Effect of Vitamin D Deficiency on COVID-19 Status: A Systematic Review

  1. Pranta Das
  2. Nandeeta Samad
  3. Bright Opoku Ahinkorah
  4. John Elvis Hagan
  5. Prince Peprah
  6. Aliu Mohammed
  7. Abdul-Aziz Seidu

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Abstract

One major micronutrient studied for its possible protective effect against the COVID-19 disease is vitamin D. This systematic review sought to identify and synthesize available evidence to aid the understanding of the possible effect of vitamin D deficiency on COVID-19 status and health outcomes in COVID-19 patients. Three databases (PubMed, ScienceDirect, and Google Scholar) were systematically used to obtain English language journal articles published between 1 December 2019 and 3 November 2020. The search consisted of the terms (“Vitamin D,” OR “25-Hydroxyvitamin D,” OR “Low vitamin D.”) AND (“COVID-19” OR “2019-nCoV” OR “Coronavirus” OR “SARS-CoV-2”) AND (“disease severity” OR “IMV” OR “ICU admission” OR “mortality” OR “hospitalization” OR “infection”). We followed the recommended PRISMA guidelines in executing this study. After going through the screening of the articles, eleven articles were included in the review. All the included studies reported a positive association between vitamin D sufficiency and improved COVID-19 disease outcomes. On the other hand, vitamin D deficiency was associated with poor COVID-19 disease outcomes. Specifically, two studies found that vitamin D-deficient patients were more likely to die from COVID-19 compared to vitamin D-sufficient patients. Three studies showed that vitamin D-deficient people were more likely to develop severe COVID-19 disease compared to vitamin D-sufficient people. Furthermore, six studies found that vitamin D-deficient people were more likely to be COVID-19 infected compared to vitamin D-sufficient people. Findings from these studies suggest that vitamin D may serve as a mitigating effect for COVID-19 infection, severity, and mortality. The current evidence supports the recommendations for people to eat foods rich in vitamin D such as fish, red meat, liver, and egg yolks. The evidence also supports the provision of vitamin D supplements to individuals with COVID-19 disease and those at risk of COVID-19 infection in order to boost their immunity and improve health outcomes.

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  1. Version published to 10.3390/covid1010008
  2. ScreenIT

    SciScore for 10.1101/2020.12.01.20242313: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationHence, randomized controlled trails, short communication, letter to the editor, review articles etc. were excluded.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Search strategy: Three databases PubMed, ScienceDirect, and Google Scholar were searched systematically to obtain English language journal article published within 1/12/2019 and 3/11/2020.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Google Scholar
    suggested: (Google Scholar, RRID:SCR_008878)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This limitation does not suggest that the evidence of positive association between Vitamin D and COVID-19 status must be dismissed. However, without indicating the causative agents and plausible mechanism in the included studies, the level of confidence of the Vitamin D impact on COVID-19 status is moderate. This is because if a COVID-19 patient is on Vitamin D, a number of factors will determine whether a good effect is likely to occur. These factors will include dose, duration, age, gender, diet, lifestyle state, state of health, among others. These confounding factors may prove important in the Vitamin D and COVID-19 status association. Evidently, one of the studies selected and included in this review (Hastie et al., 2020) show some uncertainties and also suggest that confounders should be taken into consideration when discussing effect of Vitamin D on COVID-19 status. The authors found that Vitamin D does not have significant relationship with COVID-19 status in the presence of confounders. According to Martineau, and Forouhi (2020), results from studies investigating the potential and actual impact of Vitamin D on COVID-19 status appear conflicting to date partly due to the evidence that those studies are open to residual and unmeasured confounding. From this perspective, epidemiological and hospital-based studies, and well-designed and powered randomised controlled trials are currently required to establish the actual effect of Vitamin D on COVID-19 status and to also ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.12.01.20242313 on medRxiv