Intended for healthcare professionals

Rapid response to:


Preventing a covid-19 pandemic

BMJ 2020; 368 doi: (Published 28 February 2020) Cite this as: BMJ 2020;368:m810

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Rapid Response:

Potential direct therapeutic role for Vitamin D

Dear Editor,

Vitamin D may directly prevent COVID-19 from entering lung epithelial cells; this means that Vitamin D might be a specific treatment (in addition to its potential role in prophylaxis). Here is the rationale:

1. COVID-19 enters lung cells by binding to ACE2 receptors [1].

2. ACE2 receptors utilize a specific interleukin (IL-6) when normally activated [2].

3. Blockade of IL-6 by tocilizumab may be an effective treatment for COVID-19 [3].

4. Vitamin D reduces IL-6 production in monocytes (and, presumably, macrophages) [4].

This provides a rationale for administration of Vitamin D (eg by intramuscular injection) as treatment in acutely ill patients with COVID-19.

1. Kuba K, Imai Y, Rao S, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med. 2005;11(8):875–879. doi:10.1038/nm1267
2. Senchenkova EY, Russell J, Yildirim A, Granger DN, Gavins FNE. Novel Role of T Cells and IL-6 (Interleukin-6) in Angiotensin II-Induced Microvascular Dysfunction. Hypertension. 2019;73(4):829–838. doi:10.1161/HYPERTENSIONAHA.118.12286
3. Michot JM, Albiges L, Chaput N, et al.Tocilizumab, an anti-IL6 receptor antibody, to treat Covid-19-related respiratory failure: a case report. Annals Oncology. 2020. doi:
4. Sadeghi K1, Wessner B, Laggner U, et al. Vitamin D3 down-regulates monocyte TLR expression and triggers hyporesponsiveness to pathogen-associated molecular patterns. Eur J Immunol. 2006;36(2):361-70. doi:10.1002/eji.200425995

Competing interests: No competing interests

09 April 2020
Morry Silberstein
Associate Professor, MB BS MD
School of Molecular & Life Sciences, Curtin University, Perth WA, Australia