Effect of vitamin D supplementation on COVID-19 patients: A systematic review and meta-analysis

Abstract

ObjectiveTo systematically evaluate the impact of vitamin D supplementation on mortality, ICU admission, and the rates of mechanical ventilation or intubation among COVID-19 patients.Data sources and study selectionThe PubMed, Embase, Cochrane Library, CBM, CNKI, VIP, and WanFang databases were searched from 1 December 2019 to 31 December 2022. The authors sought to identify randomized controlled trials and cohort studies that examined the relationship between vitamin D supplementation and mortality, ICU admission, and mechanical ventilation or intubation rates among COVID-19 patients.Data extraction and synthesisTwo investigators independently searched the literature, extracted the data, and assessed the quality of the included studies. The Grading of Recommendation, Assessment, Development, and Evaluation approach was used to evaluate the quality of the evidence. Meta-analysis was conducted using RevMan 5.3, STATA 15.1, and R 4.1.3 software.ResultsEight randomized controlled trials (RCTs) and eight cohort studies were included, involving 3359 COVID-19 patients. The pooled analysis of randomized controlled trials showed that vitamin D supplementation did not have a significant effect on reducing mortality (Relative Risk, RR = 0.94, 95% CI 0.69–1.29, P = 0.7), while the results of cohort studies indicated that vitamin D supplementation had a positive impact on reducing mortality among COVID-19 patients (RR = 0.33, 95% CI 0.23–0.47, P < 0.001). There was no statistically significant difference in the rates of ICU admission (RCTs: RR = 0.64, 95%CI 0.38–1.08, P = 0.10; cohort studies: RR = 0.32, 95% CI 0.08–1.29, P = 0.109) or rates of mechanical ventilation or intubation (RCTs: RR = 0.77, 95% CI 0.58–1.02, P = 0.07; cohort studies: RR = 0.93, 95% CI 0.55–1.58, P = 0.789).ConclusionThe results of this systematic review and meta-analysis suggest that vitamin D supplementation does not have a significant impact on reducing mortality, ICU admission, and the rates of mechanical ventilation or intubation among COVID-19 patients. However, due to the limited number and quality of the studies included, further high-quality studies are needed to confirm these findings.Systematic review registrationwww.crd.york.ac.uk, identifier CRD42021299521.

High‐dose vitamin D supplementation in patients with COVID‐19: A meta‐analysis of randomized controlled trials

“…found that vitamin D could significantly reduce the mortality and ICU admission rates of COVID‐19 patients, but the “regimens without bolus doses appeared to have stronger preventive effects against both COVID‐19 mortality and ICU admission rate compared to bolus doses” (Hosseini et al., 2022 ); Zhang et al. ( 2023 ) concluded that vitamin D did not have a significant impact on reducing mortality and ICU admission among COVID‐19 patients, which denied the benefits of physiological vitamin D as well. All these investigations were not focused on the effects of high‐dose vitamin D supplementation.…”

Pharmacological evaluation of vitamin D in COVID-19 and long COVID-19: recent studies confirm clinical validation and highlight metformin to improve VDR sensitivity and efficacy

“…Four randomized controlled trials(44% of studies) evaluated the effect of a single oral bolus dose of cholecalciferol (100,000–500,000 IU) on length of hospital stay and respiratory deterioration, and found no effect in 649 patients with insufficient vitamin D level (Cannata-Andía et al 2022 ; Mariani et al 2022 ; Jaun et al 2023 ; Abroug et al 2023 ). Eight cohort studies and eight randomized controlled studies involving 3359 patients with COVID-19 were included in the only meta- analysis study (Zhang et al 2023 ). This study showed that the results of the pooled analysis of cohort studies indicated that VD supplementation had a significant effect on reducing mortality in COVID-19 patients, while the results of the pooled analysis of RCTs showed that VD supplementation did not significantly change the mortality rate (Table 3 ).…”

“…However, the overall number of randomized controlled trials that failed to find a beneficial role for vitamin D was small with a small sample size of the enrolled population and heterogeneous with respect to study design, dosing and intervention strategies. In addition to the conflicting results in the meta-analysis as described with Zhang et al ( 2023 ). Therefore, these studies are considered to have low-grade evidence against the beneficial role of vitamin D in COVID-19.…”

“…However, the importance of VD supplementation in COVID-19 remains controversial. While some articles have observed a significant positive effect of VD on COVID-19 severity (ASLA et al 2023 ; Petrelli et al 2023 ), other studies have failed to find any benefit (Zhang et al 2023 ). This controversy can be explained by differences in study design, samples studied, race, age, and genetic variations.…”

Efficacy and Safety of High-Dose Vitamin D Supplementation vs Solifenacin or Standard Urotherapy for Overactive Bladder Dry in Children: A Randomized Clinical Trial

“…9 Strong evidence supports a link between vitamin D insufficiency and elevated rates of lower urinary tract symptoms. 10,11 Further, recent studies have demonstrated that vitamin D supplementation (VDS) could ameliorate urinary tract symptoms in specific adult populations. 12 A systematic review and meta-analysis confirmed the safety of high-dose VDS among children aged 0 to 6 years.…”