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Association between vitamin D supplementation or serum vitamin D level and susceptibility to SARS-CoV-2 infection or COVID-19 including clinical course, morbidity and mortality outcomes? A systematic review
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Grove, Amy L., Osokogu, Osemeke, Al-Khudairy, Lena, Mehrabian, Amin, Zanganeh, Mandana, Brown, Anna, Court, Rachel A., Taylor-Phillips, Sian, Uthman, Olalekan A., McCarthy, Noel D., Kumar, Sudhesh and Clarke, Aileen (2021) Association between vitamin D supplementation or serum vitamin D level and susceptibility to SARS-CoV-2 infection or COVID-19 including clinical course, morbidity and mortality outcomes? A systematic review. BMJ Open, 11 . e043737. doi:10.1136/bmjopen-2020-043737 ISSN 2044-6055.
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Official URL: https://doi.org/10.1136/bmjopen-2020-043737
Abstract
Objective To systemically review and critically appraise published studies of the association between vitamin D supplementation or serum vitamin D level and susceptibility to SARS-CoV-2 infection or COVID-19, including clinical course, morbidity and mortality outcomes.
Design Systematic review.
Data sources MEDLINE (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, MedRxiv and BioRxiv preprint databases. COVID-19 databases of the WHO, Cochrane, CEBM Oxford and Bern University up to 10 June 2020.
Study selection Studies that assessed vitamin D supplementation and/or low serum vitamin D in patients acutely ill with, or at risk of, severe betacoronavirus infection (SARS-CoV, MERS-CoV, SARS-CoV-2).
Data extraction Two authors independently extracted data using a predefined data extraction form and assessed risk of bias using the Downs and Black Quality Assessment Checklist.
Results Searches elicited 449 papers, 59 studies were eligible full-text assessment and 4 met the eligibility criteria of this review. The four studies were narratively synthesised and included (1) a cross-sectional study (n=107) suggesting an inverse association between serum vitamin D and SARS-CoV-2; (2) a retrospective cohort study (348 598 participants, 449 cases) in which univariable analysis showed that vitamin D protects against COVID-19; (3) an ecological country level study demonstrating a negative correlation between vitamin D and COVID-19 case numbers and mortality; and (4) a case–control survey (n=1486) showing cases with confirmed/probable COVID-19 reported lower vitamin D supplementation. All studies were at high/unclear risk of bias.
Conclusion There is no robust evidence of a negative association between vitamin D and COVID-19. No relevant randomised controlled trials were identified and there is no robust peer-reviewed published evidence of association between vitamin D levels and severity of symptoms or mortality due to COVID-19. Guideline producers should acknowledge that benefits of vitamin D supplementation in COVID-19 are as yet unproven despite increasing interest.
| Item Type: | Journal Article | ||||||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine | ||||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | COVID-19 (Disease), COVID-19 (Disease) -- Epidemiology , COVID-19 (Disease) -- Prevention, COVID-19 (Disease) -- Treatment , Vitamin D, Vitamin D in the body, Vitamin D -- Physiological effect | ||||||||||||
| Journal or Publication Title: | BMJ Open | ||||||||||||
| Publisher: | BMJ | ||||||||||||
| ISSN: | 2044-6055 | ||||||||||||
| Official Date: | 28 May 2021 | ||||||||||||
| Dates: |
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| Volume: | 11 | ||||||||||||
| Article Number: | e043737 | ||||||||||||
| DOI: | 10.1136/bmjopen-2020-043737 | ||||||||||||
| Status: | Peer Reviewed | ||||||||||||
| Publication Status: | Published | ||||||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
| Date of first compliant deposit: | 3 June 2021 | ||||||||||||
| Date of first compliant Open Access: | 3 June 2021 | ||||||||||||
| RIOXX Funder/Project Grant: |
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