维生素 D 在预防和治疗 SARS-CoV-2 感染中的作用：一项随机对照试验的荟萃分析。

The role of vitamin D in the prevention and treatment of SARS-CoV-2 infection: A meta-analysis of randomized controlled trials.

机构信息

Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan, China.

Department of Orthopaedics, Xiangya Hospital, Central South University, #87 Xiangya Road, Changsha, 410008, Hunan, China; Hunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China; Hunan Engineering Research Center of Osteoarthritis, Changsha, Hunan, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Clin Nutr. 2023 Nov;42(11):2198-2206. doi: 10.1016/j.clnu.2023.09.008. Epub 2023 Sep 20.

DOI:10.1016/j.clnu.2023.09.008

PMID:37802017

Abstract

BACKGROUND

Vitamin D (VitD) has been shown to be important for the immune response of the respiratory system, but the preventive and therapeutic effects of vitamin D supplementation on SARS-CoV-2 infection are controversial. This study aimed to determine the role of vitamin D supplementation in the prevention and treatment of SARS-CoV-2 infection through a meta-analysis of randomized controlled trials.

METHODS

The databases of PubMed, Cochrane Library, Embase, Web of Science and Google Scholar were searched systematically from inception to April 17,2023 to identify trials involving a randomized comparison of vitamin D supplementation versus non-vitamin D supplementation for SARS-CoV-2 infection prevention or treatment.

RESULTS

We retrieved 25 eligible trials, including 8128 participants. Four trials compared the preventive effects of vitamin D supplementation on SARS-CoV-2 infection, and the results (RR 0.31; 95%CI 0.07 to 1.32) were inconclusive. Regarding the treatment of SARS-CoV-2 infection with vitamin D supplementation, it was found that vitamin D supplementation could significantly reduce the rates of ICU admission (RR 0.63; 95%CI 0.44 to 0.89) and mechanical ventilation (RR 0.58; 95%CI 0.39 to 0.84), but had no statistically significant effect on mortality. However, in subgroup analyses based on the patients' specific conditions, vitamin D supplementation significantly reduced the mortality in patients with vitamin D deficiency (RR 0.76; 95%CI 0.58 to 0.98).

CONCLUSION

Vitamin D supplementation may have some beneficial impact on the severity of illness caused by SARS-CoV-2, particularly in VitD deficient patients, but further studies are still needed.

摘要

背景

维生素 D（VitD）已被证明对呼吸系统的免疫反应很重要，但维生素 D 补充剂对 SARS-CoV-2 感染的预防和治疗效果仍存在争议。本研究旨在通过对随机对照试验的荟萃分析来确定维生素 D 补充剂在预防和治疗 SARS-CoV-2 感染中的作用。

方法

系统检索了 PubMed、Cochrane 图书馆、Embase、Web of Science 和 Google Scholar 数据库，从建库至 2023 年 4 月 17 日，以确定涉及维生素 D 补充剂与非维生素 D 补充剂比较预防 SARS-CoV-2 感染或治疗 SARS-CoV-2 感染的随机对照试验。

结果

我们检索到 25 项符合条件的试验，包括 8128 名参与者。四项试验比较了维生素 D 补充剂预防 SARS-CoV-2 感染的效果，结果（RR 0.31；95%CI 0.07 至 1.32）尚无定论。关于维生素 D 补充剂治疗 SARS-CoV-2 感染，发现维生素 D 补充剂可显著降低入住 ICU 率（RR 0.63；95%CI 0.44 至 0.89）和机械通气率（RR 0.58；95%CI 0.39 至 0.84），但对死亡率无统计学意义。然而，基于患者具体情况的亚组分析显示，维生素 D 补充剂可显著降低维生素 D 缺乏患者的死亡率（RR 0.76；95%CI 0.58 至 0.98）。