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.
Clin Nutr. 2023 Nov;42(11):2198-2206. doi: 10.1016/j.clnu.2023.09.008. Epub 2023 Sep 20.
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.
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.
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).
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.
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。
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。
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）。
维生素 D 补充剂可能对 SARS-CoV-2 引起的疾病严重程度有一定的有益影响，特别是在 VitD 缺乏的患者中，但仍需要进一步研究。
