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维生素D补充剂与中重度新冠肺炎患者的死亡率:一项随机对照试验的荟萃分析

Vitamin D supplementations and mortality among patients with moderate/severe COVID-19: A meta-analysis of randomized controlled trials.

作者信息

Mirghani Hyder, Begum Shamina

机构信息

Department of Internal Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia.

Department of Microbiology, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia.

出版信息

J Res Med Sci. 2024 Nov 28;29:68. doi: 10.4103/jrms.jrms_591_23. eCollection 2024.

Abstract

BACKGROUND

Vitamin D deficiency is associated with severe COVID 19 and poor outcomes. However, the role of Vitamin D supplementation on mortality is controversial. The current meta analysis aimed to investigate the same among patients with COVID 19.

MATERIALS AND METHODS

We searched six databases from inception up to July 2023. The keywords used were COVID 19, SARS COV 2, mortality, Vitamin D, calcitriol, cholecalciferol, Calcifediol, survival, death, small dose, and high dose. Eight hundred and sixteen studies were retrieved, 103 full texts were screened, and 14 randomized controlled trials were included in the meta analysis. A structured checklist was used to gather the author's name, country, year of publication, Vitamin D dose, age, sex, number of patients, mortality, and comorbidities. The Cochrane system for meta analysis (RevMan, version 5.4) was used for the data analysis.

RESULTS

No association was found between Vitamin D supplementation and mortality among patients with COVID 19, odd ratio, 1.16, 95% confidence interval (CI), 0.84-1.59, and P = 0.36. No difference between high and low dose Vitamin D supplementation, odd ratio, 0.65, 95% CI, 0.37-1.57, and P = 0.13. In a sub analysis, no significant statistical difference was found between low dose Vitamin D supplementation versus placebo, and when considering patients who were Vitamin D deficient, odd ratio, 1.10, 95% CI, 0.74-1.63. The P = 0.64 and, odd ratio, 0.99, 95% CI, 0.71-1.40, and P = 0.97 respectively.

CONCLUSION

No association was evident between Vitamin D supplementation and mortality among patients with COVID 19 irrespective of doses and Vitamin D status. Further studies are needed to address the timing and frequency of Vitamin D supplementations.

摘要

背景

维生素D缺乏与重症新型冠状病毒肺炎及不良预后相关。然而,补充维生素D对死亡率的作用存在争议。当前的荟萃分析旨在调查新型冠状病毒肺炎患者中的这一情况。

材料与方法

我们检索了从起始到2023年7月的六个数据库。使用的关键词为新型冠状病毒肺炎、严重急性呼吸综合征冠状病毒2、死亡率、维生素D、骨化三醇、胆钙化醇、骨化二醇、生存、死亡、小剂量和大剂量。检索到816项研究,筛选了103篇全文,14项随机对照试验纳入荟萃分析。使用结构化清单收集作者姓名、国家、发表年份、维生素D剂量、年龄、性别、患者数量、死亡率和合并症。采用Cochrane荟萃分析系统(RevMan,5.4版)进行数据分析。

结果

在新型冠状病毒肺炎患者中,补充维生素D与死亡率之间未发现关联,比值比为1.16,95%置信区间(CI)为0.84 - 1.59,P = 0.36。高剂量和低剂量维生素D补充之间无差异;比值比为0.65,95% CI为0.37 - 1.57,P = 0.13。在亚组分析中,低剂量维生素D补充与安慰剂相比无显著统计学差异;在考虑维生素D缺乏的患者时,比值比为1.10,95% CI为0.74 - 1.63,P = 0.64;比值比为0.99,95% CI为0.71 - 1.40,P = 0.97。

结论

无论剂量和维生素D状态如何,新型冠状病毒肺炎患者补充维生素D与死亡率之间均无明显关联。需要进一步研究以确定维生素D补充的时间和频率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab45/11702351/321adfdf6586/JRMS-29-68-g001.jpg

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