• Sirio Fiorino, Claudio Gallo, Maddalena Zippi, Sergio Sabbatani, Roberto Manfredi, Renzo Moretti, Elisa Fogacci, Caterina Maggioli, Francesca Travasoni Loffredo, Enrico Giampieri, Ivan Corazza, Christoph Dickmans, Claudio Denitto, Michele Cammarosano, Michele Battilana, Paolo Emilio Orlandi, Francesco Del Forno, Francesco Miceli, Michela Visani, Giorgia Acquaviva, Antonio De Leo, Paolo Leandri, Wandong Hong, Thomas Brand, Giovanni Tallini, Elio Jovine, Roberto Jovine, and Dario de Biase.
• UO of Internal Medicine Unit, Hospital of Budrio, Via Benni 44, 40065, Budrio, Bologna, Italy. sirio.fiorino@ausl.bologna.it.
• Aging Clin Exp Res. 2020 Oct 1; 32 (10): 2115-2131.

BackgroundIn December 2019, a novel human-infecting coronavirus, SARS-CoV-2, had emerged. The WHO has classified the epidemic as a "public health emergency of international concern". A dramatic situation has unfolded with thousands of deaths, occurring mainly in the aged and very ill people. Epidemiological studies suggest that immune system function is impaired in elderly individuals and these subjects often present a deficiency in fat-soluble and hydrosoluble vitamins.MethodsWe searched for reviews describing the characteristics of autoimmune diseases and the available therapeutic protocols for their treatment. We set them as a paradigm with the purpose to uncover common pathogenetic mechanisms between these pathological conditions and SARS-CoV-2 infection. Furthermore, we searched for studies describing the possible efficacy of vitamins A, D, E, and C in improving the immune system function.ResultsSARS-CoV-2 infection induces strong immune system dysfunction characterized by the development of an intense proinflammatory response in the host, and the development of a life-threatening condition defined as cytokine release syndrome (CRS). This leads to acute respiratory syndrome (ARDS), mainly in aged people. High mortality and lethality rates have been observed in elderly subjects with CoV-2-related infection.ConclusionsVitamins may shift the proinflammatory Th17-mediated immune response arising in autoimmune diseases towards a T-cell regulatory phenotype. This review discusses the possible activity of vitamins A, D, E, and C in restoring normal antiviral immune system function and the potential therapeutic role of these micronutrients as part of a therapeutic strategy against SARS-CoV-2 infection.

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