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
What this study found
Overall, vitamin D supplementation was associated with reduced mortality in COVID-19, and lower vitamin D status was linked to higher infection risk, greater disease severity, and poorer prognosis. In the provided interventional comparison, ICU admission occurred in 1/50 participants in the calcifediol group versus 25/50 (50%) in the no vitamin D group. Findings for ICU admission and mechanical ventilation were otherwise inconsistent, but the authors concluded that vitamin D supplementation is supported for reducing mortality and may help prevent severe COVID-19 outcomes.
- Study & population
- This umbrella meta-analysis synthesized interventional and observational evidence in adult patients with COVID-19.
- Intervention
- Vitamin D supplementation was evaluated, including calcifediol in one interventional arm.
- Key limitation
- The evidence base was heterogeneous and included a mix of randomized and observational studies, which limits causal inference.
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Open PDFOriginal abstract
Abstract Objectives: Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with severe acute respiratory syndrome coronavirus-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 summarising data from 4 randomised controlled trial 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 the 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 intensive care unit and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients.