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The role of vitamin D in the prevention and treatment of SARS-CoV-2 infection: A meta-analysis of randomized controlled trials

Meng et al., Clinical Nutrition, doi:10.1016/j.clnu.2023.09.008, PROSPERO CRD42023417371
Sep 2023  
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Mortality 19% Improvement Relative Risk Mortality, multiple dose 41% Ventilation 42% Ventilation, multiple dose 49% ICU admission 37% ICU admission, multiple.. 58% Case 69% Vitamin D for COVID-19  Meng 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 112 treatments. c19early.org
Meta analysis of 25 RCTs showing lower mortality, ventilation, and ICU admission with vitamin D treatment. Results were better for multiple dose vs. single dose trials. For mortality, the results were statistically significant only for multiple dose trials and for trials with vitamin D deficient patients. Prophylaxis showed 69% lower cases, without statistical significance.
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, 19.0% lower, RR 0.81, p = 0.13.
risk of death, 41.0% lower, RR 0.59, p = 0.001, multiple dose.
risk of mechanical ventilation, 42.0% lower, RR 0.58, p = 0.005.
risk of mechanical ventilation, 49.0% lower, RR 0.51, p = 0.12, multiple dose.
risk of ICU admission, 37.0% lower, RR 0.63, p = 0.01.
risk of ICU admission, 58.0% lower, RR 0.42, p = 0.002, multiple dose.
risk of case, 69.0% lower, RR 0.31, p = 0.12.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Meng et al., 20 Sep 2023, peer-reviewed, 8 authors, trial PROSPERO CRD42023417371. Contact: gaoshuguang0341@qq.com.
This PaperVitamin DAll
The role of vitamin D in the prevention and treatment of SARS-CoV-2 infection: A meta-analysis of randomized controlled trials
Jiahao Meng, Xi Li, Weijie Liu, Yifan Xiao, Hang Tang, Yumei Wu, Yilin Xiong, Shuguang Gao
Clinical Nutrition, doi:10.1016/j.clnu.2023.09.008
s u m m a r y Background: Vitamin D (VitD) has been shown to be important for the immune response of the respiratory system, but the preventive and therapeutic effects of vitamin D supplementation on SARS-CoV-2 infection are controversial. This study aimed to determine the role of vitamin D supplementation in the prevention and treatment of SARS-CoV-2 infection through a meta-analysis of randomized controlled trials. Methods: The databases of PubMed, Cochrane Library, Embase, Web of Science and Google Scholar were searched systematically from inception to April 17,2023 to identify trials involving a randomized comparison of vitamin D supplementation versus non-vitamin D supplementation for SARS-CoV-2 infection prevention or treatment. Results: We retrieved 25 eligible trials, including 8128 participants. Four trials compared the preventive effects of vitamin D supplementation on SARS-CoV-2 infection, and the results (RR 0.31; 95%CI 0.07 to 1.32) were inconclusive. Regarding the treatment of SARS-CoV-2 infection with vitamin D supplementation, it was found that vitamin D supplementation could significantly reduce the rates of ICU admission (RR 0.63; 95%CI 0.44 to 0.89) and mechanical ventilation (RR 0.58; 95%CI 0.39 to 0.84), but had no statistically significant effect on mortality. However, in subgroup analyses based on the patients' specific conditions, vitamin D supplementation significantly reduced the mortality in patients with vitamin D deficiency (RR 0.76; 95%CI 0.58 to 0.98). Conclusion: Vitamin D supplementation may have some beneficial impact on the severity of illness caused by SARS-CoV-2, particularly in VitD deficient patients, but further studies are still needed.
Author contributions Dr Shuguang Gao had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Gao, Meng. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: Meng, Xiong. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: Xiao, Wu. Administrative, technical, or material support: Tang, Wu. Supervision: Gao. Conflicts of interest All authors declare no competing interests. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi.org/10.1016/j.clnu.2023.09.008.
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'10.1093/infdis/jiaa713', 'article-title': 'Correlation between early plasma interleukin 37 responses with low ' 'inflammatory cytokine levels and benign clinical outcomes in severe ' 'acute respiratory syndrome coronavirus 2 infection', 'volume': '223', 'author': 'Li', 'year': '2021', 'journal-title': 'J\xa0Infect Dis'}, { 'key': '10.1016/j.clnu.2023.09.008_bib45', 'doi-asserted-by': 'crossref', 'first-page': '155702', 'DOI': '10.1016/j.cyto.2021.155702', 'article-title': 'Interleukin-37 is down-regulated in serum of patients with severe ' 'coronavirus disease 2019 (COVID-19)', 'volume': '148', 'author': 'Ahmed', 'year': '2021', 'journal-title': 'Cytokine'}, { 'issue': '1', 'key': '10.1016/j.clnu.2023.09.008_bib46', 'doi-asserted-by': 'crossref', 'first-page': '167', 'DOI': '10.1007/s40618-021-01639-9', 'article-title': 'Vitamin D supplementation and COVID-19 risk: a population-based, cohort ' 'study', 'volume': '45', 'author': 'Oristrell', 'year': '2022', 'journal-title': 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