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Liu N, Sun J, Wang X, Zhang T, Zhao M, Li H. Low vitamin D status is associated with coronavirus disease 2019 outcomes: A systematic review and meta-analysis. Int J Infect Dis. 2021 Jan 2:S1201-9712(20)32600-X. doi: 10.1016/j.ijid.2020.12.077. Epub ahead of print. PMID: 33401034.

Background: Observational studies suggest that the risk and clinical prognosis of coronavirus disease 2019 (COVID-19) are related to low vitamin D status; however, the data are inconsistent.

Objectives: We conducted a systematic review and meta-analysis to assess the association between low vitamin D status and COVID-19.

Methods: The systematic search was conducted with PubMed, Embase, and the Cochrane Library from database inception to September 25, 2020. The standardized mean difference (SMD) or odds ratio (OR) and corresponding 95% confidence interval (CI) were applied to estimate pooled results. Random – or fixed – effect models based on heterogeneity were used for the meta-analysis. Funnel plots and Egger regression tests were used to assess publication bias.

Results: A total of 10 articles with 361, 934 participants were selected for meta-analysis. Overall, the pooled OR in the fixed-effect model showed that vitamin D deficiency or insufficiency was associated with an increased risk of COVID-19 (OR = 1.43, 95% CI 1.00 to 2.05). In addition, COVID-19-positive individuals had lower vitamin D levels than those with COVID-19-negative individuals (SMD = -0.37, 95% CI = -0.52 to -0.21). Significant heterogeneity existed in both endpoints. Funnel plots and Egger regression tests revealed significant publication bias.

Conclusions: This systematic review and meta-analysis indicated that low vitamin D status may be associated with an increased risk of COVID-19 infection. Further studies are needed to evaluate the impact of vitamin D supplementation on the clinical severity and prognosis in patients with COVID-19.

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