使用维生素或矿物质补充剂进行自我药疗以预防和治疗新冠肺炎的患病率:一项系统评价和荟萃分析。
Prevalence of self-medication with vitamin or mineral supplements in the prevention and treatment of COVID-19: a systematic review and meta-analysis.
作者信息
Rafati Shideh, Rafati Foozieh, Shahabi Nahid, Dastyar Neda, Arjmand Fatemeh, Mousavi Nejad Seyedeh Masoumeh
机构信息
Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Department of Nursing, Nursing and Midwifery School, Shahed Square, Jiroft University of Medical Sciences, Jiroft, 7861756447, Iran.
出版信息
BMC Nutr. 2025 May 20;11(1):99. doi: 10.1186/s40795-025-01083-5.
BACKGROUND
Self-medication, as a self-care practice, increased dramatically during the COVID-19 pandemic. Among the most prevalent medications used for self-medication were vitamins and minerals. Accordingly, this study aimed to estimate the prevalence of self-medication with vitamins or minerals for preventing and treating COVID-19 and its related factors.
MATERIAL AND METHOD
A comprehensive search was performed in four electronic databases (PubMed, Web of Science, Scopus, and ProQuest), two preprint repositories (MedRxiv and SciELO), two grey literature sources (Google and Google Scholar), and the reference lists of eligible studies in January 2024. The search strategy was built on two core concepts: "self-medication" and "COVID-19". No language, place, and time restrictions were applied. Risk of bias assessment tool was adapted from Hoy checklist. The protocol of this study was registered under the code CRD42023434567 in the open-access online database of the International Prospective Register of Systematic Reviews (PROSPERO). A random effect model was applied to estimate the pooled prevalence of self-medication. Statistical heterogeneity among the studies was assessed using both the I statistic and the χ2 test. Moreover, subgroup analysis and meta-regression model were used to identify the potential sources of methodological heterogeneity of the studies. A two‑sided P-value < 0.05 was considered statistically significant.
RESULTS
Out of 1424 non-duplicate studies, 56 were included in the meta-analysis. Vitamin C, vitamin D, B complex, multivitamins, and zinc were most commonly used for self-medication. The pooled prevalence of self-medication with vitamins was 29% (95% CI: 22%,37%; I = 99.62%), with minerals 15% (95% CI: 8%, 23%; I = 99.68%), and the corresponding value for the concomitant use of minerals and vitamins was 34% (95% CI: 27%, 42%; I = 98.72%). The subgroup analysis showed people who lived in the American continent practiced self-medication with vitamins less (Pooled prevalence: 12%, 95% CI: 8%,16%; I = 91.39%), and self-medication with vitamins and minerals was most prevalent in Asia. Besides; according to I values, the continents in which the studies were conducted could be the reason for the statistical heterogeneity.
CONCLUSION
The reported prevalence of self-medication with vitamins and minerals to prevent and treat COVID-19, especially in Asia, is concerning and needs more public health action. In addition, people should be educated about the possibility of poisoning with vitamins and minerals because awareness of the risks of supplements can reduce self-medication practices at present and even in future pandemics.
背景
自我药疗作为一种自我保健行为,在新冠疫情期间急剧增加。自我药疗中最常用的药物是维生素和矿物质。因此,本研究旨在估计使用维生素或矿物质进行自我药疗以预防和治疗新冠及其相关因素的流行情况。
材料与方法
2024年1月,在四个电子数据库(PubMed、科学网、Scopus和ProQuest)、两个预印本库(MedRxiv和SciELO)、两个灰色文献来源(谷歌和谷歌学术)以及符合条件研究的参考文献列表中进行了全面检索。检索策略基于两个核心概念:“自我药疗”和“新冠”。未应用语言、地点和时间限制。偏倚风险评估工具改编自霍伊检查表。本研究方案已在国际系统评价前瞻性注册库(PROSPERO)的开放获取在线数据库中以代码CRD42023434567注册。应用随机效应模型估计自我药疗的合并患病率。使用I统计量和χ²检验评估研究间的统计异质性。此外,采用亚组分析和meta回归模型确定研究方法异质性的潜在来源。双侧P值<0.05被认为具有统计学意义。
结果
在1424项非重复研究中,56项被纳入荟萃分析。维生素C、维生素D、复合维生素B、多种维生素和锌是最常用于自我药疗的。使用维生素进行自我药疗的合并患病率为29%(95%置信区间:22%,37%;I = 99.62%),使用矿物质为15%(95%置信区间:8%,23%;I = 99.68%),同时使用矿物质和维生素的相应值为34%(95%置信区间:27%,42%;I = 98.72%)。亚组分析显示,生活在美洲大陆的人使用维生素进行自我药疗的较少(合并患病率:12%,95%置信区间:8%,16%;I = 91.39%),而使用维生素和矿物质进行自我药疗在亚洲最为普遍。此外;根据I值,开展研究的各大洲可能是统计异质性的原因。
结论
报告的使用维生素和矿物质进行自我药疗以预防和治疗新冠的患病率,尤其是在亚洲,令人担忧,需要更多的公共卫生行动。此外,应教育人们关于维生素和矿物质中毒的可能性,因为对补充剂风险的认识可以减少目前甚至未来大流行期间的自我药疗行为。