Son zamanlarda üzerinde en fazla konuşulan konulardan biri D vitamini seviyesi ile Covid-19 hastalığı arasında bir ilişki olup olmadığıdır. 2020 yılının hemen başında hayatımıza davetsiz bir şekilde giren ve uzun bir dönemde gitmek gibi bir niyeti olmadığını düşündüğüm Covid-19 virüsünün, D vitamini konsantrasyon düzeyi ile ilişkisi yoğun bir şekilde tartışılmaktadır. Gerçekten D vitamini konsantrasyon düzeyinin Covid-19 ile nasıl bir ilişkisi olabilir. Kafamda bazı soru işaretlerini sıraladım ve onlara bilimsel kanıta dayalı cevaplar vermeye çalıştım.
- D Vitamini Covid-19 virüsünün bulaşmasını önler mi?
- D Vitamini konsantrasyon seviyesi Covid-19 virüsü tedavisini pozitif etkiler mi?
- D Vitamini konsantrasyon seviyesi Covid-19 virüsü nedeniyle ölüm riskini düşürür mü?
Yazılı ve görsel basında hemen her gün Covid-19 virüsü hakkında yeni bilgiler yayımlanmaktadır. Bilgi ve teknoloji çağının bize sunduğu eşi benzeri görülmemiş bu bilgi bolluğu beraberinde dezenformasyonu da getirmiştir. Covid-19’ un hayatımızı esir alması ile birlikte hastalığa yakalanma veya hastalık nedeniyle yaşamı kaybetme korkusu ve kaygısı toplumlar arasında hızla yaygınlaşmıştır. Bu konu üzerinde basın araçlarının rolü de göz ardı edilmemelidir. Korku ve kaygı ikliminin oluşmasında oldukça yüksek performans gösterildiği gözden kaçmayan bir realitedir. Buradan benim Covid-19 hastalığını önemsemediğim veya küçümsediğim çıkarılmamalıdır. Medya ve hükümetlerin Covid-19 pandemisi için harcadığı çaba ve ekonominin 10’ da 1’i kadarını dahi sigaradan, trafik kazalarından, obezite, diyabet ve kalp hastalıkları gibi sorunlardan yaşamını kaybedenler için harcamadığı düşünüldüğünde konunun derinliği daha iyi anlaşılacaktır. Neyse, konumuza dönecek olursak, salgının başlamasından hemen sonra tüm basın yayın organlarında artan vitamin ve bağışıklık güçlendirici takviye reklamları gözden kaçmamıştır. Tüm televizyon kanallarının reklamlarının büyük bölümü bu tür ürünlerin pazarlamasını yapan ünlü kişilerle dolup taşmıştır. Peki gerçekten bağışıklık yanıtının güçlenmesinde özellikle D vitamininin etkisi var mıdır? Varsa muhtemel etkisi nedir? Tüm bu soruları bilimsel kanıta dayalı olarak özetleyecek olursam.
- Soru: D-Vitamini Covid-19 virüsünün bulaşmasını önler mi?
Cevap: Literatürde bir meta analizi çalışmasında düşük D vitamini seviyesinin (düşük D vitamini seviyesi= <30 ng/mL düzeyi referans kabul edilmiştir) covid-19 bulaşma riskini %43 arttırdığı rapor edilmiştir (1).
- Soru: D-Vitamini konsantrasyon seviyesi Covid-19 virüsü tedavisini pozitif etkiler mi?
Cevap: Güncel bir araştırma bulgusuna göre D vitamini konsantrasyon seviyesinin yüksek olması Covid-19 virüsü bulaşanlarda hastalığın seyrini etkilemektedir. Araştırmada, D vitamini seviyesi yüksek olanların düşük D vitamini seviyesine sahip olanlara kıyasla hastalık semptomlarını daha hafif hissettiği ve iyileşme sürecini daha hızlı tamamladıkları rapor edilmiştir (2).
- Soru: D-Vitamini konsantrasyon seviyesi Covid-19 virüsü nedeniyle ölüm riskini düşürür mü?
Cevap: Geriye dönük yapılan bir kohort araştırmada D vitamini seviyesi düşük olanların Covid-19 kaynaklı ölüm riskinin daha yüksek olduğu saptanmıştır. Araştırmada, D vitamini seviyesi <30 ng/mL olan kişilerde ölüm oranı %25.3 bulunurken >30 ng/mL olan kişilerde bu oran sadece %9.2 olarak bulunmuştur (3).
Bilimsel literatür bugüne kadar yukarıda belirttiğim soru başlıklarına sınırlı sayıda cevap üretmiştir. Üretilen cevapların hiçbiri kişilerin fiziksel uygunluk düzeyleri, genel beslenme ve uyku alışkanlıkları, kronik hastalıkları ve genetik farklılıkları gibi faktörlerden bağımsız olarak elde edilmemiştir. Bu durum kanıtların güvenilirlik düzeyi noktasında şüphelere sahiptir. Peki, bilimsel literatür hangi bilgiye dayanarak D Vitamininin Covid-19 hastalığını önlemede etkili olacağını varsaymaktadır. Genel kabul olarak literatür, D vitamininin hücresel arası haberleşme ve yanıt oluşturma, bağışıklık yanıtından sorumlu gen ifadesinde ve anti-mikrobiyal etkilere neden olma gibi faktörlerle doğuştan getirdiğimiz bağışıklık yanıtımızı pozitif etkileyebileceğini vurgulamaktadır.
Sonuç olarak, D vitamini konsantrasyon düzeyinin Covid-19 hastalığı üzerine etkinliği hala tartışmalıdır. Ancak, içinde bulunduğumuz kaotik durum göz önüne alındığında doğal yollardan D vitamini düzeyini arttırmaya çalışmak (güneşe çıkmak, yeşil yapraklı sebzeler tüketmek gibi), doğal ve mevsiminde beslenmek, fiziksel aktif olmak, yeterli ve kaliteli uyumak, stresi yönetmek gibi başlıklar Covid-19 semptomlarını hafifletebilir ve sağkalım oranını yükseltebilir. Ayrıca, muhtemel D vitamini düşüklüğü durumunda mutlaka öncelikle doğal yollardan D vitamini seviyesini yükseltecek stratejileri takip etmek ve gerekli durumlarda D vitamini takviyelerini hekim konsültasyonunda kullanmak son derece faydalı olacaktır.
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