Hüseyin Feyzi ÖZMEN, Ömer ÇETİN

108109

D VİTAMİNİ VE COVID-19

Çin’in Wuhan eyaletinde ortaya çıkan ve kısa zamanda tüm dünyaya yayılan SARSCoV-2 (şiddetli akut solunum sendromu koronavirüs-2), yeni bir koronavirüs olup damlacık yoluyla bulaşmakta ve COVID-19 (koronavirüs hastalığı 2019) hastalığına neden olmaktadır. Hastalık genelde asemptomatik seyrederken bazı vakalarda hafif-orta veya şiddetli semptomlar görülebilmektedir. Koronavirüs hastalığı ilk görüldüğü tarihten yaklaşık 1 yıl sonra pandemi olarak ilan edilmiş ve beraberinde aşı ve tedavi arayışları da yoğunlaşmıştır. D vitamini, kalsiyum emilimi ve kemik mineralizasyonu gibi iskelet sistemine ait görevleri bulunan; ancak immünomodülatör görevlere de sahip olduğu düşünülen bir maddedir. Yağda çözünmekte, temel olarak ultraviyole (UV) irradyasyon yoluyla deride sentezlenmekte ve aynı zamanda yağlı balık ve balık karaciğer yağı başta olmak üzere besinlerden, zenginleştirilmiş besinlerden veya D vitamini desteklerinden alınabilmektedir. Henüz konsensus sağlanamasa da, D vitamininin akut solunum yolu enfeksiyon riskiyle ilişkili olduğunu gösteren gözlemsel ve klinik çalışmalar mevcuttur. Bununla birlikte vitaminin, sitokin salınımını regüle etme ve βdefensin ve katelisidin gibi antimikrobiyal peptidleri eksprese etme yoluyla COVID-19’da prognozu iyileştirdiği öne sürülmektedir. Pandeminin başlarında ekolojik çalışmalarca D vitamini ile COVID-19 arasında bir korelasyon olduğu bildirilmiştir. Bu korelasyon diğer gözlemsel çalışmalarla da desteklenmiş, D vitaminindeki yetersizliğin COVID-19 enfeksiyonunda artmış duyarlılık, yükselmiş hastanede yatış oranı, uzamış hastanede kalış süresi ve artmış hastalık şiddeti ve mortalite ile ilişkili olduğu bildirilmiştir. Ancak, D vitamini desteğinin hastalık şiddetine ve mortaliteye etkisini inceleyen az sayıdaki klinik çalışma, tasarım bakımından farklılıklar göstermiş, tutarsız sonuçlar vermiş ve D vitamini ile hastalık şiddeti veya mortalite arasındaki ilişkiyi kanıtlamada yetersiz kalmıştır. Koronavirüs hastalığı ile D vitamini arasındaki ilişkiyi inceleyen daha fazla sayıda iyi tasarlanmış klinik çalışmaya ihtiyaç olduğu düşünülmektedir.
Anahtar Kelimeler:

D vitamini, COVİD-19, SARS-COV-2

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İstanbul Rumeli Üniversitesi Sağlık Bilimleri Dergisi-Cover
  • Başlangıç: 2022
  • Yayıncı: İstanbul Rumeli Üniversitesi
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