Effect of vitamin D supplementation on clinical outcomes in adult patients with COVID-19: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials.

IF 2.9 4区 医学 Q2 PHARMACOLOGY & PHARMACY Pharmacology Research & Perspectives Pub Date : 2024-10-01 DOI:10.1002/prp2.70013
Zohreh-Al-Sadat Ghoreshi, Javad Charostad, Nasir Arefinia, Mohsen Nakhaie, Mohammad Rezaei Zadeh Rukerd, Faranak Salajegheh
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Abstract

The COVID-19 pandemic has emerged as a major global health crisis. Vitamin D, a crucial fat-soluble vitamin, has been recommended for COVID-19 patients, though evidence of its effectiveness is inconsistent. This systematic literature review and meta-analysis aimed to evaluate the impact of vitamin D supplementation on COVID-19-related outcomes. A comprehensive search was conducted across PubMed, Scopus, Web of Science, Embase, and Cochrane databases. Primary outcomes included mortality and hospital length of stay, while secondary outcomes encompassed C-reactive protein (CRP), ferritin, D-dimer, hemoglobin (Hb) concentrations, and lymphocyte, neutrophil, and platelet counts. Data analysis was performed using Stata™ Version 14. A total of 16 trials were analyzed. The meta-analysis revealed that vitamin D supplementation significantly reduced hospital length of stay (mean difference = -1.16; 95% confidence interval [CI]: -2.23, -0.09; p = .033) with significant heterogeneity (I2 = 69.2%, p = .002). Subgroup analysis showed a more pronounced reduction in studies with vitamin D dosages ≤10 000 international units (IU) (mean difference = -1.27; 95% CI: -1.96, -0.57; p < .001) and in patients over 60 years old (mean difference = -1.84; 95% CI: -2.53, -1.14; p < .001). Additionally, vitamin D significantly reduced CRP concentrations in older adults (>60 years) (mean difference = -1.13; 95% CI: -2.07, -0.18; p = .019). No significant changes were found in ferritin, D-dimer, Hb concentrations, or in lymphocyte, neutrophil, and platelet counts (p > .05). In conclusion, while vitamin D supplementation did not significantly affect most COVID-19-related biomarkers, however, it reduces the length of hospital stay.

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补充维生素 D 对 COVID-19 成年患者临床疗效的影响:对随机对照试验进行GRADE评估的系统综述和荟萃分析。
COVID-19 大流行已成为一场重大的全球健康危机。维生素 D 是一种重要的脂溶性维生素,已被推荐用于 COVID-19 患者,但有关其有效性的证据并不一致。本系统性文献综述和荟萃分析旨在评估补充维生素 D 对 COVID-19 相关结果的影响。我们在 PubMed、Scopus、Web of Science、Embase 和 Cochrane 数据库中进行了全面检索。主要结果包括死亡率和住院时间,次要结果包括 C 反应蛋白 (CRP)、铁蛋白、D-二聚体、血红蛋白 (Hb) 浓度以及淋巴细胞、中性粒细胞和血小板计数。数据分析使用 Stata™ Version 14 进行。共分析了 16 项试验。荟萃分析显示,补充维生素 D 可显著缩短住院时间(平均差异 = -1.16; 95% 置信区间 [CI]: -2.23, -0.09; p = .033),但存在显著的异质性(I2 = 69.2%, p = .002)。亚组分析表明,维生素 D 剂量≤10 000 国际单位 (IU) 的研究结果显示了更明显的降低(平均差异 = -1.27; 95% CI: -1.96, -0.57; p 60 years)(平均差异 = -1.13; 95% CI: -2.07, -0.18; p = .019)。铁蛋白、D-二聚体、血红蛋白浓度以及淋巴细胞、中性粒细胞和血小板计数均无明显变化(p > .05)。总之,虽然维生素 D 补充剂对大多数 COVID-19 相关生物标志物无明显影响,但却能缩短住院时间。
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来源期刊
Pharmacology Research & Perspectives
Pharmacology Research & Perspectives Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics
CiteScore
5.30
自引率
3.80%
发文量
120
审稿时长
20 weeks
期刊介绍: PR&P is jointly published by the American Society for Pharmacology and Experimental Therapeutics (ASPET), the British Pharmacological Society (BPS), and Wiley. PR&P is a bi-monthly open access journal that publishes a range of article types, including: target validation (preclinical papers that show a hypothesis is incorrect or papers on drugs that have failed in early clinical development); drug discovery reviews (strategy, hypotheses, and data resulting in a successful therapeutic drug); frontiers in translational medicine (drug and target validation for an unmet therapeutic need); pharmacological hypotheses (reviews that are oriented to inform a novel hypothesis); and replication studies (work that refutes key findings [failed replication] and work that validates key findings). PR&P publishes papers submitted directly to the journal and those referred from the journals of ASPET and the BPS
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