Conflict of Interests in the Scientific Production on Vitamin D and COVID-19: A Scoping Review
- PMID: 35903374
- PMCID: PMC9320027
- DOI: 10.3389/fpubh.2022.821740
Conflict of Interests in the Scientific Production on Vitamin D and COVID-19: A Scoping Review
Abstract
The use of scientific evidence to support the process of formulating and implementing public policies might be biased by studies funded by the pharmaceutical and food industry, which more often than not meet corporate interests. This review aimed to analyze the occurrence of conflict of interest (COI) in academic production regarding vitamin D and COVID-19, considering the facility offered during the pandemic for academic publications of heterogeneous quality. A scoping review of observational studies published in Medline, Lilacs, and Google Scholar databases was carried out. The selected studies were published between December 2019 and August 2021, focused on the relationship between vitamin D and prevention or treatment of COVID-19 in non-institutionalized individuals, with no language restrictions. Twenty-nine studies met eligibility criteria. COI was disclosed in five papers and further identified by review authors in eight other papers, meaning COI was present in thirteen papers (44.8%). Studies were funded by companies in the diagnostics, pharmaceutical and food sectors. Conclusions favorable to vitamin D supplementation were more prevalent in papers where COI was identified (9/13, 69.2%) than among papers where COI was not found (4/16, 25.0%). Omissions of disclosure of COI, funding source, and sponsor functions were observed. The identification of possible corporate political activities in scientific papers about vitamin D published during the COVID-19 pandemic signals a need for greater transparency and guideline development on the prevention of COI in scientific production.
Keywords: COVID-19; SARS-CoV-2; commercial determinants of health; conflict of interest (COI); corporations; public health; scientific production; vitamin D.
Copyright © 2022 Passini, Cavalcanti, Ribas, de Carvalho, Bocca and Lamarca.
Conflict of interest statement
Among included studies, five reported COI with industries (42, 44, 49, 51, 53) and 24 reported absence of COI or did not report on COI (25–41, 43, 45–48, 50, 52). After analyzing the funding section as well as other papers published by authors in 2020 and 2021, eight studies were found to have ties with industries (25, 26, 28, 33, 36, 38, 46, 48), totaling 13 studies (44.8% of the sample) where COI was identified. In addition to COI, other CPA were evaluated. No “striking titles” were identified. No attempt to discredit other studies was identified either. Regarding the reporting of limitations and bias, only one study (33) did not objectively report on it. Exposures and outcomes were considered adequate to respond each study's questions. However, in eight of the 29 studies (25, 26, 30–33, 42, 51) authors suggested supplementation of vitamin D for the prevention or treatment of COVID-19 in the conclusion, even though this was not one of the study's stated aims. Of these eight studies which support vitamin D supplementation unsupported by their own data, five (62.5%) were identified as having COI (25, 26, 33, 42, 51). The flowchart of the identification of COI and CPA situations is shown in Figure 2. Figure 2Conflict of Interest and Corporate Political Activities identification flowchart.Diagnostics-, pharmaceuticals- and food- companies were the source of COI in the analyzed papers. A relationship with diagnostic industry was observed in five of the 13 studies (42, 44, 46, 48, 53), seven of the studies had COI due to their links with the pharmaceutical industry (25, 26, 28, 33, 36, 38, 51), while one study had ties to both pharmaceutical and food industries (49) (Table 2). Table 2Characterization of conflict of interest present in the sample (n = 13).References, CountryConclusion in favor of vitamin D supplementationFunding, financial support or employment relationships between authors and corporationsCorporation sectorAbdulateef et al. (46), IraqYesDA, authored a study supported by the companies MediaMed Lab and Saman Lab in February 2020DiagnosticsAl-Daghri et al. (25), Saudi ArabiaYesAD, Synergy Pharma provided vitamin supplements for the studyPharmacologicalAl Safar et al. (51), United Arab EmiratesYesWBG, receives funding from Bio-Tech Pharmacal, Inc. (Fayetteville, AR)PharmacologicalBasaran et al. (26), TurkeyYesTY, had a study funded by Gilead Sciences in January 2021PharmacologicalBrenner et al. (33), GermanyYesHB, had a study funded by Epigenomics, Applied Proteomics and Roche DiagnosticsPharmacologicalJude et al. (28), United KingdomNoEBJ, a study form March 2021 earned him honoraria from the consulting council of Sanofi, had received honoraria as a lecturer from Bayer AG, Boehringer Ingelheim, Eli Lilly, Novo Nordisk and Takeda. In a study published in December 2020, disclosed relationships with SanofiPharmacologicalKatz et al. (48), USANoJK, disclosed Consulting for HT Bioimaging in a study in October 2020DiagnosticsKaufman et al. (42), USAYesHWK, JKN, MHK e CB are directly employed by Quest Diagnostics. HWK, MHK e CB have Quest Diagnostics action shares. MFH is a consultant for Quest Diagnostics and has been a member of the lecturer committee for Abbott Inc. and Hyatt Pharmaceutical Industries Company PLCDiagnosticsLi et al. (44), USANoStudy was funded by Quest DiagnosticsDiagnosticsLouca et al. (49), United KingdomYesTDS, AMV, ERL e SEB consult for Zoe Global Limited ('Zoe'); JW is directly employed by Zoe; PCC has research funding from BASF AS and Bayer Consumer Care, and is a consultant for BASF AS, DSM, Danone Nutricia, Cargill, Smartfish, Nutrileads, Bayer Consumer Care and Pfizer (now GSK) and Consumer Healthcare. He has received refunds for trips and fees conceded by Danone, Fresenius Kabi, Pfizer (now GSK), Consumer Healthcare, Smartfish, Biogredia and the California Walnut Commission. ATC has recied honoraria as a consultant to Bayer Pharma, Pfizer and Boehringer IngelheimPharmacological/ food industryOristell et al. (36), BarcelonaYesEC, disclosed having received honoraria as a lecturer or consultant from Amgen, Lilly, UCB, Rubió and Theramex in a paper published in 2021. In a different study published 2020 he disclosed to be a lecturer for Amgen Inc., Lilly and Rubió; and receiving honoraria from Stada, Theramex and UCB PharmaPharmacologicalPapadimitriou et al. (53), GreeceYesMFH, was a consultant for Quest Diagnostics and Ontometrics Inc. and a lecturer with Abbott Inc.DiagnosticsRaisi-Estabragh et al. (38), United KingdomNoNH, disclosed in a study published in October 2021 to have received consulting feed, honoraria or subsidies from Alliance for Better Bone Health, Amgen, MSD, Eli Lilly, Servier, Shire, UCB, Consilient Healthcare, Radius Health, Kyowa Kirin, and Internis PharmaPharmacologicalOnly 23% of all COI (3/13) were due to direct funding to carry out the study (39, 41, 49). Authors of two of these studies (39, 41) stated that the sponsoring company did not play a role in the selection or methodological evaluation of the included studies, nor in the interpretation of the results or conclusions reached. No COI were identified in 16 studies in the sample. Of these, 12 acknowledge funding via grants from governments, universities or academic research centers (25, 27, 31, 33–35, 37, 41, 43, 45, 47, 52) and three studies explicitly stated that there had been no sources of funding and no sponsorships (30, 40, 50). One study did not mention whether or not funding was available (32). In studies where COI was identified, the chance of a conclusion recommending vitamin D supplementation for the prevention or treatment of COVID-19 was higher than among studies where COI was not identified [OR: 6.75 (1.32, 34.57)]. In the whole sample, most of the studies (16/29, 55.2%) concluded that vitamin D was not associated with the prevention or treatment of COVID-19 (28, 29, 33, 34, 37–41, 43–45, 47, 48, 50, 52). Among independent studies, the prevalence of a lack of association was even higher (12/16, 75.0%). Regarding the studies where COI was identified (25, 26, 33, 36, 42, 46, 49, 51, 53), the majority concluded in favor of an association between vitamin D and prevention or treatment of COVID-19 (9/13, 69.2%, p = 0.027), as described in Table 3. Table 3Distribution of conclusions regarding vitamin D and COVID-19 prevention or treatment, according to conflict of interest.Conflict of interest (n = 29)Conclusion regarding vitamin D supplementationOdds ratio (95% CI)p-valueaPositive association [n (%)]No association [n (%)]Present (n = 13)9 (69.2%)4 (30.8%)6.75 (1.32, 34.57)0.027Not present (n = 16)4 (25.0%)12 (75.0%)aFisher's exact test.CI, confidence interval.
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References
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- Organização Pan-Americana da Saúde,. Histórico da pandemia de COVID-19 - OPAS/OMS (2020). Available online at: https://www.paho.org/pt/covid19/historico-da-pandemia-covid-19 (accessed June 3, 2021).
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