Al Kiyumi Maisa Hamed, Kalra Sanjay, Davies J S, Kalhan Atul
Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Muscat, Oman.
Department of Endocrinology, Bharti Hospital, Karnal, India.
Indian J Endocrinol Metab. 2021 Jul-Aug;25(4):261-282. doi: 10.4103/ijem.ijem_115_21. Epub 2021 Dec 15.
We aimed to study the prevalence of vitamin D deficiency (VDD) in patients with COVID-19 infection and evaluate the impact of vitamin D levels on the severity of symptoms and the case fatality rate.
A comprehensive literature search was performed up to December 20, 2020, using the following databases: MEDLINE, PubMed, EMBASE, SCOPUS, Web of Science, and preprint databases (BioRxiv and MedRxiv). Any individual observational study related to the prevalence and impact of vitamin D deficiency/insufficiency (VDD/VDI) on the severity of COVID-19 symptoms and mortality rates was included. No language restrictions were applied, and both published and non-published studies were included.
Two of the authors independently performed the literature search and assessed the eligibility of studies. The quality of studies included was assessed using the Newcastle-Ottawa Scale. Data were analyzed using the Review Manager Software (version 5) and Comprehensive Meta-analysis Software (version 3). A total of 43 studies were included with a sample size of 254,963 patients with COVID-19. Pooled analysis showed a higher prevalence of VDD and VDI in patients with COVID-19 (59.0% and 40.1%, respectively). Moreover, a significant association was noticed between vitamin D levels and severity of symptoms (odds ratio [OR] = 3.38, 95% confidence interval [CI]: 1.94-5.87, < 0.0001), as well as the case fatality rate (OR = 2.30, 95% CI: 1.47-3.59, < 0.00001).
VDD is highly prevalent in patients with COVID-19 infection. Lower vitamin D levels correlate with disease severity and poor prognosis although most of the data have been derived from moderate-quality observational studies.
我们旨在研究新型冠状病毒肺炎（COVID-19）感染患者中维生素D缺乏（VDD）的患病率，并评估维生素D水平对症状严重程度和病死率的影响。
截至2020年12月20日，使用以下数据库进行了全面的文献检索：医学文献数据库（MEDLINE）、美国国立医学图书馆生物医学期刊数据库（PubMed）、荷兰医学文摘数据库（EMBASE）、Scopus数据库、科学引文索引（Web of Science）和预印本数据库（BioRxiv和MedRxiv）。纳入任何与维生素D缺乏/不足（VDD/VDI）对COVID-19症状严重程度和死亡率的患病率及影响相关的个体观察性研究。不设语言限制，纳入已发表和未发表的研究。
两位作者独立进行文献检索并评估研究的合格性。使用纽卡斯尔-渥太华量表评估纳入研究的质量。使用Review Manager软件（版本5）和综合荟萃分析软件（版本3）进行数据分析。共纳入43项研究，样本量为254,963例COVID-19患者。汇总分析显示，COVID-19患者中VDD和VDI的患病率较高（分别为59.0%和40.1%）。此外，发现维生素D水平与症状严重程度（优势比[OR]=3.38，95%置信区间[CI]：1.94-5.87，P<0.0001）以及病死率（OR=2.30，95%CI：1.47-3.59，P<0.00001）之间存在显著关联。
VDD在COVID-19感染患者中非常普遍。较低的维生素D水平与疾病严重程度和不良预后相关，尽管大多数数据来自中等质量的观察性研究。
