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Rheumatologist explained the rules of tanning “against coronavirus”: a person is not enough

What parts of the body need to be exposed to the sun in order to accumulate vitamin D

– The role of vitamin D in rheumatology has been discussed for a long time. And today, in the coronavirus pandemic, the most talked about is its effect on the immune response. There are two types of immune response – congenital and acquired. At low levels of vitamin D, an adequate immune response cannot be, it is most often perverted. Therefore, we always control the level of vitamin D in our patients. Due to the fact that COVID-19 is primarily a viral infection, the logical question is: what is the level of this vitamin in people with reduced immunity and those who have become infected with coronavirus?

– It is amazing that it was in patients from European countries – Italy, Spain and France, where there is always a lot of sunshine, the level of vitamin D was in the lowest concentration.

– This may be bewildering because vitamin D is produced under the influence of direct sunlight, but professionals know that there is no direct correlation between the number of sunny days and the level of vitamin D in the population, because in the sunniest countries there was always a hidden epidemic of lack of this vitamin . Even in the Near and Middle East.

And it has long been shown that there is a dependence on which areas of the skin fall under the sun’s rays. For example, a woman wears a burqa and opens her face, this does not lead to an increase in the level of vitamin D if her forearms, shoulders, legs are closed. That’s when these parts of the body are open to the sun, then the production of vitamin D increases. That is, there are a lot of nuances.

Returning to Italy, Spain and France, it can be noted that the outbreak occurred in nursing homes. Old people, of course, do not “roast” in the sun, so they have a big drawdown in the level of vitamin D.

Professor Alexander Dubikov.

“But why do we need to expose the sun to our feet and hands?”

– There is no answer to this question yet. Apparently, this is due to the surface area or to the special sensitivity of these areas, which contributes to the rapid production of vitamin D. But the face does not. I have seen studies from the United Arab Emirates. They were presented at international congresses.

– Does vitamin D kill the virus?

– Of course not. But there have been many publications that investigated its effect on the modulation of the immune response to a viral infection. These seasonal viral infections in people with high levels of vitamin D are either very easy or simply not infected. At the same time, treatment with vitamin D megadoses in New York (500 thousand IU (international units) each did not show any effect. And it can be assumed for what reason. Not megadoses are important, but the optimal biological initial level of vitamin D content in a particular person.

– Is it possible to make up for vitamin D deficiency with food or is it only the sun that saves?

– Vitamin D is fat-soluble, so it is found in certain concentrations in foods such as butter, fatty fish, cod liver, lard, but you will not adequately make up for it only with food. The main method is the formation of vitamin D in direct sunlight.

“But we have been told for years that it is harmful to sunbathe, that the open sun can provoke even skin cancer …”

“We are going to the other extreme.” All anti-tanning campaigns and advertising with an increased protection factor aggravate the epidemic of a reduced concentration of vitamin D, and a person becomes defenseless against many diseases, starting with a viral infection and ending with cancer. The sun’s rays – a natural way of forming vitamin D, which is now called hormone, its functions are much more diverse.

– Warm weather does not protect. What else can affect this terrible infection?

– Americans published a study that tracks the relationship of mortality in coronavirus infection with the geographic latitude of the state. It turned out that states that are below 35 degrees north latitude have less mortality. And vice versa.

– Moscow is located at a latitude of 55 °, and everything is not very well with us. And the geographical coordinates of Vietnam are only 16, and there they quickly coped with COVID-19, and mortality was low. But the latitude of New York is 40 degrees.

– New York is a special topic. In this terrible stone jungle, even the black population cannot have a high level of vitamin D, we also know this from other diseases. A population that doesn’t eat well, consumes little fat-soluble products containing a high concentration of vitamin D, does not have work and medical insurance, does not relax at sea, is a potential risk group. Everything goes well in a particular mosaic.

– Tell me, doctor, and your patients suffering from rheumatological diseases are at risk for COVID-19?

– Of course. They take drugs for many serious autoimmune diseases that inhibit the immune response. But this is a formal approach, because something else is interesting. Previous outbreaks of the coronavirus group: SARS, MERS – did not show a sharp increase in the number of patients in hospitals. There were even fewer than in the general population! There is a funny paradox here. You have probably heard that today rheumatology preparations are used to treat COVID-19, which are intended for the treatment of autoimmune diseases, for example, the chloroquine group, etc. It seems that treatment of our patients most likely protects against an excessive immune response, which often leads to serious consequences.

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