DataSheet_1_Vitamin D supplementation for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials.docx

Vitamin D supplementation and its impact on immunoregulation are widely investigated. We aimed to assess the prevention and treatment efficiency of vitamin D supplementation in the context of coronavirus disease 2019 (COVID-19) and any disease-related complications. For this systematic review and meta-analysis, we searched databases (PubMed, Embase, Scopus, Web of Science, The Cochrane Library, medRxiv, Cochrane COVID-19 Study Register, and ClinicalTrial.gov) for studies published between 1 November 2019 and 17 September 2021. We considered randomized trials (RCTs) as potentially eligible when patients were tested for SARS-CoV-2 infection and received vitamin D supplementation versus a placebo or standard-of-care control. A random-effects model was implemented to obtain pooled odds ratios for the effect of vitamin D supplementation on the main outcome of mortality as well as clinical outcomes. We identified a total of 5,733 articles, of which eight RCTs (657 patients) met the eligibility criteria. Although no statistically significant effects were reached, the use of vitamin D supplementation showed a trend for reduced mortality [odds ratio (OR) 0.74, 95% confidence interval (CI) 0.32–1.71, p = 0.48] compared with the control group, with even stronger effects, when vitamin D was administered repeatedly (OR 0.33, 95% CI 0.1–1.14). The mean difference for the length of hospitalization was −0.28 (95% CI −0.60 to 0.04), and the ORs were 0.41 (95% CI 0.15–1.12) and 0.52 (95% CI 0.27–1.02) for ICU admission and mechanical ventilation, respectively. In conclusion, vitamin D supplementation did not improve the clinical outcomes in COVID-19 patients, but trends of beneficial effects were observed. Further investigations are required, especially studies focusing on the daily administration of vitamin D.

维生素D补充疗法及其对免疫调节的影响已得到广泛研究。本研究旨在评估维生素D补充疗法在新型冠状病毒肺炎（coronavirus disease 2019, COVID-19）背景下的预防与治疗效能，及其对各类疾病相关并发症的干预效果。本项系统评价与荟萃分析中，我们检索了PubMed、Embase、Scopus、Web of Science、The Cochrane Library、medRxiv、Cochrane COVID-19 Study Register及ClinicalTrial.gov等数据库，检索时限为2019年11月1日至2021年9月17日期间发表的相关研究。我们将符合以下条件的随机对照试验（randomized trials, RCTs）纳入潜在合格研究：患者经SARS-CoV-2感染检测，且接受维生素D补充疗法，与安慰剂组或标准治疗对照组进行对照。本研究采用随机效应模型，以合并维生素D补充疗法对主要结局指标（死亡率）及临床结局的比值比（odds ratio, OR）。我们共检索到5733篇文献，其中8项随机对照试验（共纳入657名患者）符合纳入标准。尽管未达到统计学显著性差异，但与对照组相比，使用维生素D补充疗法呈现出降低死亡率的趋势[比值比（odds ratio, OR）=0.74，95%置信区间（confidence interval, CI）：0.32~1.71，p=0.48]；若采用反复给药方案，其效应更为显著[OR=0.33，95%CI：0.1~1.14]。住院时长的平均差为-0.28（95%CI：-0.60~0.04）；ICU收治率与机械通气率的合并OR值分别为0.41（95%CI：0.15~1.12）与0.52（95%CI：0.27~1.02）。综上，维生素D补充疗法并未显著改善新型冠状病毒肺炎患者的临床结局，但观察到了潜在获益趋势。未来仍需开展进一步研究，尤其是聚焦于维生素D每日给药方案的相关研究。