tetano
Editor, Senior Moderator
Int J Clin Pract
. 2021 Jul 26;e14649.
doi: 10.1111/ijcp.14649. Online ahead of print.
Insufficient evidence for Vitamin D use in COVID-19: A rapid systematic review
Aline Pereira da Rocha[SUP] 1 2 [/SUP], Alvaro Nagib Atallah[SUP] 1 2 [/SUP], José Mendes Aldrighi[SUP] 3 [/SUP], Andréa Larissa Ribeiro Pires[SUP] 4 [/SUP], Maria Eduarda Dos Santos Puga[SUP] 1 2 [/SUP], Ana Carolina Pereira Nunes Pinto[SUP] 1 2 5 6 [/SUP]
Affiliations
Abstract
Background: Vitamin D deficiency has been linked to increased severity of numerous viral infections.
Objective: To assess whether vitamin D supplementation is safe and effective for the treatment of COVID-19.
Methods: We searched MEDLINE, EMBASE, CENTRAL, LILACS, and LOVE for randomized controlled trials (RCT) published up to March 2nd evaluating the effects of vitamin D for the treatment of coronavirus disease (COVID-19). Two authors selected studies and analyzed the data evidence following Cochrane Recommendations.
Results: We included three RCTs with a total of 285 participants. We found low certainty-evidence indicating that hospitalized patients under calcifediol plus standard care (SC) treatment seem to present a significantly lower risk of being admitted to ICU, but no difference on mortality. We found low to very low certainty-evidence that the improvement in fibrinogen levels is slightly greater in mildly symptomatic or asymptomatic patients with COVID-19 that used cholecalciferol plus SC than in those treated with placebo plus SC [Mean difference, and the patients that used cholecalciferol plus SC achieved more SARS-CoV-2 negativity, but not on d-dimer, c-reactive protein (CRP) or procalcitonin when compared with the patients in the placebo plus SC group. We also found low to moderate certainty-evidence that a single high dose of vitamin D does not seem to be effective for reducing mortality, length of hospital stay, ICU admissions, and d-dimer or CRP levels when used in patients with moderate to severe COVID-19.
Conclusions: As a practical implication, the use of vitamin D associated with SC seems to provide some benefit to patients with COVID-19. However, the evidence is currently insufficient to support the routine use of vitamin D for the management of COVID-19, as its effectiveness seems to depend on the dosage, on the baseline vitamin D levels, and on the degree of COVID-19 severity.
. 2021 Jul 26;e14649.
doi: 10.1111/ijcp.14649. Online ahead of print.
Insufficient evidence for Vitamin D use in COVID-19: A rapid systematic review
Aline Pereira da Rocha[SUP] 1 2 [/SUP], Alvaro Nagib Atallah[SUP] 1 2 [/SUP], José Mendes Aldrighi[SUP] 3 [/SUP], Andréa Larissa Ribeiro Pires[SUP] 4 [/SUP], Maria Eduarda Dos Santos Puga[SUP] 1 2 [/SUP], Ana Carolina Pereira Nunes Pinto[SUP] 1 2 5 6 [/SUP]
Affiliations
- PMID: 34310814
- DOI: 10.1111/ijcp.14649
Abstract
Background: Vitamin D deficiency has been linked to increased severity of numerous viral infections.
Objective: To assess whether vitamin D supplementation is safe and effective for the treatment of COVID-19.
Methods: We searched MEDLINE, EMBASE, CENTRAL, LILACS, and LOVE for randomized controlled trials (RCT) published up to March 2nd evaluating the effects of vitamin D for the treatment of coronavirus disease (COVID-19). Two authors selected studies and analyzed the data evidence following Cochrane Recommendations.
Results: We included three RCTs with a total of 285 participants. We found low certainty-evidence indicating that hospitalized patients under calcifediol plus standard care (SC) treatment seem to present a significantly lower risk of being admitted to ICU, but no difference on mortality. We found low to very low certainty-evidence that the improvement in fibrinogen levels is slightly greater in mildly symptomatic or asymptomatic patients with COVID-19 that used cholecalciferol plus SC than in those treated with placebo plus SC [Mean difference, and the patients that used cholecalciferol plus SC achieved more SARS-CoV-2 negativity, but not on d-dimer, c-reactive protein (CRP) or procalcitonin when compared with the patients in the placebo plus SC group. We also found low to moderate certainty-evidence that a single high dose of vitamin D does not seem to be effective for reducing mortality, length of hospital stay, ICU admissions, and d-dimer or CRP levels when used in patients with moderate to severe COVID-19.
Conclusions: As a practical implication, the use of vitamin D associated with SC seems to provide some benefit to patients with COVID-19. However, the evidence is currently insufficient to support the routine use of vitamin D for the management of COVID-19, as its effectiveness seems to depend on the dosage, on the baseline vitamin D levels, and on the degree of COVID-19 severity.