Vitamin D Status and SARS-CoV-2 Infection and COVID-19 Clinical Outcomes
Iacopo Chiodini, Davide Gatti, Davide Soranna, Daniela Merlotti, Christian Mingiano, Angelo Fassio, Giovanni Adami, Alberto Falchetti, Cristina Eller-Vainicher, Maurizio Rossini, Luca Persani, Antonella Zambon, Luigi Gennari
Frontiers in Public Health, doi:10.3389/fpubh.2021.736665
Background: Several studies suggest an association between serum 25-hydroxyvitamin D (25OHD) and the outcomes of Severe Acute Respiratory Syndrome Corona-Virus-2 (SARS-CoV-2) infection, in particular Coronavirus Disease-2019 (COVID-19) related severity and mortality. The aim of the present meta-analysis was to investigate whether vitamin D status is associated with the COVID-19 severity, defined as ARDS requiring admission to intensive care unit (ICU) or mortality (primary endpoints) and with the susceptibility to SARS-CoV-2 and COVID-19-related hospitalization (secondary endpoints). Methods: A search in PubMed, ScienceDirect, Web of Science, Google Scholar, Scopus, and preprints repositories was performed until March 31th 2021 to identify all original observational studies reporting association measures, or enough data to calculate them, between Vitamin D status (insufficiency <75, deficiency <50, or severe deficiency <25 nmol/L) and risk of SARS-CoV-2 infection, COVID-19 hospitalization, ICU admission, or death during COVID-19 hospitalization. Findings: Fifty-four studies (49 as fully-printed and 5 as pre-print publications) were included for a total of 1,403,715 individuals. The association between vitamin D status and SARS-CoV2 infection, COVID-19 related hospitalization, COVID-19 related ICU admission, and COVID-19 related mortality was reported in 17, 9, 27, and 35 studies, respectively. Severe deficiency, deficiency and insufficiency of vitamin D were all associated with ICU admission (odds ratio [OR], 95% confidence intervals [95%CIs]:
SUPPLEMENTARY MATERIAL The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh. 2021.736665/full#supplementary-material Supplementary Figure 1
Conflict of Interest: IC received speaker fees from HRA Pharma, Corcept Therapeutics, Eli-Lilly, Amgen, and UCB. DG received honoraria and/or speaker fees from Amgen, Celgene, Eli-Lilly, MSD-italia, Organon, and UCB. DM received honoraria form UCB Pharma and Savio Pharma. GA has received advisory board honoraria and consultancy fees from Theramex. CE-V has received advisory board honoraria from Kyowa Kirin, Sandoz. MR has received advisory board honoraria, consultancy fees, and/or speaker fees from Abiogen, Amgen, Abbvie, BMS, Eli-Lilly, Galapagos, Menarini, MSD, Novartis, Pfizer, Sandoz, Theramex, and UCB. LP received consultancy fees, and/or speaker fees from Merck, Sandoz, Recordati. LG received honoraria from Sandoz and Kyowa Kirin. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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'abstract': '<jats:p><jats:bold>Background:</jats:bold> Several studies suggest an association between '
'serum 25-hydroxyvitamin D (25OHD) and the outcomes of Severe Acute Respiratory Syndrome '
'Corona-Virus-2 (SARS-CoV-2) infection, in particular Coronavirus Disease-2019 (COVID-19) '
'related severity and mortality. The aim of the present meta-analysis was to investigate '
'whether vitamin D status is associated with the COVID-19 severity, defined as ARDS requiring '
'admission to intensive care unit (ICU) or mortality (primary endpoints) and with the '
'susceptibility to SARS-CoV-2 and COVID-19-related hospitalization (secondary '
'endpoints).</jats:p><jats:p><jats:bold>Methods:</jats:bold> A search in PubMed, '
'ScienceDirect, Web of Science, Google Scholar, Scopus, and preprints repositories was '
'performed until March 31th 2021 to identify all original observational studies reporting '
'association measures, or enough data to calculate them, between Vitamin D status '
'(insufficiency &lt;75, deficiency &lt;50, or severe deficiency &lt;25 nmol/L) and '
'risk of SARS-CoV-2 infection, COVID-19 hospitalization, ICU admission, or death during '
'COVID-19 hospitalization.</jats:p><jats:p><jats:bold>Findings:</jats:bold> Fifty-four studies '
'(49 as fully-printed and 5 as pre-print publications) were included for a total of 1,403,715 '
'individuals. The association between vitamin D status and SARS-CoV2 infection, COVID-19 '
'related hospitalization, COVID-19 related ICU admission, and COVID-19 related mortality was '
'reported in 17, 9, 27, and 35 studies, respectively. Severe deficiency, deficiency and '
'insufficiency of vitamin D were all associated with ICU admission (odds ratio [OR], 95% '
'confidence intervals [95%CIs]: 2.63, 1.45–4.77; 2.16, 1.43–3.26; 2.83, 1.74–4.61, '
'respectively), mortality (OR, 95%CIs: 2.60, 1.93–3.49; 1.84, 1.26–2.69; 4.15, 1.76–9.77, '
'respectively), SARS-CoV-2 infection (OR, 95%CIs: 1.68, 1.32–2.13; 1.83, 1.43–2.33; 1.49, '
'1.16–1.91, respectively) and COVID-19 hospitalization (OR, 95%CIs 2.51, 1.63–3.85; 2.38, '
'1.56–3.63; 1.82, 1.43–2.33). Considering specific subgroups (i.e., Caucasian patients, high '
'quality studies, and studies reporting adjusted association estimates) the results of primary '
'endpoints did not change.</jats:p><jats:p><jats:bold>Interpretations:</jats:bold> Patients '
'with low vitamin D levels present an increased risk of ARDS requiring admission to intensive '
'care unit (ICU) or mortality due to SARS-CoV-2 infection and a higher susceptibility to '
'SARS-CoV-2 infection and related hospitalization.</jats:p>',
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