维生素D缺乏与新型冠状病毒肺炎发病风险及预后相关性的Meta分析

The correlation between vitamin D deficiency and the risk and prognosis of COVID-19:a Meta-analysis

目的:系统评价维生素D缺乏与新型冠状病毒肺炎发病风险及预后的关系,为临床决策提供依据。方法:计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、Web of Science及the Cochrane Library数据库,全面搜集有关维生素D缺乏与新型冠状病毒肺炎发病风险及预后的队列研究及病例对照研究。检索时限均从建库至2021年5月19日。由2名研究者按照纳入与排除标准独立筛选文献、质量评价及提取资料,数据核对无误后使用RevMan 5.1软件对数据进行Meta分析。本研究主要关注的是复合不良预后结局,包括死亡率、机械通气和需要重症监护病房护理。结果:共纳入29项研究,涉及6218例新型冠状病毒肺炎病人,Meta分析显示,维生素D缺乏与新型冠状病毒肺炎发病风险有关[SMD=-1.28,95%CI(-1.94,-0.62),P=0.0001],维生素D与新型冠状病毒肺炎病人复合不良预后结局有关[RR=1.38,95%CI(1.14,1.67),P=0.001],其中血清维生素D缺乏与新型冠状病毒肺炎的死亡率有关[RR=1.43,95%CI(1.02,2.00),P=0.04],与需要重症监护病房(ICU)护理的风险有关[RR=1.57,95%CI(1.16,2.13),P=0.004],与机械通气发生率无关[RR=1.22,95%CI(0.95,1.56),P=0.13]。结论:现有证据表明,维生素D缺乏会增加新型冠状病毒肺炎的发病风险,并与新型冠状病毒肺炎病人复合不良预后结局有关。

Objective:To systematically evaluate the relationship between vitamin D deficiency and the risk and prognosis of COVID-19,and to provide evidence for clinical decision-making.Methods:Cohort and case-control studies on vitamin D deficiency and the risk and prognosis of COVID-19 were retrieved from CNKI,WanFang Database,VIP,CBM,PubMed,EMbase,Web of Sicence and the Cochrane Library.The retrieval period is from the establishment of each database to May 19,2021.According to inclusion and exclusion criteria,literature screening,quality evaluation and data extraction were independently carried out by 2 researchers.After data verification,RevMan 5.1 software was used for Meta analysis of the data.Compounding adverse outcomes,including mortality,mechanical ventilation,and the need for intensive care unit care were of primary concern in this study.Results:A total of 29 studies involving 6218 patients with COVID-19 were included.Meta-analysis showed that vitamin D deficiency was associated with the risk of COVID-19[SMD=-1.28,95%CI(-1.94,-0.62),P=0.0001],vitamin D was associated with adverse compound outcome in patients with COVID-19[RR=1.38,95%CI(1.14,1.67),P=0.001],serum vitamin D deficiency was associated with the mortality of COVID-19[RR=1.43,95%CI(1.02,2.00),P=0.04],and ICU incidence[RR=1.57,95%CI(1.16,2.13),P=0.004],serum vitamin D deficiency was not associated with the incidence of mechanical ventilation[RR=1.22,95%CI(0.95,1.56),P=0.13].Conclusions:Existing evidence shows that vitamin D deficiency can increase the risk of COVID-19 and is related to the poor prognosis of patients with COVID-19.