Low vitamin D status is associated with coronavirus disease 2019 outcomes: a systematic review and meta-analysis

Liu, Nanyang; Sun, Jiahui; Wang, Xiyuan; Zhang, Tingting; Zhao, Ming; Li, Hao

doi:10.1016/j.ijid.2020.12.077

Cited by 145 publications

(121 citation statements)

References 42 publications

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“…Evidence also indicated that vitamin D might help in the treatment of COVID-19 by preventing the cytokine storm and subsequent ARDS which is commonly the cause of mortality (29,34). The pooled estimate showed that subjects with VDD were 80 % more likely to acquire COVID-19 infection (OR = 1.80; 95% CI: 1.72, 1.88), which is in line with the previous meta-analysis where vitamin D deficiency or insufficiency participants were at increased risk of COVID-19 infection (OR = 1.43, 95% CI: 1.00-2.05) (35). Besides, Ilie et al reported that vitamin D levels are severely low in COVID-19 positive individuals and found a negative correlation between levels of mean vitamin D and COVID-19 infection (11).…”

Section: Discussionsupporting

confidence: 88%

The Impact of Vitamin D Level on COVID-19 Infection: Systematic Review and Meta-Analysis

Teshome

Adane

Girma

et al. 2021

Front. Public Health

112

101

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Background: Coronavirus disease (COVID-19) is a respiratory and systemic disorder caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or novel Coronavirus (nCoV). To date, there is no proven curative treatment for this virus; as a result, prevention remains to be the best strategy to combat coronavirus infection (COVID-19). Vitamin D deficiency (VDD) has been proposed to play a role in coronavirus infection (COVID-19). However, there is no conclusive evidence on its impact on COVID-19 infection. Therefore, the present review aimed to summarize the available evidence regarding the association between Vitamin D levels and the risk of COVID-19 infection.Methods: A systematic literature search of databases (PUBMED/MEDLINE, Cochrane/Wiley library, Scopus, and SciELO) were conducted from May 15, 2020, to December 20, 2020. Studies that assessed the effect of vitamin D level on COVID-19/SARS-2 infection were considered for the review. The qualities of the included studies were evaluated using the JBI tools. Meta-analysis with a random-effects model was conducted and odds ratio with their 95%CI were reported. This systematic review and meta-analysis are reported according to the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline.Results: The electronic and supplementary searches for this review yielded 318 records from which, only 14 of them met the inclusion criteria. The qualitative synthesis indicated that vitamin D deficient individuals were at higher risk of COVID-19 infection as compared to vitamin D sufficient patients. The pooled analysis showed that individuals with Vitamin-D deficiency were 80% more likely to acquire COVID-19 infection as compared to those who have sufficient Vitamin D levels (OR = 1.80; 95%CI: 1.72, 1.88). Begg's test also revealed that there was no significant publication bias between the studies (P = 0.764). The subgroup analysis revealed that the risk of acquiring COVID-19 infection was relatively higher in the case-control study design (OR = 1.81).Conclusions: In conclusion, low serum 25 (OH) Vitamin-D level was significantly associated with a higher risk of COVID-19 infection. The limited currently available data suggest that sufficient Vitamin D level in serum is associated with a significantly decreased risk of COVID-19 infection.

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Section: Discussionsupporting

confidence: 88%

The Impact of Vitamin D Level on COVID-19 Infection: Systematic Review and Meta-Analysis

Teshome

Adane

Girma

et al. 2021

Front. Public Health

112

101

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“…In the case of alcohol content per 1000 kcal, a remarkable 20% increase started in April and remained until July. Among the nutrients whose density decreased, vitamin D should be highlighted, as due to the reduced sun exposure the population faces during lockdown, the risk of vitamin D deficiency could be increased, and low levels of this vitamin have been related to several adverse health consequences, including more severe COVID-19 [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Composition and Nutritional Quality of the Diet in Spanish Households during the First Wave of the COVID-19 Pandemic

et al. 2021

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In Spain, the health crisis caused by the COVID-19 pandemic led to the declaration of a state of alarm in the whole country in 2020; in this context, a nationwide lockdown was implemented, potentially altering the dietary habits of the population. The aims of this study were to describe the diet and its nutritional quality in Spanish households during the first COVID-19 epidemic wave and to compare them with the same period in 2019. Data on monthly foods and beverages household purchases in 2019 and 2020 were obtained from the nationwide Food Consumption Surveys. In April, there was an average increase, compared with 2019, of more than 40% for all food groups, with significant peaks in: alcoholic beverages (75%), appetizers (60%), eggs (59%), sugar and sweets (52%), and vegetables (50%). In March, the greatest peak was for pulses, with a 63% increment. The mean energy value of purchased foods in April was 2801 kcal/person/day, corresponding to an increase of 771 kcal/person/day (+38%), compared to the same month of 2019 (March and May: +520 kcal (+26%), June: +343 kcal (+18%)). Regarding nutrient density, there was a reduction in calcium, iodine, zinc, selenium, riboflavin, vitamins B12, D, A, especially retinol, and an increase in fibre, sodium, folic acid, carotenes and vitamin E. Alcohol content per 1000 kcal increased by more than 20% from April to July. Food purchase patterns in Spanish households changed during lockdown and after it, with no appreciable improvement in the quality of the diet.

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“…One study performed in vitro showed that the active form of Vitamin D, calcitriol, exhibits significant potent activity against SARS-CoV-2 in African green monkey kidney cells, human hepatoma cells, and human nasal epithelial cells ( Mok et al, 2020 ). In fact, the interest in the field has been growing and some systematic reviews and meta-analysis were performed to measure the risk of infection and severity of COVID-19 due to low levels of 25(OH)D in observational studies ( Pereira et al, 2020 ; Kazemi et al, 2021 ; Liu et al, 2021 ; Petrelli et al, 2021 ; Teshome et al, 2021 ). Pereira et al (2020) reported that severe cases of COVID-19 present 64% (OR = 1.64; 95% CI = 1.30–2.09) of vitamin D deficiency and that insufficiency increased hospitalization (OR = 1.81;95% CI = 1.41–2.21) and mortality (OR = 1.82; 95% CI = 1.06–2.58).…”

Section: Vitamin D and Covid-19mentioning

confidence: 99%

“… Kazemi et al (2021) found that vitamin D deficiency was a higher risk of SARS-CoV-2 infection (OR = 1.77; 95% CI = 1.24–2.53) and presented a higher severity (OR = 2.57; 95% CI = 1.65–4.01). Liu et al (2021) showed that vitamin D deficiency or insufficiency also was associated with an increased risk of COVID-19 (OR = 1.43; 95% CI = 1.00–2.05). Petrelli et al (2021) revealed that deficient vitamin D values showed a higher risk of COVID-19 infection (OR = 1.26; 95% CI = 1.19–1.34) and worse severity (OR = 2.6; 95% CI = 1.84–3.67) and higher mortality (OR = 1.22; 95% CI, 1.04–1.43).…”

Section: Vitamin D and Covid-19mentioning

confidence: 99%

Vitamin D, Depressive Symptoms, and Covid-19 Pandemic

et al. 2021

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Graphical AbstractRole of vitamin D in the development of depressive symptoms. The synthesis of vitamin D from sunlight is impaired by lockdown and social distance measures imposed by the governments around the world during COVID-10 pandemic. Endogenous vitamin D synthesis initiates in the skin when 7-dehydrocholesterol (7-DHC) is converted in pre-vitamin D3 and then vitamin D3 [25(OH)D3]. It is transported through blood circulation by the vitamin D binding protein (VDBP) to the liver, the kidney, and the brain, where can be converted in its the active form [1,25(OH)2D3]. In the brain, the biological effects of 1,25(OH)2D3 are largely mediated by vitamin D receptor (VDR) through genomic mechanisms, which influence several aspects of serotonin metabolism, such as increasing serotonin synthesis by induction of the tryptophan hydroxylase 2 (TPH2) gene expression; influencing the expression of serotonin reuptake transporter (SERT) and the levels of monoamine oxidase-A (MAO-A), responsible to serotonin catabolism; and indirectly may regulate the synthesis of melatonin that improve the circadian rhythm. This mechanism can be impaired during social isolation and consequent reduction of vitamin D due to low sun exposure during the pandemic, which could contribute to the development of depressive symptoms.

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Low vitamin D status is associated with coronavirus disease 2019 outcomes: a systematic review and meta-analysis

Cited by 145 publications

References 42 publications

The Impact of Vitamin D Level on COVID-19 Infection: Systematic Review and Meta-Analysis

The Impact of Vitamin D Level on COVID-19 Infection: Systematic Review and Meta-Analysis

Composition and Nutritional Quality of the Diet in Spanish Households during the First Wave of the COVID-19 Pandemic

Vitamin D, Depressive Symptoms, and Covid-19 Pandemic

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