Objectives To assess the association between vitamin D deficiency and increased morbidity/mortality with COVID-19 respiratory dysfunction. Design Scoping review. Data Sources Ovid MEDLINE (1946 to 24 of April 2020) and PubMed (2020 to 17 of September 2020). Eligibility Criteria for Selecting Studies A search using the search terms: [(cholecalciferol or ergocalciferol or vitamin D2 or vitamin D3 or vitamin D or 25OHD) and (SARS-CoV-2 or coronavirus or COVID or betacoronavirus or MERS-CoV or SARS-CoV or respiratory infection or acute respiratory distress syndrome or ARDS)]m.p. was conducted on the 24/04/2020 (Search A) and 17/09/2020 (Search B). Results 91 studies were identified as being concerned with Acute Respiratory Infection (ARI)/Acute Respiratory Distress Syndrome (ARDS) and vitamin D, and 25 publications specifically explored the role of vitamin D deficiency in the development and progression of SARS-CoV-2/COVID-19 related ARDS. Search “A” identified three main themes of indirect evidence supporting such an association. Consistent epidemiological evidence exists linking low vitamin D levels to increased risk and severity of respiratory tract infections. We also report on plausible biological processes supporting such an association; and present weaker evidence supporting the benefit of vitamin D supplementation in reducing the risk and severity of ARIs. Uncertainty remains about what constitutes an appropriate dosing regimen in relation to reducing risk/severity of ARI/ARDS. More recent evidence (Search B) provided new insights into some direct links between vitamin D and COVID-19; with a number of cohort and ecological studies supporting an association with PCR-positivity for SARS-CoV-2 and vitamin D deficiency. The exact efficacy of the vitamin D supplementation for prevention of, or as an adjunct treatment for COVID-19 remains to be determined; but a number of randomized control trials (RCTs) currently underway are actively investigating these potential benefits. Conclusion Our rapid review of literature supports the need for observational studies with COVID-19 infected populations to measure and assess vitamin D levels in relation to risk/severity and outcomes; alongside RCTs designed to evaluate the efficacy of supplementation both in preventive and therapeutic contexts. The overlap in the vitamin D associated biological pathways with the dysregulation reported to drive COVID-19 outcomes warrants further investigation.
【저자키워드】 COVID-19, SARS-CoV-2, Vitamin D, scoping review, association, respiratory dysfunction, COVID-19 risk/severity, vitamin D prophylaxis, 【초록키워드】 Efficacy, ARDS, coronavirus, SARS-CoV, severity, risk, progression, outcome, MERS-CoV, RCT, Betacoronavirus, observational study, Population, COVID, Respiratory tract infections, Cohort, respiratory infection, therapeutic, epidemiological, respiratory, Uncertainty, RCTs, acute respiratory distress, Evidence, randomized control trial, regimen, dysregulation, Support, dysfunction, deficiency, Vitamin D supplementation, overlap, increased risk, syndrome, 25OHD, vitamin D level, OVID, potential benefits, objective, benefit, Result, evaluate, reported, conducted, provided, reducing, Source, ecological, biological processe, biological pathway, treatment for COVID-19, with COVID-19, 【제목키워드】 review, novel, respiratory, current,