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Review
. 2023 Jan 16;16(1):130.
doi: 10.3390/ph16010130.

RETRACTED: Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis

Christiano Argano  1 , Raffaella Mallaci Bocchio  1 , Giuseppe Natoli  1 , Salvatore Scibetta  1 , Marika Lo Monaco  1   2 , Salvatore Corrao  1   2
Affiliations
Review

RETRACTED: Protective Effect of Vitamin D Supplementation on COVID-19-Related Intensive Care Hospitalization and Mortality: Definitive Evidence from Meta-Analysis and Trial Sequential Analysis

Christiano Argano et al. Pharmaceuticals (Basel). .

Retraction in

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.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study selection process: the flowchart shows the selection process regarding the retrieved citations; randomized controlled trials of treatment and studies not pertinent were excluded, such as studies that did not have outcomes of interest.
Figure 2
Figure 2
Forest plot of the association of protective effect of vitamin D supplementation with intensive care unit admission in patients hospitalized with COVID-19. CI, confidence interval; OR, odds ratio [26,32,36,37,38].
Figure 3
Figure 3
Forest plot of the association of protective effect of vitamin D supplementation with mortality in patients hospitalized with COVID-19. CI, confidence interval; OR, odds ratio [26,32,36,37,38].
Figure 4
Figure 4
Trial sequential analysis of the positive association of protective effect of vitamin D supplementation with intensive care unit admission in patients hospitalized with COVID-19. The cumulative z-curve crosses the trial sequential alpha boundary, suggesting that the positive result is conclusive.
Figure 5
Figure 5
Trial sequential analysis of the false-positive association of protective effect of vitamin D supplementation with mortality in patients hospitalized with COVID-19. The cumulative z-curve is inside the futile boundaries, suggesting that further studies are necessary to confirm the association.
See this image and copyright information in PMC

References

    1. COVID-19 Map. [(accessed on 22 September 2022)]. Available online: https://coronavirus.jhu.edu/map.html.
    1. Gallo G., Calvez V., Savoia C. Hypertension and COVID-19: Current Evidence and Perspectives. High Blood Press. Cardiovasc. Prev. 2022;29:115–123. doi: 10.1007/s40292-022-00506-9. - DOI - PMC - PubMed
    1. Bansal M. Cardiovascular Disease and COVID-19. Diabetes Metab. Syndr. 2020;14:247–250. doi: 10.1016/j.dsx.2020.03.013. - DOI - PMC - PubMed
    1. Corrao S., Pinelli K., Vacca M., Raspanti M., Argano C. Type 2 Diabetes Mellitus and COVID-19: A Narrative Review. Front. Endocrinol. 2021;12:609470. doi: 10.3389/fendo.2021.609470. - DOI - PMC - PubMed
    1. Singh D., Mathioudakis A.G., Higham A. Chronic Obstructive Pulmonary Disease and COVID-19: Interrelationships. Curr. Opin. Pulm. Med. 2022;28:76–83. doi: 10.1097/MCP.0000000000000834. - DOI - PMC - PubMed