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补充维生素D治疗2019冠状病毒病患者的疗效:一项随机对照试验的系统评价和荟萃分析

Efficacy of vitamin D supplementation in the treatment of patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Adil Mariam, Saleem Muhammad Meeran, Vijay Sneha, Ehsan Muhammad, Atiq Isha, Anwar Eman, Oduoye Malik Olatunde

机构信息

Department of Medicine, Dow University of Health Sciences.

Department of Medicine, King Edward Medical University, Lahore, Pakistan.

出版信息

Ann Med Surg (Lond). 2024 Aug 14;86(10):6079-6090. doi: 10.1097/MS9.0000000000002445. eCollection 2024 Oct.

Abstract

CONTEXT

COVID-19 has substantial effects on respiratory health and overall well-being. Recent studies suggest vitamin D as a potential treatment, but the results are inconclusive.

OBJECTIVE

The authors conducted a systematic review of randomized controlled trials (RCTs) to examine the link between vitamin D and patients with COVID-19.

DATA SOURCES

The authors searched electronic databases PubMed, Cochrane, CINAHL, EMBASE and Google Scholar from their inception till August 2023.

STUDY SELECTION

Inclusion criteria used in our systematic review include: (1) patients who tested positive for COVID-19, (2) intervention was vitamin D supplementation, (3) the comparator was either a placebo, standard care of treatment, or, no treatment, (4) at least one of the clinical outcomes of interest were investigated, (5) study design being RCTs.

DATA EXTRACTION

Two independent reviewers manually extracted information from selected articles, including study characteristics, patient characteristics, and the primary outcomes: all-cause mortality, ICU and hospital stay length and secondary outcomes: mechanical ventilation, supplemental oxygen, ICU admission, and adverse events. Risk ratios or mean differences and 95% CIs were calculated using a random-effects model.

DATA SYNTHESIS

The authors' analysis included 14 RCTs with 2165 patients. Vitamin D significantly reduced ICU admissions and lowered the need for mechanical ventilation compared to placebo. However, it did not significantly affect hospital stay length, ICU stay length, mechanical ventilation duration, mortality, or the need for supplemental oxygen.

CONCLUSION

Vitamin D does not significantly improve certain clinical outcomes, such as hospital and ICU stay length, for patients with COVID-19. However, it still may be significantly beneficial in decreasing the burden on intensive care services.

摘要

背景

新冠病毒病(COVID-19)对呼吸健康和整体健康状况有重大影响。近期研究表明维生素D可能是一种治疗方法,但结果尚无定论。

目的

作者对随机对照试验(RCT)进行了系统评价,以研究维生素D与COVID-19患者之间的联系。

数据来源

作者检索了电子数据库PubMed、Cochrane、CINAHL、EMBASE和谷歌学术,检索时间从各数据库建库至2023年8月。

研究选择

我们系统评价中使用的纳入标准包括:(1)COVID-19检测呈阳性的患者;(2)干预措施为补充维生素D;(3)对照为安慰剂、标准治疗或不治疗;(4)至少研究了一项感兴趣的临床结局;(5)研究设计为随机对照试验。

数据提取

两名独立的审阅者从选定的文章中手动提取信息,包括研究特征、患者特征以及主要结局:全因死亡率、重症监护病房(ICU)和住院时间,以及次要结局:机械通气、补充氧气、入住ICU和不良事件。使用随机效应模型计算风险比或均值差异以及95%置信区间。

数据综合

作者的分析纳入了14项随机对照试验,共2165例患者。与安慰剂相比,维生素D显著降低了入住ICU的比例,并减少了机械通气的需求。然而,它对住院时间、ICU住院时间、机械通气持续时间、死亡率或补充氧气的需求没有显著影响。

结论

对于COVID-19患者,维生素D并不能显著改善某些临床结局,如住院和ICU住院时间。然而,它在减轻重症监护服务负担方面仍可能有显著益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c908/11444563/c259f0d5dc71/ms9-86-6079-g001.jpg

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