Background and Aim The evidence regarding the efficacy of vitamin D supplementation in reducing severity of COVID-19 is still insufficient. This is partially due to the lack of primary robust trial-based data and heterogenous study designs. This evidence summary, aims to study the effect of vitamin D supplementation on morbidity and mortality in hospitalized COVID-19 patients. Methods For this study, systematic reviews and meta-analysis published from December 2019 to January 2022 presenting the impact of vitamin D supplementation on COVID-19 severity were screened and selected from PubMed and Google scholar. After initial screening, 10 eligible reviews were identified and quality of included reviews were assessed using AMSTAR and GRADE tools and overlapping among the primary studies used were also assessed. Results The number of primary studies included in the systematic reviews ranged from 3-13. Meta-analysis of seven systematic reviews showed strong evidence that vitamin D supplementation reduces the risk of mortality (Odds ratio: 0.48, 95% CI: 0.346-0.664; p < 0.001) in COVID patients. It was also observed that supplementation reduces the need for intensive care (Odds ratio: 0.35; 95%CI: 0.28-0.44; p < 0.001) and mechanical ventilation (Odds ratio: 0.54; 95% CI: 0.411-0.708; p < 0.001) requirement. The findings were robust and reliable as level of heterogeneity was considerably low. Qualitative analysis showed that supplements (oral and IV) are well tolerated, safe and effective in COVID patients. Conclusion Findings of this study shows that vitamin D supplementation is effective in reducing COVID-19 severity. Hence vitamin D should be recommended as an adjuvant therapy for COVID-19.
Aim We aim to study the relationship between vitamin D level, risk and severity of COVID-19 infection in pediatric population through systematic review. Methods We searched PubMed, CINAHL, EMBASE, Cochrane Library and Google Scholar from December 2019 to June 2021 for retrieving articles studying association between vitamin D deficiency with COVID-19. Qualitative details were synthesized in evidence table and quantitative data was used for deriving pooled estimate through meta-analysis. Results After initial search of 2261 articles, eight eligible studies (two reviews) were included in the systematic review. Meta-analysis of the quantitative data (six studies) showed pooled prevalence of vitamin D deficiency as 45.91% (95% CI : 25.148-67.450). In infected pediatric patients, low levels of vitamin D increased the risk of severe disease (odds ratio - 5.5; 95% CI : 1.560- 19.515; p = 0.008). It was also found that children and adolescents having vitamin D deficiency had greater risk of COVID infection as compared to patients with normal vitamin D levels. Improvement in disease severity with vitamin D supplementation was also noted. Conclusion The systematic review showed that almost half of the pediatric COVID patients suffer from vitamin D deficiency. It is also clear that the low level of vitamin D is associated with greater risk of infection and poorer outcome in pediatrics.
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