Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs
Abstract Background The associations between vitamin D and coronavirus disease 2019 (COVID-19) infection and clinical outcomes are controversial. The efficacy of vitamin D supplementation in COVID-19 is also not clear. Methods We identified relevant cohort studies that assessed the relationship betw...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Nutrition Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12937-021-00744-y |
| _version_ | 1818981341787586560 |
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| author | Jie Chen Kaibo Mei Lixia Xie Ping Yuan Jianyong Ma Peng Yu Wengen Zhu Chunhua Zheng Xiao Liu |
| author_facet | Jie Chen Kaibo Mei Lixia Xie Ping Yuan Jianyong Ma Peng Yu Wengen Zhu Chunhua Zheng Xiao Liu |
| author_sort | Jie Chen |
| collection | DOAJ |
| description | Abstract Background The associations between vitamin D and coronavirus disease 2019 (COVID-19) infection and clinical outcomes are controversial. The efficacy of vitamin D supplementation in COVID-19 is also not clear. Methods We identified relevant cohort studies that assessed the relationship between vitamin D, COVID-19 infection and associated death and randomized controlled trials (RCTs) that reported vitamin D supplementation on the outcomes in patients with COVID-19 by searching the PubMed, EMBASE, and medRxiv databases up to June 5th, 2021. Evidence quality levels and recommendations were assessed using the GRADE system. Results Eleven cohort studies with 536,105 patients and two RCTs were identified. Vitamin D deficiency (< 20 ng/ml) or insufficiency (< 30 ng/ml) was not associated with an significant increased risk of COVID-19 infection (OR for < 20 ng/ml: 1.61, 95% CI: 0.92–2.80, I2 = 92%) or in-hospital death (OR for < 20 ng/ml: 2.18, 95% CI: 0.91–5.26, I2 = 72%; OR for < 30 ng/ml: 3.07, 95% CI: 0.64–14.78, I2 = 66%). Each 10 ng/ml increase in serum vitamin D was not associated with a significant decreased risk of COVID-19 infection (OR: 0.92, 95% CI: 0.79–1.08, I2 = 98%) or death (OR: 0.65, 95% CI: 0.40–1.06, I2 = 79%). The overall quality of evidence (GRADE) for COVID-19 infection and associated death was very low. Vitamin D supplements did not significantly decrease death (OR: 0.57, I2 = 64%) or ICU admission (OR: 0.14, I2 = 90%) in patients with COVID-19. The level of evidence as qualified using GRADE was low. Conclusions Current evidence suggested that vitamin D deficiency or insufficiency was not significantly linked to susceptibility to COVID-19 infection or its associated death. Vitamin D supplements did not significantly improve clinical outcomes in patients with COVID-19. The overall GRADE evidence quality was low, we suggest that vitamin D supplementation was not recommended for patients with COVID-19. |
| first_indexed | 2024-12-20T17:29:47Z |
| format | Article |
| id | doaj.art-7bcae721fb4a447fbabb7c467b7d4946 |
| institution | Directory Open Access Journal |
| issn | 1475-2891 |
| language | English |
| last_indexed | 2024-12-20T17:29:47Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Nutrition Journal |
| spelling | doaj.art-7bcae721fb4a447fbabb7c467b7d49462022-12-21T19:31:25ZengBMCNutrition Journal1475-28912021-10-0120111010.1186/s12937-021-00744-yLow vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTsJie Chen0Kaibo Mei1Lixia Xie2Ping Yuan3Jianyong Ma4Peng Yu5Wengen Zhu6Chunhua Zheng7Xiao Liu8Department of Cardiology, the First Hospital of NanchangDepartment of Anaesthesia, the People’s Hospital of ShangraoDepartment of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiology, the Second Affiliated Hospital of Nanchang UniversityDepartment of Pharmacology and Systems Physiology, University of Cincinnati College of MedicineEndocrine Department, the Second Affiliated Hospital of Nanchang UniversityDepartment of Cardiology, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cardiology, the First Hospital of NanchangDepartment of Cardiology, The Sun Yat-Sen Memorial Hospital of Sun Yat-Sen UniversityAbstract Background The associations between vitamin D and coronavirus disease 2019 (COVID-19) infection and clinical outcomes are controversial. The efficacy of vitamin D supplementation in COVID-19 is also not clear. Methods We identified relevant cohort studies that assessed the relationship between vitamin D, COVID-19 infection and associated death and randomized controlled trials (RCTs) that reported vitamin D supplementation on the outcomes in patients with COVID-19 by searching the PubMed, EMBASE, and medRxiv databases up to June 5th, 2021. Evidence quality levels and recommendations were assessed using the GRADE system. Results Eleven cohort studies with 536,105 patients and two RCTs were identified. Vitamin D deficiency (< 20 ng/ml) or insufficiency (< 30 ng/ml) was not associated with an significant increased risk of COVID-19 infection (OR for < 20 ng/ml: 1.61, 95% CI: 0.92–2.80, I2 = 92%) or in-hospital death (OR for < 20 ng/ml: 2.18, 95% CI: 0.91–5.26, I2 = 72%; OR for < 30 ng/ml: 3.07, 95% CI: 0.64–14.78, I2 = 66%). Each 10 ng/ml increase in serum vitamin D was not associated with a significant decreased risk of COVID-19 infection (OR: 0.92, 95% CI: 0.79–1.08, I2 = 98%) or death (OR: 0.65, 95% CI: 0.40–1.06, I2 = 79%). The overall quality of evidence (GRADE) for COVID-19 infection and associated death was very low. Vitamin D supplements did not significantly decrease death (OR: 0.57, I2 = 64%) or ICU admission (OR: 0.14, I2 = 90%) in patients with COVID-19. The level of evidence as qualified using GRADE was low. Conclusions Current evidence suggested that vitamin D deficiency or insufficiency was not significantly linked to susceptibility to COVID-19 infection or its associated death. Vitamin D supplements did not significantly improve clinical outcomes in patients with COVID-19. The overall GRADE evidence quality was low, we suggest that vitamin D supplementation was not recommended for patients with COVID-19.https://doi.org/10.1186/s12937-021-00744-yVitamin DCOVID-19Meta-analysisNutrition |
| spellingShingle | Jie Chen Kaibo Mei Lixia Xie Ping Yuan Jianyong Ma Peng Yu Wengen Zhu Chunhua Zheng Xiao Liu Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs Nutrition Journal Vitamin D COVID-19 Meta-analysis Nutrition |
| title | Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs |
| title_full | Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs |
| title_fullStr | Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs |
| title_full_unstemmed | Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs |
| title_short | Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs |
| title_sort | low vitamin d levels do not aggravate covid 19 risk or death and vitamin d supplementation does not improve outcomes in hospitalized patients with covid 19 a meta analysis and grade assessment of cohort studies and rcts |
| topic | Vitamin D COVID-19 Meta-analysis Nutrition |
| url | https://doi.org/10.1186/s12937-021-00744-y |
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