The link between COVID-19 and VItamin D (VIVID): A systematic review and meta-analysis
Bassatne A, Basbous M, Chakhtoura M, El Zein O, Rahme M, El-Hajj Fuleihan G
Metabolism: clinical and experimental · 131 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Office of Dietary Supplements
- Gobierno
- National Institutes of Health
- Gobierno
- Fogarty International Center
- Gobierno
- FIC NIH HHS
- Subvenciones
- Fogarty International Center (D43 TW009118); National Institutes of Health (D43 TW009118)
Según 4 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2021-03-24 · Metabolism · vol. 119 · pág. 154753
- Editorial
- Elsevier BV
- Citado
- 217 citas · más que el 100% de estudios similares · 12.0× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 98 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY-NC-ND
- Áreas de investigación
- Vitamin D Research Studies · COVID-19 Clinical Research Studies · SARS-CoV-2 and COVID-19 Research
- Palabras clave
- vitamin D, vitamin D deficiency, vitamin D supplementation, 25-hydroxyvitamin D, mortality, intensive care unit admission, invasive mechanical ventilation, disease severity, SARS-CoV-2, 1,25-dihydroxyvitamin D3, vitamin D3, inflammation, immune function, older adults, chronic disease, hospitalization, length of hospital stay, D-dimer, fibrinogen, procalcitonin
- MeSH
- humans, vitamin d deficiency, vitamins, vitamin d, nutritional status, dietary supplements, covid-19
6 autores
- Aya Bassatne🇱🇧American University of Beirut Medical Center; American University of Beirut
- Maya Basbous🇱🇧American University of Beirut
- Marlene Chakhtoura🇱🇧American University of Beirut Medical Center; American University of Beirut
- Ola El Zein🇱🇧American University of Beirut
- Maya Rahme🇱🇧American University of Beirut Medical Center; American University of Beirut
- Ghada El‐Hajj Fuleihan🇱🇧 · autor de correspondenciaAmerican University of Beirut Medical Center; American University of Beirut
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Disease severity and mortality rates due to COVID-19 infection are greater in the elderly and chronically ill patients, populations at high risk for vitamin D deficiency. Vitamin D plays an important role in immune function and inflammation. This systematic review and meta-analysis assesses the impact of vitamin D status and supplementation on COVID-19 related mortality and health outcomes.
Methods
We searched four databases until December 18th 2020, and trial registries until January 20th 2021. Two reviewers screened the studies, collected data, assessed the risk of bias, and graded the evidence for each outcome across studies, independently and in duplicate. Pre-specified outcomes of interest were mortality, ICU admission, invasive and non-invasive ventilation, hospitalization, time of hospital stay, disease severity and SARS-CoV-2 positivity. We only included data from peer-reviewed articles in our primary analyses.
Results
We identified 31 peer-reviewed observational studies. In our primary analysis, there was a positive trend between serum 25(OH)D level <20 ng/ml and an increased risk of mortality, ICU admission, invasive ventilation, non-invasive ventilation or SARS-CoV-2 positivity. However, these associations were not statistically significant. Mean 25(OH)D levels was 5.9 ng/ml (95% CI [-9.5, -2.3]) significantly lower in COVID-19 positive, compared to negative patients. The certainty of the evidence was very low. We identified 32 clinical trial protocols, but only three have published results to-date. The trials administer vitamin D doses of 357 to 60,000 IU/day, from one week to 12 months. Eight megatrials investigate the efficacy of vitamin D in outpatient populations. A pilot trial revealed a significant decrease in ICU admission with calcifediol, compared to placebo (OR = 0.003), but the certainty of the evidence was unclear. Another small trial showed that supplementation with cholecalciferol, 60,000 IU/day, decreased fibrinogen levels, but did not have an effect on D-dimer, procalcitonin and CRP levels, compared to placebo. The third trial did not find any effect of vitamin D supplementation on COVID-19 related health outcomes.
Conclusion
While the available evidence to-date, from largely poor-quality observational studies, may be viewed as showing a trend for an association between low serum 25(OH)D levels and COVID-19 related health outcomes, this relationship was not found to be statistically significant. Calcifediol supplementation may have a protective effect on COVID-19 related ICU admissions. The current use of high doses of vitamin D in COVID-19 patients is not based on solid evidence. It awaits results from ongoing trials to determine the efficacy, desirable doses, and safety, of vitamin D supplementation to prevent and treat COVID-19 related health outcomes.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY-NC-ND).
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