The role of vitamin D in the age of COVID‐19: A systematic review and meta‐analysis

Ghasemian, Roya; Shamshirian, Amir; Heydari, Keyvan; Malekan, Mohammad; Alizadeh‐Navaei, Reza; Ebrahimzadeh, Mohammad Ali; Ebrahimi Warkiani, Majid; Jafarpour, Hamed; Razavi Bazaz, Sajad; Rezaei Shahmirzadi, Arash; Khodabandeh, Mehrdad; Seyfari, Benyamin; Motamedzadeh, Alireza; Dadgostar, Ehsan; Aalinezhad, Marzieh; Sedaghat, Meghdad; Razzaghi, Nazanin; Zarandi, Bahman; Asadi, Anahita; Yaghoubi Naei, Vahid; Beheshti, Reza; Hessami, Amirhossein; Azizi, Soheil; Mohseni, Ali Reza; Shamshirian, Danial

BACKGROUND: Evidence recommends that vitamin D might be a crucial supportive agent for the immune system, mainly in cytokine response regulation against COVID‐19. Hence, we carried out a systematic review and meta‐analysis in order to maximise the use of everything that exists about the role of vitamin D in the COVID‐19. METHODS: A systematic search was performed in PubMed, Scopus, Embase and Web of Science up to December 18, 2020. Studies focused on the role of vitamin D in confirmed COVID‐19 patients were entered into the systematic review. RESULTS: Twenty‐three studies containing 11 901 participants entered into the meta‐analysis. The meta‐analysis indicated that 41% of COVID‐19 patients were suffering from vitamin D deficiency (95% CI, 29%‐55%), and in 42% of patients, levels of vitamin D were insufficient (95% CI, 24%‐63%). The serum 25‐hydroxyvitamin D concentration was 20.3 ng/mL among all COVID‐19 patients (95% CI, 12.1‐19.8). The odds of getting infected with SARS‐CoV‐2 are 3.3 times higher among individuals with vitamin D deficiency (95% CI, 2.5‐4.3). The chance of developing severe COVID‐19 is about five times higher in patients with vitamin D deficiency (OR: 5.1, 95% CI, 2.6‐10.3). There is no significant association between vitamin D status and higher mortality rates (OR: 1.6, 95% CI, 0.5‐4.4). CONCLUSION: This study found that most of the COVID‐19 patients were suffering from vitamin D deficiency/insufficiency. Also, there is about three times higher chance of getting infected with SARS‐CoV‐2 among vitamin‐D‐deficient individuals and about five times higher probability of developing the severe disease in vitamin‐D‐deficient patients. Vitamin D deficiency showed no significant association with mortality rates in this population.