tetano
Editor, Senior Moderator
Front Immunol
. 2022 Oct 31;13:1023903.
doi: 10.3389/fimmu.2022.1023903. eCollection 2022.
Vitamin D supplementation for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials
Lara S Kümmel[SUP] 1 [/SUP], Hanna Krumbein[SUP] 1 [/SUP], Paraskevi C Fragkou[SUP] 2 [/SUP], Ben L Hünerbein[SUP] 1 [/SUP], Rieke Reiter[SUP] 1 [/SUP], Konstantinos A Papathanasiou[SUP] 3 [/SUP], Clemens Thölken[SUP] 4 [/SUP], Scott T Weiss[SUP] 5 [/SUP], Harald Renz[SUP] 1 [/SUP], Chrysanthi Skevaki[SUP] 1 [/SUP]
Affiliations
Abstract
Vitamin D supplementation and its impact on immunoregulation are widely investigated. We aimed to assess the prevention and treatment efficiency of vitamin D supplementation in the context of coronavirus disease 2019 (COVID-19) and any disease-related complications. For this systematic review and meta-analysis, we searched databases (PubMed, Embase, Scopus, Web of Science, The Cochrane Library, medRxiv, Cochrane COVID-19 Study Register, and ClinicalTrial.gov) for studies published between 1 November 2019 and 17 September 2021. We considered randomized trials (RCTs) as potentially eligible when patients were tested for SARS-CoV-2 infection and received vitamin D supplementation versus a placebo or standard-of-care control. A random-effects model was implemented to obtain pooled odds ratios for the effect of vitamin D supplementation on the main outcome of mortality as well as clinical outcomes. We identified a total of 5,733 articles, of which eight RCTs (657 patients) met the eligibility criteria. Although no statistically significant effects were reached, the use of vitamin D supplementation showed a trend for reduced mortality [odds ratio (OR) 0.74, 95% confidence interval (CI) 0.32-1.71, p = 0.48] compared with the control group, with even stronger effects, when vitamin D was administered repeatedly (OR 0.33, 95% CI 0.1-1.14). The mean difference for the length of hospitalization was -0.28 (95% CI -0.60 to 0.04), and the ORs were 0.41 (95% CI 0.15-1.12) and 0.52 (95% CI 0.27-1.02) for ICU admission and mechanical ventilation, respectively. In conclusion, vitamin D supplementation did not improve the clinical outcomes in COVID-19 patients, but trends of beneficial effects were observed. Further investigations are required, especially studies focusing on the daily administration of vitamin D.
Keywords: COVID-19; SARS-CoV-2; meta-analysis; systematic review; vitamin D.
. 2022 Oct 31;13:1023903.
doi: 10.3389/fimmu.2022.1023903. eCollection 2022.
Vitamin D supplementation for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials
Lara S Kümmel[SUP] 1 [/SUP], Hanna Krumbein[SUP] 1 [/SUP], Paraskevi C Fragkou[SUP] 2 [/SUP], Ben L Hünerbein[SUP] 1 [/SUP], Rieke Reiter[SUP] 1 [/SUP], Konstantinos A Papathanasiou[SUP] 3 [/SUP], Clemens Thölken[SUP] 4 [/SUP], Scott T Weiss[SUP] 5 [/SUP], Harald Renz[SUP] 1 [/SUP], Chrysanthi Skevaki[SUP] 1 [/SUP]
Affiliations
- PMID: 36389703
- PMCID: PMC9659578
- DOI: 10.3389/fimmu.2022.1023903
Abstract
Vitamin D supplementation and its impact on immunoregulation are widely investigated. We aimed to assess the prevention and treatment efficiency of vitamin D supplementation in the context of coronavirus disease 2019 (COVID-19) and any disease-related complications. For this systematic review and meta-analysis, we searched databases (PubMed, Embase, Scopus, Web of Science, The Cochrane Library, medRxiv, Cochrane COVID-19 Study Register, and ClinicalTrial.gov) for studies published between 1 November 2019 and 17 September 2021. We considered randomized trials (RCTs) as potentially eligible when patients were tested for SARS-CoV-2 infection and received vitamin D supplementation versus a placebo or standard-of-care control. A random-effects model was implemented to obtain pooled odds ratios for the effect of vitamin D supplementation on the main outcome of mortality as well as clinical outcomes. We identified a total of 5,733 articles, of which eight RCTs (657 patients) met the eligibility criteria. Although no statistically significant effects were reached, the use of vitamin D supplementation showed a trend for reduced mortality [odds ratio (OR) 0.74, 95% confidence interval (CI) 0.32-1.71, p = 0.48] compared with the control group, with even stronger effects, when vitamin D was administered repeatedly (OR 0.33, 95% CI 0.1-1.14). The mean difference for the length of hospitalization was -0.28 (95% CI -0.60 to 0.04), and the ORs were 0.41 (95% CI 0.15-1.12) and 0.52 (95% CI 0.27-1.02) for ICU admission and mechanical ventilation, respectively. In conclusion, vitamin D supplementation did not improve the clinical outcomes in COVID-19 patients, but trends of beneficial effects were observed. Further investigations are required, especially studies focusing on the daily administration of vitamin D.
Keywords: COVID-19; SARS-CoV-2; meta-analysis; systematic review; vitamin D.