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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

Jamilian et al., Public Health Nutrition, doi:10.1017/S1368980024000934
Apr 2024  
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Mortality 58% Improvement Relative Risk Vitamin D for COVID-19  Jamilian et al.  META ANALYSIS c19early.org Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
Umbrella meta analysis of 13 meta analyses showing significantly lower mortality with vitamin D supplementation, and significantly higher mortality, infection risk, and severity with vitamin D deficiency in COVID-19 patients. Lower vitamin D levels were also associated with poor prognosis. No significant association was found between vitamin D levels and COVID-19 positivity.
19 meta analyses show significant improvements with vitamin D treatment for mortality1-14, mechanical ventilation1,6,7,12,15,16, ICU admission1,3,6,7,10,12,14-18, hospitalization5,12, severity2,4,6,11,19, and cases8,18,19.
Currently there are 122 vitamin D treatment for COVID-19 studies, showing 36% lower mortality [28‑43%], 19% lower ventilation [-3‑36%], 45% lower ICU admission [28‑58%], 19% lower hospitalization [9‑29%], and 17% fewer cases [9‑24%].
risk of death, 58.0% lower, RR 0.42, p = 0.05.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Jamilian et al., 24 Apr 2024, peer-reviewed, 9 authors. Contact: ostadrahimi@tbzmed.ac.ir, meysam.za93@gmail.com, zarezadehm@tbzmed.ac.ir.
This PaperVitamin DAll
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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