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3 februari 2023: Bron:  2023 Jan; 16(1): 130. Published online 2023 Jan 16. Met dank aan Ton Geurtsen die mij op deze studie attent maakte. 

De resultaten van verschillende meta-analyses en respectievelijke sequentiële analyses (TSA's) tonen aan dat er een definitief verband is tussen de beschermende rol van vitamine D en een ziekenhuisopname op de Intensive Care (IC) door een besmetting met het coronavirus - Covid-19.
Mensen die extra vitamine D gebruikten tijdens de besmetting met het coronavirus - Covid-19 en daardoor in het ziekenhuis waren beland hoefden veel minder vaak opgenomen te worden op de Intensive Care (IC) in vergelijking met mensen die geen extra vitamine D gebruikten. Ook het risico te overlijden lag lager bij de vitamine D gebruikers maar omdat de studies niet specifiek daarnaar onderzochten blijken de onderzoekers daar geen harde uitspraken over te doen. 

Een citaat uit het studierapport:

Naar onze mening stellen we, vanwege de steekproefomvang en de precisie van het effect, het Nogues-protocol voor, dat positieve effecten heeft op ziekenhuisopname op de intensive care en mortaliteit. Bij patiënten die met COVID-19 in het ziekenhuis zijn opgenomen, bestaat het toe te dienen protocol uit de toediening van 21.620 IE op dag 1 en 10.810 IE op dag 3, 7, 15 en 30.

Met betrekking tot onze analyse is het de moeite waard om te benadrukken dat, hoewel de aanwezigheid van statistische heterogeniteit en een grote effectgrootte werd waargenomen en slechts een klein aantal studies in aanmerking kwam voor de analyse, de nieuwe uitgevoerde meta-analyses en de TSA's over vitamine D-interventies en opname op de IC en het risico op overlijden bij patiënten die met COVID-19 in het ziekenhuis zijn opgenomen, bevestigen de aanwezigheid van een sterk verband tussen het beschermende effect van vitamine D tegen opname op de IC.
Om het gunstige effect van vitamine D op de mortaliteit in het kader van COVID-19 te bevestigen, is het belangrijk dat studies met een consistente steekproefomvang worden uitgevoerd, en de onderzoeksperiode, de duur van de vitamine D-interventie en de de tijd tot follow-upevaluaties zou lang genoeg moeten zijn om voldoende vitamine D-serumspiegels te bereiken.

Conclusie van een meta-analyse en aparte analyse van elke gerandomiseerde studie (TSA) suggereren een definitief verband tussen de beschermende rol van vitamine D en ziekenhuisopname op de IC..

Het volledige studierapport is gratis in te zien en is zeer gedetailleerd met vele grafieken. Ik vertaal dan ook niet verder maar verwijs naar dit studierapport. Klik op de titel van het abstract:

Abstract

Background: The COVID-19 pandemic represents one of the world's most important challenges for global public healthcare. Various studies have found an association between severe vitamin D deficiency and COVID-19-related outcomes. Vitamin D plays a crucial role in immune function and inflammation. Recent data have suggested a protective role of vitamin D in COVID-19-related health outcomes. The purpose of this meta-analysis and trial sequential analysis (TSA) was to better explain the strength of the association between the protective role of vitamin D supplementation and the risk of mortality and admission to intensive care units (ICUs) in patients with COVID-19.

Methods: We searched four databases on 20 September 2022. Two reviewers screened the randomized clinical trials (RCTs) and assessed the risk of bias, independently and in duplicate. The pre-specified outcomes of interest were mortality and ICU admission.

Results: We identified 78 bibliographic citations. After the reviewers' screening, only five RCTs were found to be suitable for our analysis. We performed meta-analyses and then TSAs. Vitamin D administration results in a decreased risk of death and ICU admission (standardized mean difference (95% CI): 0.49 (0.34-0.72) and 0.28 (0.20-0.39), respectively). The TSA of the protective role of vitamin D and ICU admission showed that, since the pooling of the studies reached a definite sample size, the positive association is conclusive. The TSA of the protective role of vitamin D in mortality risk showed that the z-curve was inside the alpha boundaries, indicating that the positive results need further studies.

Discussion: The results of the meta-analyses and respective TSAs suggest a definitive association between the protective role of vitamin D and ICU hospitalization.

Keywords: COVID-19; ICU hospitalization; meta-analysis; mortality; trial sequential analysis; vitamin D.

Conflict of interest statement

The authors declare no conflict of interest.

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The ENFARMA S.R.L. company contributed only to publication costs and did not influence in any way the conception and writing of the manuscript.

corona virus, COVID-19, bescherming, vitamine D, IC opnames, risico op overlijden, meta-analyse


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