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维生素D与2019冠状病毒病的共识与争议方面

Consensus and Controversial Aspects of Vitamin D and COVID-19.

作者信息

Bilezikian John P, Binkley Neil, De Luca Hector F, Fassio Angelo, Formenti Anna Maria, El-Hajj Fuleihan Ghada, Heijboer Annemieke C, Giustina Andrea

机构信息

Department of Medicine, Vagelos College of Physicians and Surgeons, New York, New York 10032, USA.

Department of Medicine, Geriatrics Faculty, Medical Sciences Center, University of Wisconsin, Madison, Wisconsin 53705, USA.

出版信息

J Clin Endocrinol Metab. 2023 Apr 13;108(5):1034-1042. doi: 10.1210/clinem/dgac719.

Abstract

OBJECTIVE

This work aims to review and discuss controversial topics in the field of vitamin D, SARS-CoV-2 infection, and COVID-19.

METHODS

The International Conferences "Controversies in Vitamin D" are a series of workshops that started in 2017 featuring international experts and leaders in vitamin D research and clinical practice. The fifth annual conference was held in Stresa, Italy, September 15 to 18, 2021.

EVIDENCE

Before the event, participants reviewed available studies on their assigned topic, drafted a related abstract, and presented their findings at the time of the conference. Relevant literature that became available since was also discussed within the panel and updated accordingly.

CONSENSUS

Before the event, the drafted abstracts had been merged to prepare a preliminary document. After the conference presentations, in-depth discussions in open sessions led to consensus. The document was subsequently modified according to discussions and up-to-date literature inclusion.

CONCLUSIONS

There is quite consistent evidence for an association between low 25 OH vitamin D (25(OH)D) levels and poor COVID-19 outcomes, despite heterogeneous publications of variable quality. However, the low vitamin D status in COVID-19 patients might also reflect reverse causality. Vitamin D supplementation might have a positive role in COVID-19 prevention. The evidence supporting a beneficial effect of vitamin D treatment in decreasing the risk of COVID-19 complications is conflicting. Conclusive statements regarding the beneficial effect of vitamin D in this context await high-quality, randomized controlled trials.

摘要

目的

本研究旨在回顾和讨论维生素D、严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染和2019冠状病毒病(COVID-19)领域的争议性话题。

方法

“维生素D争议”国际会议是一系列始于2017年的研讨会,参会人员包括维生素D研究和临床实践领域的国际专家和领军人物。第五届年度会议于2021年9月15日至18日在意大利斯特雷萨举行。

证据

会议召开前,参会人员回顾了关于其指定主题的现有研究,起草了相关摘要,并在会议期间展示了他们的研究结果。此后出现的相关文献也在小组内进行了讨论并相应更新。

共识

会议召开前,已将起草的摘要合并以准备一份初步文件。会议报告结束后,在公开会议上进行的深入讨论达成了共识。随后根据讨论结果和纳入的最新文献对该文件进行了修改。

结论

尽管有质量参差不齐的不同研究发表,但有相当一致的证据表明,25羟维生素D(25(OH)D)水平低与COVID-19不良预后之间存在关联。然而,COVID-19患者维生素D水平低也可能反映了反向因果关系。补充维生素D可能在预防COVID-19方面发挥积极作用。支持维生素D治疗对降低COVID-19并发症风险有有益作用的证据相互矛盾。关于维生素D在此背景下有益作用的确切结论有待高质量的随机对照试验得出。

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