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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  
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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.
9 meta analyses show significant improvements with vitamin D treatment for mortality Argano, D’Ecclesiis, Hariyanto, Hosseini, Nikniaz, Shah, Xie, mechanical ventilation Hariyanto, Shah, Xie, ICU admission Hariyanto, Hosseini, Shah, Tentolouris, Xie, hospitalization Argano, severity D’Ecclesiis, Nikniaz, Varikasuvu, Xie, and cases Varikasuvu.
Currently there are 116 vitamin D treatment for COVID-19 studies, showing 36% lower mortality [27‑43%], 16% lower ventilation [-8‑35%], 47% lower ICU admission [29‑61%], 20% lower hospitalization [8‑29%], and 16% fewer cases [7‑23%].
Petrelli et al., 26 Mar 2021, peer-reviewed, 6 authors.
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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.
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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