Therapeutic and prognostic role of vitamin D for COVID-19 infection: A systematic review and meta-analysis of 43 observational studies

Petrelli et al., The Journal of Steroid Biochemistry and Molecular Biology, doi:10.1016/j.jsbmb.2021.105883, Mar 2021
Mortality 59% improvement lower risk ← → higher risk Severe case 73% Vitamin D  Petrelli et al.  META ANALYSIS c19early.org Petrelli et al., The J. Steroid Bioche.., Mar 2021 0 0.5 1 1.5 2+ RR
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 126 studies, recognized in 18 countries.
Lower risk for mortality, ICU, hospitalization, progression, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,200+ studies for 200+ treatments. c19early.org
Download Meta Analysis
Meta analysis showing vitamin D deficiency associated with higher risk of COVID-19, worse severity, and higher mortality.
Supplementation with vitamin D reduced the risk of severe cases and mortality.
19 meta analyses show significant improvements with vitamin D treatment for mortality1-13, mechanical ventilation1,5,6,11,14-16, ICU admission1,3,5,6,9,11,13-18, hospitalization11, severity2,4,5,10,19, and cases7,18,19.
Currently there are 126 vitamin D treatment for COVID-19 studies, showing 38% lower mortality [31‑45%], 19% lower ventilation [-3‑36%], 45% lower ICU admission [28‑58%], 19% lower hospitalization [9‑29%], and 17% fewer cases [9‑24%].
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risk of death, 59.0% lower, OR 0.41, p = 0.010, RR approximated with OR.
risk of severe case, 73.0% lower, OR 0.27, p = 0.004, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Petrelli et al., 26 Mar 2021, peer-reviewed, 6 authors.
Therapeutic and prognostic role of vitamin D for COVID-19 infection: A systematic review and meta-analysis of 43 observational studies
Fausto Petrelli, Andrea Luciani, Gianluca Perego, Giuseppina Dognini, Paolo Luigi Colombelli, Antonio Ghidini
The Journal of Steroid Biochemistry and Molecular Biology, doi:10.1016/j.jsbmb.2021.105883
Vitamin D modulates the systemic inflammatory response through interaction with immune system. As such, it has a possible protective role against the risk of respiratory tract infections and other diseases. It may be useful in particular, during COVID-19 pandemic. PubMed, the Cochrane Library, and EMBASE were searched from inception until January 31, 2021, for observational or clinical studies reporting the prognosis (and therapeutic effect) of COVID-19 infection in patients with deficient vitamin D levels. The infection rate, severity, and death from COVID-19 infection were pooled to provide an odds ratio with a 95 % confidence interval (OR 95 % CI). An OR > 1 was associated with the worst outcome in deficient compared with nondeficient patients. We assessed the association between vitamin D and risk, severity, and mortality for COVID-19 infection, through a review of 43 observational studies. Among subjects with deficient vitamin D values, risk of COVID-19 infection was higher compared to those with replete values (OR = 1.26; 95 % CI, 1.19-1.34; P < .01). Vitamin D deficiency was also associated with worse severity and higher mortality than in nondeficient patients (OR = 2.6; 95 % CI, 1.84-3.67; P < .01 and OR = 1.22; 95 % CI, 1.04-1.43; P < .01, respectively). Reduced vitamin D values resulted in a higher infection risk, mortality and severity COVID-19 infection. Supplementation may be considered as preventive and therapeutic measure.
Authors statement Fausto Petrelli: Conceptualization, Methodology, Software Writing-Original draft preparation. Antonio Ghidini, Gianluca Perego: Data curation. Andrea Luciani: Supervision, Visualization, Investigation. Paolo Colombelli: Supervision. Giuseppina Dognini: Writing-Reviewing and Editing. Funding The authors declare no funding.
References
Ahmed, A network-based analysis reveals the mechanism underlying vitamin D in suppressing cytokine storm and virus in SARS-CoV-2 infection, Front. Immunol, doi:10.3389/fimmu.2020.590459
Arboleda, Urcuqui-Inchima, Vitamin D supplementation: a potential approach for COVID-19 therapeutics?, Front. Immunol
Heath, Kim, Hodge, English, Muller, Vitamin D status and mortality: a systematic review of observational studies, Int. J. Environ. Res. Public Health, doi:10.3390/ijerph16030383
Kempker, Martin, Vitamin D and sepsis: from associations to causal connections, Inflamm. Allergy Drug Targets
Zdrenghea, Makrinioti, Bagacean, Vitamin D modulation of innate immune responses to respiratory viral infections, Rev. Med. Virol
Zhang, Fang, Tang, Jia, Feng et al., Association between vitamin D supplementation and mortality: systematic review and meta-analysis, BMJ, doi:10.1136/bmj.l4673
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