Does vitamin D supplementation reduce COVID-19 severity?: a systematic review.

ABSTRACT

BACKGROUND: 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 heterogeneous study designs. AIM: This evidence summary, aims to study the effect of vitamin D supplementation on morbidity and mortality in hospitalized COVID-19 patients.Design: Evidence summary of systematic reviews. 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 to 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. However the included studies were of varied quality. Qualitative analysis showed that supplements (oral and IV) are well tolerated, safe and effective in COVID patients. CONCLUSION: The findings of this study show that vitamin D supplementation is effective in reducing the COVID-19 severity. Hence, vitamin D should be recommended as an adjuvant therapy for COVID-19.However, more robust and larger trials are required to substantiate it further.