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
References
Bassatne, Basbous, Chakhtoura, The link between COVID-19 and VItamin D (VIVID): a systematic review and meta-analysis, Metabolism
Castillo, Costa, Barrios, Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study, The Journal of steroid biochemistry and molecular biology,
doi:10.1017/S1368980024000934
Chakhtoura, Napoli, Fuleihan, Commentary: myths and facts on vitamin D amidst the COVID-19 pandemic, Metabolism-Clinical and Experimental
Daneshkhah, Agrawal, Eshein, Evidence for possible association of vitamin D status with cytokine storm and unregulated inflammation in COVID-19 patients, Aging Clinical and Experimental Research
Grant, Lahore, Mcdonnell, Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths, Nutrients
Jain, Chaurasia, Sengar, Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers, Scientific reports
Kaya, Yakar, The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies, Epidemiology and health
Kazemi, Mohammadi, Aghababaee, Association of vitamin D status with SARS-CoV-2 infection or COVID-19 severity: a systematic review and metaanalysis, Advances in Nutrition
Liu, Li, Xu, Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19, Journal of clinical virology
Liu, Sun, Wang, Low vitamin D status is associated with coronavirus disease 2019 outcomes: a systematic review and meta-analysis, International Journal of Infectious Diseases,
doi:10.1017/S1368980024000934
Maghbooli, Ebrahimi, Shirvani, Vitamin D sufficiency reduced risk for morbidity and mortality in COVID-19 patients
Martineau, Jolliffe, Hooper, Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data
Mcgregor, Chauss, Freiwald, An autocrine Vitamin D-driven Th1 shutdown program can be exploited for COVID-19
Munshi, Hussein, Toraih, Vitamin D insufficiency as a potential culprit in critical COVID-19 patients
Murai, Fernandes, Sales, Effect of a single high dose of vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: a randomized clinical trial, Jama
Nikniaz, Akbarzadeh, Hosseinifard, The impact of vitamin D supplementation on mortality rate and clinical outcomes of COVID-19 patients: A systematic review and meta-analysis
Oristrell, Oliva, Subirana, Association of calcitriol supplementation with reduced COVID-19 mortality in patients with chronic kidney disease: a populationbased study, Biomedicines
Oscanoa, Amado, Vidal, The relationship between the severity and mortality of SARS-CoV-2 infection and 25-hydroxyvitamin D concentration-a metaanalysis, Advances in respiratory medicine
Pal, Banerjee, Bhadada, Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis, Journal of endocrinological investigation
Pereira, Damascena, Azevedo, Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis, Critical reviews in food science and nutrition
Pinzon, Pradana, Vitamin D deficiency among patients with COVID-19: case series and recent literature review, Tropical Medicine and Health
Pizzini, Aichner, Sahanic, Impact of vitamin D deficiency on COVID-19-a prospective analysis from the CovILD Registry, Nutrients
Rawat, Roy, Maitra, Vitamin D supplementation and COVID-19 treatment: A systematic review and meta-analysis, Diabetes & Metabolic Syndrome: Clinical Research & Reviews
Shah, Saxena, Mavalankar, Vitamin D supplementation, COVID-19 and disease severity: a meta-analysis, QJM: An International Journal of Medicine
Shea, Grimshaw, Wells, Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews, BMC medical research methodology
Sun, Zhang, Zou, Serum calcium as a biomarker of clinical severity and prognosis in patients with coronavirus disease 2019, Aging
Szarpak, Rafique, Gasecka, A systematic review and meta-analysis of effect of vitamin D levels on the incidence of COVID-19, Cardiology journal
Teshome, Adane, Girma, The impact of vitamin D level on COVID-19 infection: systematic review and meta-analysis, Frontiers in public health
{ 'indexed': {'date-parts': [[2024, 4, 25]], 'date-time': '2024-04-25T00:27:09Z', 'timestamp': 1714004829376},
'reference-count': 0,
'publisher': 'Cambridge University Press (CUP)',
'license': [ { 'start': { 'date-parts': [[2024, 4, 24]],
'date-time': '2024-04-24T00:00:00Z',
'timestamp': 1713916800000},
'content-version': 'unspecified',
'delay-in-days': 0,
'URL': 'http://creativecommons.org/licenses/by/4.0/'}],
'content-domain': {'domain': [], 'crossmark-restriction': False},
'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>',
'DOI': '10.1017/s1368980024000934',
'type': 'journal-article',
'created': {'date-parts': [[2024, 4, 24]], 'date-time': '2024-04-24T07:25:17Z', 'timestamp': 1713943517000},
'page': '1-25',
'source': 'Crossref',
'is-referenced-by-count': 0,
'title': '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',
'prefix': '10.1017',
'author': [ {'given': 'Abdolreza', 'family': 'Jamilian', 'sequence': 'first', 'affiliation': []},
{'given': 'Faezeh', 'family': 'Ghalichi', 'sequence': 'additional', 'affiliation': []},
{'given': 'Fatemeh', 'family': 'Hamedi Kalajahi', 'sequence': 'additional', 'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-9353-8066',
'authenticated-orcid': False,
'given': 'Nima',
'family': 'Radkhah',
'sequence': 'additional',
'affiliation': []},
{'given': 'Neda', 'family': 'Jourabchi', 'sequence': 'additional', 'affiliation': []},
{'given': 'Vali', 'family': 'Musazadeh', 'sequence': 'additional', 'affiliation': []},
{'given': 'Ehsan', 'family': 'Amini-Salehi', 'sequence': 'additional', 'affiliation': []},
{'given': 'Meysam', 'family': 'Zarezadeh', 'sequence': 'additional', 'affiliation': []},
{'given': 'Alireza', 'family': 'Ostadrahimi', 'sequence': 'additional', 'affiliation': []}],
'member': '56',
'published-online': {'date-parts': [[2024, 4, 24]]},
'container-title': 'Public Health Nutrition',
'original-title': [],
'language': 'en',
'link': [ { 'URL': 'https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1368980024000934',
'content-type': 'unspecified',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2024, 4, 24]],
'date-time': '2024-04-24T07:25:17Z',
'timestamp': 1713943517000},
'score': 1,
'resource': { 'primary': { 'URL': 'https://www.cambridge.org/core/product/identifier/S1368980024000934/type/journal_article'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2024, 4, 24]]},
'references-count': 0,
'alternative-id': ['S1368980024000934'],
'URL': 'http://dx.doi.org/10.1017/S1368980024000934',
'relation': {},
'ISSN': ['1368-9800', '1475-2727'],
'subject': [],
'container-title-short': 'Public Health Nutr.',
'published': {'date-parts': [[2024, 4, 24]]}}