Expert Consensus Statement Role of vitamin D in the prevention of acute respiratory infections
Authors:   A.I.Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation, Gorelov A.V. , Malyavin A.G. ,   A.I.Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation, Babak S.L. ,   A.I.Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation, Zaitsev A.A. ,   Academician N.N.Burdenko military Clinical Hospital, Moscow, Russian Federation, Karonova T.L. ,   V.A.Almazov National Medical Research Center, Saint Peterburg, Russian Federation, Lioznov D.A. ,   A.A.Smorodintsev Scientific Research Institute of Influenza, Saint Peterburg, Russian Federation, Petrov V.A. ,   Obninsk Institute of Atomic Energy, National Research Nuclear University "MEPhI", Obninsk, Russian Federation, Pigarova E.A. ,   National Medical Research Center of Endocrinology, Moscow, Russian Federation, Esaulenko E.V. ,   Saint Petersburg State Pediatric Medical University, Saint Peterburg, Russian Federation
Published: March 2024

Acute respiratory viral infections (ARVIs) are the most common respiratory tract diseases that can reduce the quality of life of patients and aggravate bronchopulmonary and cardiovascular diseases. All ARVIs annually lead to a total economic damage of approximately 758 billion rubles, which corresponds to 80% of the damage from all infectious diseases. Due to a relatively limited number of non-specific causal therapy options, specific and non-specific prevention of ARVIs becomes extremely important. However, no specific vaccines against ARVIs, except influenza, have been developed so far. The majority of drugs for ARVI prevention have suboptimal efficacy and weak evidence (grade C). Given the pronounced economic damage from ARVIs (reaching 40 billion rubles annually), as well as the need for effective non-specific preventive agents, it is important to analyze the evidence base of new drugs for non-specific ARVI prevention, assess their cost-effectiveness, and availability for most patients. This can contribute to reducing ARVI incidence and both direct and indirect healthcare costs. Objective. Present the main provisions of the Council of Experts "The role of vitamin D in the prevention of acute respiratory infections" (February 18, 2023, Moscow, Russia) and assess the prospects for using in routine practice for improving the quality of patients life and optimize the costs of health care system. Main points. Preventive doses of colecalciferol (vitamin D3) is associated with a low risk of ARVI with daily or weekly intake lasting from 6 months. Vitamin D3 supplementation of 6 to 12 months should be recommended for people without obesity (BMI<30 kg / m2) in a dose of 2000 IU / day or 10,000 IU / week, and with obesity (BMI>30 kg / m2) in doses from 3000 IU / day to 6,000 IU / day for a long time. Long-term using of preventive doses of vitamin D3 is associated with a necessary maintain its target level throughout the year. Conclusions. In Russian Federation there is a high prevalence of deficiency and insufficiency of colecalciferol (vitamin D3) among the population, regardless of region and age group. According to the results of randomized clinical studies and metaanalyses, daily or weekly intake of vitamin D3 is associated with a low risk of ARVI. At the same time, vitamin D3 has a high therapeutic range, which makes its using more safe. Experts consider it it important to include colecalciferol (vitamin D3) in Russian clinical guidelines "Acute respiratory viral infections (ARVI) in adults" as part of their next revision as a means of non-specific prevention of ARVI. Level of evidence A (higher quality of evidence- 1). Key words: acute respiratory viral infections, influenza, COVID-19, nonspecific prevention, vitamin D3, colecalciferol