BACKGROUND: Coronavirus disease 2019 (COVID-19) is a disease primarily affecting the respiratory tract, however due to the nature of the pathogenesis it is able to affect the whole body. So far, no causative treatment has been found and the main strategy when dealing with COVID-19 relies on widespread vaccination programs and symptomatic treatment. Vitamin D due to its ability to modulate the immunological system has been proposed as a factor playing role in the organism response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Therefore, we decided to perform this meta-analysis which aimed to establish a connection between vitamin D status and COVID-19 infection. METHODS: Study was designed as a systematic review and meta-analysis. PubMed, EMBASE, Web of Science, Cochrane Collaboration Databases and Scopus electronic databases were searched for relevant studies from database inception to May 10th, 2021. Mean differences (MDs) with their 95% confidence intervals (CI) were calculated. RESULTS: Thirteen studies providing data for 14,485 participants met the inclusion criteria. Mean vitamin D levels in SARS-CoV-2 negative patients was 17.7 ± 6.9 ng/mL compared to SARS-CoV-2 positive patients 14.1 ± 8.2 ng/mL (MD = 3.93; 95% CI 2.84-5.02; I2 = 99%; p < 0.001). CONCLUSIONS: Low serum vitamin D levels are statistically significantly associated with the risk of COVID-19 infection. Supplementation of vitamin D especially in the deficiency risk groups is indicated.

1st Chair and Department of Cardiology Medical University of Warsaw Poland

1st Department of Cardiology Medical University of Gdansk Poland

Department of Cardiology University Medical Center Utrecht The Netherlands

Department of Pediatrics and Children's Diabetology Faculty of Medical Sciences in Katowice Medical University of Silesia Zabrze Poland

Department of Surgery The Silesian Hospital in Opava Czech Republic

Health Service Department Italian State Police Ministry of the Interior Milano Italy

Henry JN Taub Department of Emergency Medicine Baylor College of Medicine Houston TX United States

Institute of Outcomes R esearch Polonia University Czestochowa Poland

Maria Sklodowska Curie Bialystok Oncology Center Bialystok Poland

Maria Sklodowska Curie Medical Academy Warsaw Poland

Polish Society of Disaster Medicine Warsaw Poland

Post graduate School of Occupational Health Università Cattolica del Sacro Cuore Rome Italy

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Vitamin D supplementation to treat SARS-CoV-2 positive patients. Evidence from meta-analysis