

Hollis BW, Johnson D, Hulsey TC, Ebeling M, Wagner CL. Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res. 2011 Oct;26(10):2341-57. [PubMed] [Google Scholar]

Dawodu A, Tsang RC. Maternal vitamin D status: effect on milk vitamin D content and vitamin D status of breastfeeding infants. Adv Nutr. 2012 May;3(3):353-61. [PubMed] [Google Scholar]

Murai IH, Fernandes AL, Sales LP, Pinto AJ, Goessler KF, Duran CS, Silva CBR, Franco AS, Macedo MB, Dalmolin HH, Baggio J, Balbi GG, Reis BZ, Antonangelo L, Caparbo VF, Gualano B, Pereira RM. Effect of a Single High Dose of Vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: a randomised clinical trial. JAMA. 2021;325(11):1053-60. [PubMed] [Google Scholar]

Lakkireddy M, Gadiga SG, Malathi RD, Karra ML, Raju IS, Ragini, Chinapaka S, Baba KS, Kandakatla M. Impact of daily high dose oral vitamin D therapy on the inflammatory markers in patients with COVID 19 disease. Sci Rep. 2021 May 20;11(1):10641. [PubMed] [Google Scholar]