Therapeutic effects of vitamin D supplementation on COVID-19 aggravation: a systematic review and meta-analysis of randomized controlled trials
Yiyuan Yang, Wanli Sun, Fan Yang, Guoxia Zhang, Xinye Li, Shipeng Sun, Yanwei Xing
Frontiers in Pharmacology, doi:10.3389/fphar.2024.1367686
Background: The therapeutic effects of vitamin D supplementation on Coronavirus disease 2019 (COVID-19) aggravation remain controversial and inconclusive. To probe into this contentious issue, we performed the present meta-analysis of randomized controlled trials (RCTs). Methods: Literature published up to June 2023 was retrieved from Cochrane Library, PubMed, Web of Science and Embase. RCTs assessing mortality, intensive care unit (ICU) admission, mechanical ventilation (MV), length of hospitalization (LOH), and inflammatory markers containing C-reactive protein (CRP), D-dimer, interleukin-6 (IL-6), lactate dehydrogenase (LDH) were included. 19 RCTs were involved in the analysis and were conducted subgroup analyses on the baseline COVID-19 severity and vitamin D administration. Results: In the severity subgroup, statistically significant effects in moderate to severe group were observed in ICU admission (OR 0.43, 95% CI 0.23, 0.80; p = 0.008), MV (OR 0.44, 95% CI 0.27, 0.72; p = 0.001) and LOH (SMD -0.49, 95% CI -0.92, -0.06; p = 0.027). In the administration subgroup, effects of ICU admission (OR 0.39, 95% CI 0.16, 0.97; p = 0.044), MV (OR 0.18, 95% CI 0.07, 0.46; p = 0.000) and LOH (SMD -0.50, 95% CI -0.96, -0.04; p = 0.034) were more pronounced in patients supplied with multiple-dose vitamin D than single-dose. Although the result of mortality showed no statistically significant effect, it indicated a reduced trend (OR 0.87, 95% CI 0.63, 1.12; p > 0.05). The results of inflammatory markers reached no statistical differences.
Conclusion: This meta-analysis revealed that moderate to severe COVID-19 patients supplied with multiple doses of vitamin D were less apt to need ICU admission, mechanical ventilation and have shorter hospital stays.
Author contributions YY: Data curation, Formal Analysis, Investigation, Methodology, Software, Supervision, Validation, Writing-original draft. WS: Data curation, Investigation, Methodology, Supervision, Writing-review and editing. FY: Investigation, Software, Supervision, Validation, Writing-review and editing. GZ: Conceptualization, Investigation, Methodology, Supervision, Writing-review and editing. XL: Conceptualization, Supervision, Validation, Writing-review and editing. SS: Supervision, Validation, Writing-review and editing. YX: Funding acquisition, Investigation, Supervision, Validation, Writing-review and editing.
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Supplementary material The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fphar.2024.1367686/ full#supplementary-material
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'abstract': '<jats:sec><jats:title>Background</jats:title><jats:p>The therapeutic effects of vitamin D '
'supplementation on Coronavirus disease 2019 (COVID-19) aggravation remain controversial and '
'inconclusive. To probe into this contentious issue, we performed the present meta-analysis of '
'randomized controlled trials '
'(RCTs).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Literature '
'published up to June 2023 was retrieved from Cochrane Library, PubMed, Web of Science and '
'Embase. RCTs assessing mortality, intensive care unit (ICU) admission, mechanical ventilation '
'(MV), length of hospitalization (LOH), and inflammatory markers containing C-reactive protein '
'(CRP), D-dimer, interleukin-6 (IL-6), lactate dehydrogenase (LDH) were included. 19 RCTs were '
'involved in the analysis and were conducted subgroup analyses on the baseline COVID-19 '
'severity and vitamin D '
'administration.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the '
'severity subgroup, statistically significant effects in moderate to severe group were '
'observed in ICU admission (OR 0.43, 95% CI 0.23, 0.80; <jats:italic>p</jats:italic> = 0.008), '
'MV (OR 0.44, 95% CI 0.27, 0.72; <jats:italic>p</jats:italic> = 0.001) and LOH (SMD –0.49, 95% '
'CI –0.92, −0.06; <jats:italic>p</jats:italic> = 0.027). In the administration subgroup, '
'effects of ICU admission (OR 0.39, 95% CI 0.16, 0.97; <jats:italic>p</jats:italic> = 0.044), '
'MV (OR 0.18, 95% CI 0.07, 0.46; <jats:italic>p</jats:italic> = 0.000) and LOH (SMD –0.50, 95% '
'CI –0.96, −0.04; <jats:italic>p</jats:italic> = 0.034) were more pronounced in patients '
'supplied with multiple-dose vitamin D than single-dose. Although the result of mortality '
'showed no statistically significant effect, it indicated a reduced trend (OR 0.87, 95% CI '
'0.63, 1.12; <jats:italic>p</jats:italic> &gt; 0.05). The results of inflammatory markers '
'reached no statistical '
'differences.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This '
'meta-analysis revealed that moderate to severe COVID-19 patients supplied with multiple doses '
'of vitamin D were less apt to need ICU admission, mechanical ventilation and have shorter '
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