Epidemiology and Health

COVID-19: Original Article

The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies: Mehmet Onur Kaya, Esra Pamukçu, Burkay Yakar; Epidemiol Health. 2021;43:e2021074. Published online September 23, 2021; DOI: https://doi.org/10.4178/epih.e2021074

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Although vaccination has started, coronavirus disease 2019 (COVID-19) poses a continuing threat to public health. Therefore, in addition to vaccination, the use of supplements to support the immune system may be important. The purpose of this study was to synthesize evidence on the possible effect of low serum vitamin D levels (25[OH]D<20 ng/mL or 50 nmol/L) on COVID-19 infection and outcomes.

METHODS

We searched Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect without any language restrictions for articles published between January 1 and December 15, 2020. We performed 3 meta-analyses (called vitamin D and COVID-19 infection meta-analysis [D-CIMA], vitamin D and COVID-19 severity meta-analysis [D-CSMA], and vitamin D and COV ID-19 mortality meta-analysis [D-CMMA] for COVID-19 infection, severity, and mortality, respectively) to combine odds ratio values according to laboratory measurement units for vitamin D and the measured serum 25(OH)D level.

RESULTS

Twenty-one eligible studies were found to be relevant to the relationship between vitamin D and COVID-19 infection/outcomes (n=205,869). The D-CIMA meta-analysis showed that individuals with low serum vitamin D levels were 1.64 times (95% confidence interval [CI], 1.32 to 2.04; p<0.001) more likely to contract COVID-19. The D-CSMA meta-analysis showed that people with serum 25(OH)D levels below 20 ng/mL or 50 nmol/L were 2.42 times (95% CI, 1.13 to 5.18; p=0.022) more likely to have severe COVID-19. The D-CMMA meta-analysis showed that low vitamin D levels had no effect on COVID-19 mortality (OR, 1.64; 95% CI, 0.53 to 5.06, p=0.390).

CONCLUSIONS

According to our results, vitamin D deficiency may increase the risk of COVID-19 infection and the likelihood of severe disease. Therefore, we recommend vitamin D supplementation to prevent COVID-19 and its negative outcomes.

Summary

Key Message
Although vaccination has started, it seems that Covid-19 will continue to threaten public health for a long time. In addition to the vaccine, the use of supplements to support the immune system may also be important. The purpose of this study is to indicate the possible effect of low serum vitamin D (25(OH)D<20 ng/mL or 50nmol/L) on the Covid-19 infection and outcomes. According to our remarkable results, vitamin D deficiency increases the risk of Covid-19 infection and the potential for the severity of the disease. Therefore, vitamin D supplements should be added to prevention and treatment protocols for Covid-19 disease.

Citations

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Original Article

Development and validation of a sunlight exposure questionnaire for urban adult Filipinos: Marc Gregory Yu, Nina Castillo-Carandang, Maria Elinor Grace Sison, Angelique Bea Uy, Katrina Lenora Villarante, Patricia Maningat, Elizabeth Paz-Pacheco, Eileen Abesamis-Cubillan; Epidemiol Health. 2018;40:e2018050. Published online October 11, 2018; DOI: https://doi.org/10.4178/epih.e2018050

17,061 View
200 Download
5 Web of Science
5 Crossref

Abstract PDF

Abstract

OBJECTIVES
To develop and validate a self-reported sunlight exposure questionnaire (SEQ) for urban adult Filipinos.

METHODS

The study included adults (19-76 years old) in Metro Manila, Philippines, well-versed in the Filipino (Tagalog) language and had resided in Metro Manila for at least 1 year. Exclusion criteria included pregnancy, active skin disorders, and immunocompromised states. An expert panel created a questionnaire in Likert-scale format based on a conceptual framework and 4 existing instruments. The study proceeded in 4 phases: questionnaire item development, translation and back-translation, pretesting, and construct validity and reliability testing using factor analysis, the Cronbach alpha coefficient, and the paired t-test.

RESULTS

A 25-item, self-administered, Filipino (Tagalog) SEQ answerable using a 4-point Likert scale was created. The questionnaire was administered to 260 adult participants twice at a 2-week interval, with all participants completing both the first and second rounds of testing. All questionnaire items possessed adequate content validity indices of at least 0.86. After factor analysis, 3 questionnaire domains were identified: intensity of sunlight exposure, factors affecting sunlight exposure, and sun protection practices. Internal consistency was satisfactory for both the overall questionnaire (Cronbach alpha, 0.80) and for each of the domains (Cronbach alpha, 0.74, 0.71, and 0.72, respectively). No statistically significant differences were observed in the responses between the first and second rounds of testing, indicating good test-retest reliability.

CONCLUSIONS

We developed a culturally-appropriate SEQ with sufficient content validity, construct validity, and reliability to assess sunlight exposure among urban adult Filipinos in Metro Manila, Philippines.

Summary

Citations

Citations to this article as recorded by

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