Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis

Study answer

What this study found

Vitamin D supplementation during hospitalization for COVID-19 reduced ICU admission risk (pooled effect 0.28, 95% CI 0.20-0.39) with substantial heterogeneity (I2 = 74.2%). Trial sequential analysis shows the ICU result is conclusive. Mortality risk also reduced (0.49, 95% CI 0.34-0.72), but TSA indicated further studies are needed to confirm mortality benefit. Conclusion: There is a definitive association between vitamin D supplementation and reduced ICU admission in hospitalized COVID-19 patients; mortality benefit remains uncertain and requires more evidence.

Study & population

Five randomized controlled trials in adults hospitalized with COVID-19; study designs were randomized trials (some multicenter, some single-center) with varying allocation ratios.

Intervention

Sabico 2021: vitamin D3 5,000 IU/day vs 1,000 IU/day for 14 days.

Key limitation

Small number of trials (n=5) with varied regimens and populations; heterogeneity in vitamin D formulations (D3 vs calcifediol) and dosing; some trials were single-center; risk-of-bias concerns across several trials; mortality result not yet definitively proven by TSA; findings limited to hospitalized adults.

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Original abstract