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Systematic Review
Vitamin D Deficiency and Comorbidities as Risk Factors of COVID-19 Infection: A Systematic Review and Meta-analysis
Pinki Mishra, Rizwana Parveen, Ram Bajpai, Nidhi Agarwal
J Prev Med Public Health. 2022;55(4):321-333.   Published online June 13, 2022
DOI: https://doi.org/10.3961/jpmph.21.640
  • 5,305 View
  • 198 Download
  • 6 Web of Science
  • 9 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Extensive evidence links low vitamin D status and comorbidities with coronavirus disease 2019 (COVID-19) outcomes, but the results of published studies are contradictory. Therefore, we investigated the association of lower levels of vitamin D and comorbidities with the risk of COVID-19 infection.
Methods
We searched MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for articles published until August 20, 2021. Sixteen eligible studies were identified (386 631 patients, of whom 181 114 were male). We included observational cohort and case-control studies that evaluated serum levels of vitamin D in COVID-19-positive and COVID-19-negative patients. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated.
Results
Significantly lower vitamin D levels were found in COVID-19-positive patients (MD, -1.70; 95% CI, -2.74 to -0.66; p=0.001), but with variation by study design (case-control: -4.04; 95% CI, -5.98 to -2.10; p<0.001; cohort: -0.39; 95% CI, -1.62 to 0.84; p=0.538). This relationship was more prominent in female patients (MD, -2.18; 95% CI, -4.08 to -0.28; p=0.024) than in male patients (MD, -1.74; 95% CI, -3.79 to 0.31; p=0.096). Male patients showed higher odds of having low vitamin D levels (odds ratio [OR], 2.09; 95% CI, 1.38 to 3.17; p<0.001) than female patients (OR, 1.17; 95% CI, 0.74 to 1.86; p=0.477). Comorbidities showed inconsistent, but generally non-significant, associations with COVID-19 infection.
Conclusions
Low serum vitamin-D levels were significantly associated with the risk of COVID-19 infection. This relationship was stronger in female than in male COVID-19 patients. Limited evidence was found for the relationships between comorbidities and COVID-19 infection, warranting large population-based studies to clarify these associations.
Summary

Citations

Citations to this article as recorded by  
  • Effects of vitamin D on the incidence and severity of COVID-19
    V. V. Krivosheev, L. Yu. Nikitina, I. V. Kozlovskiy, A. V. Fedorov
    Sanitarnyj vrač (Sanitary Doctor).2024; (1): 27.     CrossRef
  • Ukrainian Consensus on Diagnosis and Management of Vitamin D Deficiency in Adults
    Nataliia Grygorieva, Mykola Tronko, Volodymir Kovalenko, Serhiy Komisarenko, Tetiana Tatarchuk, Ninel Dedukh, Mykola Veliky, Serhiy Strafun, Yulia Komisarenko, Andrii Kalashnikov, Valeria Orlenko, Volodymyr Pankiv, Oleg Shvets, Inna Gogunska, Svitlana Reg
    Nutrients.2024; 16(2): 270.     CrossRef
  • Effect of Vitamin D3 Supplementation on Severe COVID-19: A Meta-Analysis of Randomized Clinical Trials
    Marharyta Sobczak, Rafał Pawliczak
    Nutrients.2024; 16(10): 1402.     CrossRef
  • Methodological issues in designing and reporting of systematic reviews in assessing association between vitamin D supplementation and COVID-19 severity
    R Bajpai
    QJM: An International Journal of Medicine.2023; 116(5): 406.     CrossRef
  • Mechanistic Insight into the role of Vitamin D and Zinc in Modulating Immunity Against COVID-19: A View from an Immunological Standpoint
    Nuzhat Ahsan, Mohammad Imran, Yousuf Mohammed, Fatme Al Anouti, Mohammad Idreesh Khan, Tanushree Banerjee, Mohd Adnan, Fauzia Ashfaq, Marek Kieliszek, Syed Amir Ashraf, Afrozul Haq
    Biological Trace Element Research.2023; 201(12): 5546.     CrossRef
  • The Role of Diet and Specific Nutrients during the COVID-19 Pandemic: What Have We Learned over the Last Three Years?
    Petra Rust, Cem Ekmekcioglu
    International Journal of Environmental Research and Public Health.2023; 20(7): 5400.     CrossRef
  • Self-Reported Pre-Pandemic Physical Activity and Likelihood of COVID-19 Infection: Data from the First Wave of the CoCo-Fakt Survey
    Nikola Schmidt, Andreas Gehlhar, Barbara Grüne, Annelene Kossow, Thomas Kraus, Johannes Nießen, Stefanie Wessely, Christine Joisten
    Sports Medicine - Open.2023;[Epub]     CrossRef
  • Diagnosis, prevention and treatment of vitamin D deficiency in adults: Ukrainian experts consensus statement
    N.V. Grygorieva, M.D. Tronko, V.M. Kovalenko, S.V. Komisarenko, T.F. Tatarchuk, N.V. Dedukh, M.M. Veliky, S.S. Strafun, Y.I. Komisarenko, A.V. Kalashnikov, V.L. Orlenko, V.I. Pankiv, O.V. Shvets, I.V. Gogunska, S.I. Regeda
    PAIN, JOINTS, SPINE.2023; 13(2): 60.     CrossRef
  • Vitamin D Deficiency and COVID-19: A Biological Database Study on Pathways and Gene-Disease Associations
    Ángela Alcalá-Santiago, Miguel Rodríguez-Barranco, Marta Rava, María Ángeles Jiménez-Sousa, Ángel Gil, María José Sánchez, Esther Molina-Montes
    International Journal of Molecular Sciences.2022; 23(22): 14256.     CrossRef
Original Article
Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013
Ram Bajpai, Himanshu Chaturvedi, Lakshmanan Jayaseelan, Pauline Harvey, Nicole Seguy, Laxmikant Chavan, Pinnamaneni Raj, Arvind Pandey
J Prev Med Public Health. 2016;49(6):394-405.   Published online October 28, 2016
DOI: https://doi.org/10.3961/jpmph.16.073
  • 7,783 View
  • 167 Download
  • 9 Crossref
AbstractAbstract PDF
Objectives
The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India.
Methods
The present study used data from 139 679 HIV patients aged ≥15 years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival.
Results
The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for <100 cells/mm3 vs. >350 cells/mm3), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients.
Conclusions
The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.
Summary

Citations

Citations to this article as recorded by  
  • Highly active antiretroviral therapy is necessary but not sufficient. A systematic review and meta-analysis of mortality incidence rates and predictors among HIV-infected adults receiving treatment in Ethiopia, a surrogate study for resource-poor settings
    Beshada Zerfu Woldegeorgis, Yordanos Sisay Asgedom, Aklilu Habte, Gizachew Ambaw Kassie, Abebe Sorsa Badacho
    BMC Public Health.2024;[Epub]     CrossRef
  • Association Between Body Mass Index Variation and Early Mortality Among 834 Ethiopian Adults Living with HIV on ART: A Joint Modelling Approach
    Animut Alebel, David Sibbritt, Pammla Petrucka, Daniel Demant
    Infectious Diseases and Therapy.2023; 12(1): 227.     CrossRef
  • Prognoses of the HIV Infection Under Long-Time Arv Therapy: The Role of Timely Treatment Initiation and the Drugs' Effectiveness
    Ramón E. R. González, Pedro Hugo de Figueirêdo, Sergio Galvao Coutinho
    SSRN Electronic Journal.2022;[Epub]     CrossRef
  • Rate and Predictors of Mortality Among Adults on Antiretroviral Therapy at Debre Markos Referral Hospital, North West Ethiopia
    Haddis Birhanu, Atsede Alle, Molla Yigzaw Birhanu
    HIV/AIDS - Research and Palliative Care.2021; Volume 13: 251.     CrossRef
  • Predictors of Mortality Among Adult HIV-Infected Patients Taking Antiretroviral Therapy (ART) in Harari Hospitals, Ethiopia
    Abdi Birhanu, Tariku Dingeta, Moti Tolera
    HIV/AIDS - Research and Palliative Care.2021; Volume 13: 727.     CrossRef
  • Cost-effectiveness of a novel strategy of HIV/AIDS care in Armed Forces: A stochastic model with Monte Carlo simulation
    S. Shankar, Santosh Karade, Rajul K. Gupta, M.V. Singh
    Medical Journal Armed Forces India.2020; 76(3): 284.     CrossRef
  • How varying CD4 criteria for treatment initiation was associated with mortality of HIV-patients? A retrospective analysis of electronic health records from Andhra Pradesh, India
    Ram Bajpai, Himanshu K Chaturvedi, Josip Car
    Journal of Global Health.2020;[Epub]     CrossRef
  • Survival after Long-Term ART Exposure: Findings from an Asian Patient Population Retained in Care beyond 5 Years on ART
    Rimke Bijker, Sasisopin Kiertiburanakul, Nagalingeswaran Kumarasamy, Sanjay Pujari, Ly P Sun, Oon T Ng, Man P Lee, Jun Y Choi, Kinh V Nguyen, Yu J Chan, Tuti P Merati, Do D Cuong, Jeremy Ross, Awachana Jiamsakul
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  • Survival rate and mortality risk factors among TB–HIV co-infected patients at an HIV-specialist hospital in Myanmar: A 12-year retrospective follow-up study
    Zaw Zaw Aung, Yu Mon Saw, Thu Nandar Saw, Nwe Oo, Hnin Nwe Ni Aye, Sithu Aung, Htun Nyunt Oo, Su Myat Cho, Moe Khaing, Tetsuyoshi Kariya, Eiko Yamamoto, Nobuyuki Hamajima
    International Journal of Infectious Diseases.2019; 80: 10.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health
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