Vitamin D supplementation, COVID-19 and disease severity: a meta-analysis

Abstract

Objective: Current meta-analysis aims to understand the effect of oral supplementation of vitamin D on intensive care unit (ICU) requirement and mortality in hospitalized COVID-19 patients. Methods: Databases PubMed, preprint servers, and google scholar were searched from December 2019 to December 2020. Authors searched for the articles assessing role of vitamin D supplementation on COVID-19. Cochrane RevMan tool was used for quantitative assessment of the data, where heterogeneity was assessed using I2 and Q statistics and data was expressed using odds ratio with 95% confidence interval. Results: Final meta-analysis involved pooled data of 532 hospitalized patients (189 on vitamin D supplementation and 343 on usual care/placebo) of COVID-19 from three studies (Two randomized controlled trials, one retrospective case-control study). Statistically (p<0.0001) lower ICU requirement was observed in patients with vitamin D supplementation as compared to patients without supplementations (odds ratio: 0.36; 95% CI: 0.210-0.626). However, it suffered from significant heterogeneity, which reduced after sensitivity analysis. In case of mortality, vitamin D supplements has comparable findings with placebo treatment/usual care (odds ratio: 0.93; 95% CI: 0.413-2.113; p=0.87). The studies did not show any publication bias and had fair quality score. Subgroup analysis could not be performed due to limited number of studies and hence dose and duration dependent effect of vitamin D could not be evaluated. Conclusions: Although the current meta-analysis findings indicate potential role of vitamin D in improving COVID-19 severity in hospitalized patients, more robust data from randomized controlled trials are needed to substantiate its effects on mortality.

“Vitamin D supplementation and COVID-19 treatment: A systematic review and meta-analysis”

“…Observational study including 10 articles and nearly 3 lakh patients done by Liu et al (Dec 2020) showed that low vitamin D levels were associated with more frequently with COVID positivity [ 10 ]. In a similar meta-analysis [ 28 ] which included two RCTS [ 13 , 16 ] similar to our study along with a retrospective case control study [ 29 ], it was concluded that vitamin D supplementation had reduction of ICU admission rates but insignificant effect on mortality [ 28 ]. The different result from this study as compared to ours could be attributable to the inclusion of retrospective study [ 29 ].…”

Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis

“…A somewhat similar meta-analysis published earlier in 2021 found no significant benefit of vitamin D supplementation on mortality in COVID-19; however, the meta-analysis had included only three studies. Besides, the authors had presented only unadjusted risk estimates, thereby failing to consider potential confounding factors [48]. On the other hand, we have pooled data from 13 studies and have provided adjusted apart from unadjusted risk estimates, to make the results more robust and generalizable.…”

Association of Vitamin D, Zinc and Selenium Related Genetic Variants With COVID-19 Disease Severity

“…Also, patients with severe COVID-19 disease have lower status of vitamin D, zinc and selenium than mild and moderate disease patients (14)(15)(16). Preliminary evidence from intervention studies suggests that supplementation with these micronutrients protects from severe COVID-19 disease (17,18).…”