Vitamin D Metabolism is Dysregulated in Asthma and Chronic Obstructive Pulmonary Disease

Journal article

Background: Vitamin D is a likely candidate for treatment as its immune modulating characteristics have effects on coronavirus disease 2019 (COVID-19) patients. It was  sought herein, to summarize the studies published to date regarding the vitamin D supplementation to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients. Methods: A systematic review and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome were 14-day and in-hospital mortality reported as an odds ratio (OR) with the associated 95% confidence interval (CI). Results: Eight articles were included in the review with a combined total of 2,322 individual patients, 786 in the vitamin D supplementation group and 1,536 in the control group. The use of vitamin D compared to the group without vitamin D supplementation was associated with a lower 14-day mortality (18.8% vs. 31.3%, respectively; OR = 0.51; 95% CI: 0.12–2.19; p = 0.36), a lower in-hospital mortality (5.6% vs. 16.1%; OR = 0.56; 95% CI: 0.23–1.37; I2 = 74%; p = 0.20), the rarer intensive care unit admission (6.4% vs. 23.4%; OR = 0.19; 95% CI: 0.06–0.54; I2 = 77%; p = 0.002) as well as rarer mechanical ventilation (6.5% vs. 18.9%; OR = 0.36; 95% CI: 0.16–0.80; I2 = 0.48; p = 0.01). Conclusions: Vitamin D supplementation in SARS-CoV-2 positive patients has the potential to positively impact patients with both mild and severe symptoms. As several high-quality randomized control studies have demonstrated a benefit in hospital mortality, vitamin D should be considered a supplemental therapy of strong interest. Should vitamin D prove to reduce hospitalization rates and symptoms outside of the hospital setting, the cost and benefit to global pandemic mitigation efforts would be substantial

Authors: Jolliffe, DA; Stefanidis, C; Wang, Z; Kermani, NZ; Dimitrov, V

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: American Thoracic Society
• Journal: American Journal of Respiratory and Critical Care Medicine
• Volume: 202
• Issue: 3
• Pages: 371-382
• Publication date: 2020-03-18
• DOI: 10.1164/rccm.201909-1867oc
• EISSN: 1535-4970
• ISSN: 1073-449X
• Language: English
• Keywords: Asthma; Medicine; Gastroenterology; vitamin D deficiency; COPD; Pulmonary disease; Endocrinology; Vitamin D and neurology; Metabolite; Internal medicine; Vitamin