The role of vitamin D in outcomes of critical care in COVID-19 patients: Evidence from an umbrella meta-analysis of interventional and observational studies

Jamilian et al., Public Health Nutrition, doi:10.1017/S1368980024000934, Apr 2024
Mortality 58% improvement lower risk ← → higher risk Vitamin D  Jamilian et al.  META ANALYSIS c19early.org Jamilian et al., Public Health Nutrition, Apr 2024 0 0.5 1 1.5 2+ RR
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 138 studies, recognized in 18 countries.
Lower risk for mortality, ICU, hospitalization, progression, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,600+ studies for 220+ treatments. c19early.org
Meta-analysis
Umbrella meta analysis of 13 meta analyses showing significantly lower mortality with vitamin D supplementation, and significantly higher mortality, infection risk, and severity with vitamin D deficiency in COVID-19 patients. Lower vitamin D levels were also associated with poor prognosis. No significant association was found between vitamin D levels and COVID-19 positivity.
22 meta-analyses show significant improvements with vitamin D treatment for mortality1-15, mechanical ventilation1,5,6,11,16-18, ICU admission1,3,5,6,9,11,13,15-21, hospitalization11, severity2,4,5,10,22, and cases7,20,22.
Currently there are 138 vitamin D treatment for COVID-19 studies, showing 39% lower mortality [32‑45%], 17% lower ventilation [-5‑35%], 45% lower ICU admission [28‑57%], 22% lower hospitalization [13‑30%], and 18% fewer cases [10‑25%].
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risk of death, 58.0% lower, RR 0.42, p = 0.05.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Jamilian et al., 24 Apr 2024, peer-reviewed, 9 authors. Contact: ostadrahimi@tbzmed.ac.ir, meysam.za93@gmail.com, zarezadehm@tbzmed.ac.ir.
The role of vitamin D in outcomes of critical care in COVID-19 patients: Evidence from an umbrella meta-analysis of interventional and observational studies
Abdolreza Jamilian, Faezeh Ghalichi, Fatemeh Hamedi Kalajahi, Nima Radkhah, Neda Jourabchi, Vali Musazadeh, Ehsan Amini-Salehi, Ph. Meysam Zarezadeh, Alireza Ostadrahimi
Public Health Nutrition, doi:10.1017/s1368980024000934
Objectives: Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with SARS-CoV-2. This umbrella meta-analysis aims to evaluate influence of vitamin D supplementation on clinical outcomes and the mortality rate of COVID-19 patients. Design: Present study was designed as an umbrella meta-analysis. The following international databases were systematically searched till March 2023: Web of Science, PubMed, Scopus, and Embase. Settings: Random-effects model was employed to perform meta-analysis. Using AMSTAR critical evaluation tools, the methodological quality of the included meta-analyses was evaluated. Participants: Adult patients suffering from COVID-19 were studied. Results: Overall, 13 meta-analyses summarizing data from 4 RCTs and 9 observational studies were identified in this umbrella review. Our findings revealed that vitamin D supplementation and status significantly reduced mortality of COVID-19 [Interventional studies: (ES= 0.42; 95% CI: 0.10, 0.75, p <0.001; I 2 = 20.4%, p=0.285) and observational studies (ES= 1.99; 95% CI: 1.37, 2.62, p <0.001; I 2 = 00.0%, p=0.944). Also, vitamin D deficiency increased risk of infection and disease severity among patients. Conclusion: Overall, vitamin D status is a critical factor influencing the mortality rate, disease severity, admission to ICU and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients.
The result of assess the methodological quality using AMSTAR: each item for included studies (? : can't answer; -: means no; + : means yes). https://doi.org/10.1017/S1368980024000934 Published online by Cambridge University Press
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DOI record: { "DOI": "10.1017/s1368980024000934", "ISSN": [ "1368-9800", "1475-2727" ], "URL": "http://dx.doi.org/10.1017/S1368980024000934", "abstract": "<jats:title>Abstract</jats:title>\n\t <jats:sec id=\"S1368980024000934_as1\">\n\t <jats:title>Objectives:</jats:title>\n\t <jats:p>Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with SARS-CoV-2. This umbrella meta-analysis aims to evaluate influence of vitamin D supplementation on clinical outcomes and the mortality rate of COVID-19 patients.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as2\">\n\t <jats:title>Design:</jats:title>\n\t <jats:p>Present study was designed as an umbrella meta-analysis. The following international databases were systematically searched till March 2023: Web of Science, PubMed, Scopus, and Embase.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as3\">\n\t <jats:title>Settings:</jats:title>\n\t <jats:p>Random-effects model was employed to perform meta-analysis. Using AMSTAR critical evaluation tools, the methodological quality of the included meta-analyses was evaluated.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as4\">\n\t <jats:title>Participants:</jats:title>\n\t <jats:p>Adult patients suffering from COVID-19 were studied.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as5\">\n\t <jats:title>Results:</jats:title>\n\t <jats:p>Overall, 13 meta-analyses summarizing data from 4 RCTs and 9 observational studies were identified in this umbrella review. Our findings revealed that vitamin D supplementation and status significantly reduced mortality of COVID-19 [Interventional studies: (ES= 0.42; 95% CI: 0.10, 0.75, p &lt;0.001; I<jats:sup>2</jats:sup> = 20.4%, p=0.285) and observational studies (ES= 1.99; 95% CI: 1.37, 2.62, p &lt;0.001; I<jats:sup>2</jats:sup> = 00.0%, p=0.944). Also, vitamin D deficiency increased risk of infection and disease severity among patients.</jats:p>\n\t </jats:sec>\n\t <jats:sec id=\"S1368980024000934_as6\">\n\t <jats:title>Conclusion:</jats:title>\n\t <jats:p>Overall, vitamin D status is a critical factor influencing the mortality rate, disease severity, admission to ICU and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients.</jats:p>\n\t </jats:sec>", "alternative-id": [ "S1368980024000934" ], "author": [ { "affiliation": [], "family": "Jamilian", "given": "Abdolreza", "sequence": "first" }, { "affiliation": [], "family": "Ghalichi", "given": "Faezeh", "sequence": "additional" }, { "affiliation": [], "family": "Hamedi Kalajahi", "given": "Fatemeh", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-9353-8066", "affiliation": [], "authenticated-orcid": false, "family": "Radkhah", "given": "Nima", "sequence": "additional" }, { "affiliation": [], "family": "Jourabchi", "given": "Neda", "sequence": "additional" }, { "affiliation": [], "family": "Musazadeh", "given": "Vali", "sequence": "additional" }, { "affiliation": [], "family": "Amini-Salehi", "given": "Ehsan", "sequence": "additional" }, { "affiliation": [], "family": "Zarezadeh", "given": "Meysam", "sequence": "additional" }, { "affiliation": [], "family": "Ostadrahimi", "given": "Alireza", "sequence": "additional" } ], "container-title": "Public Health Nutrition", "container-title-short": "Public Health Nutr.", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2024, 4, 24 ] ], "date-time": "2024-04-24T07:25:17Z", "timestamp": 1713943517000 }, "deposited": { "date-parts": [ [ 2024, 4, 24 ] ], "date-time": "2024-04-24T07:25:17Z", "timestamp": 1713943517000 }, "indexed": { "date-parts": [ [ 2024, 4, 25 ] ], "date-time": "2024-04-25T00:27:09Z", "timestamp": 1714004829376 }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2024, 4, 24 ] ] }, "language": "en", "license": [ { "URL": "http://creativecommons.org/licenses/by/4.0/", "content-version": "unspecified", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 4, 24 ] ], "date-time": "2024-04-24T00:00:00Z", "timestamp": 1713916800000 } } ], "link": [ { "URL": "https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1368980024000934", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "56", "original-title": [], "page": "1-25", "prefix": "10.1017", "published": { "date-parts": [ [ 2024, 4, 24 ] ] }, "published-online": { "date-parts": [ [ 2024, 4, 24 ] ] }, "publisher": "Cambridge University Press (CUP)", "reference-count": 0, "references-count": 0, "relation": {}, "resource": { "primary": { "URL": "https://www.cambridge.org/core/product/identifier/S1368980024000934/type/journal_article" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [], "title": "The role of vitamin D in outcomes of critical care in COVID-19 patients: Evidence from an umbrella meta-analysis of interventional and observational studies", "type": "journal-article" }
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