The role of vitamin D in outcomes of critical care in COVID-19 patients: Evidence from an umbrella meta-analysis of interventional and observational studies
Abdolreza Jamilian, Faezeh Ghalichi, Fatemeh Hamedi Kalajahi, Nima Radkhah, Neda Jourabchi, Vali Musazadeh, Ehsan Amini-Salehi, Ph. Meysam Zarezadeh, Alireza Ostadrahimi
Public Health Nutrition, doi:10.1017/s1368980024000934
Objectives: Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with SARS-CoV-2. This umbrella meta-analysis aims to evaluate influence of vitamin D supplementation on clinical outcomes and the mortality rate of COVID-19 patients. Design: Present study was designed as an umbrella meta-analysis. The following international databases were systematically searched till March 2023: Web of Science, PubMed, Scopus, and Embase. Settings: Random-effects model was employed to perform meta-analysis. Using AMSTAR critical evaluation tools, the methodological quality of the included meta-analyses was evaluated. Participants: Adult patients suffering from COVID-19 were studied. Results: Overall, 13 meta-analyses summarizing data from 4 RCTs and 9 observational studies were identified in this umbrella review. Our findings revealed that vitamin D supplementation and status significantly reduced mortality of COVID-19 [Interventional studies: (ES= 0.42; 95% CI: 0.10, 0.75, p <0.001; I 2 = 20.4%, p=0.285) and observational studies (ES= 1.99; 95% CI: 1.37, 2.62, p <0.001; I 2 = 00.0%, p=0.944). Also, vitamin D deficiency increased risk of infection and disease severity among patients.
Conclusion: Overall, vitamin D status is a critical factor influencing the mortality rate, disease severity, admission to ICU and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients.
The result of assess the methodological quality using AMSTAR: each item for included studies (? : can't answer; -: means no; + : means yes). https://doi.org/10.1017/S1368980024000934 Published online by Cambridge University Press
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DOI record:
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"abstract": "<jats:title>Abstract</jats:title>\n\t <jats:sec id=\"S1368980024000934_as1\">\n\t <jats:title>Objectives:</jats:title>\n\t <jats:p>Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with SARS-CoV-2. This umbrella meta-analysis aims to evaluate influence of vitamin D supplementation on clinical outcomes and the mortality rate of COVID-19 patients.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as2\">\n\t <jats:title>Design:</jats:title>\n\t <jats:p>Present study was designed as an umbrella meta-analysis. The following international databases were systematically searched till March 2023: Web of Science, PubMed, Scopus, and Embase.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as3\">\n\t <jats:title>Settings:</jats:title>\n\t <jats:p>Random-effects model was employed to perform meta-analysis. Using AMSTAR critical evaluation tools, the methodological quality of the included meta-analyses was evaluated.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as4\">\n\t <jats:title>Participants:</jats:title>\n\t <jats:p>Adult patients suffering from COVID-19 were studied.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as5\">\n\t <jats:title>Results:</jats:title>\n\t <jats:p>Overall, 13 meta-analyses summarizing data from 4 RCTs and 9 observational studies were identified in this umbrella review. Our findings revealed that vitamin D supplementation and status significantly reduced mortality of COVID-19 [Interventional studies: (ES= 0.42; 95% CI: 0.10, 0.75, p <0.001; I<jats:sup>2</jats:sup> = 20.4%, p=0.285) and observational studies (ES= 1.99; 95% CI: 1.37, 2.62, p <0.001; I<jats:sup>2</jats:sup> = 00.0%, p=0.944). Also, vitamin D deficiency increased risk of infection and disease severity among patients.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as6\">\n\t <jats:title>Conclusion:</jats:title>\n\t <jats:p>Overall, vitamin D status is a critical factor influencing the mortality rate, disease severity, admission to ICU and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients.</jats:p>\n\t </jats:sec>",
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