Drug treatments for covid-19: living systematic review and network meta-analysis

BMJ, Journal Year: 2020, Volume and Issue: unknown, P. m2980 - m2980

Published: July 30, 2020

To compare the effects of treatments for coronavirus disease 2019 (covid-19). Living systematic review and network meta-analysis. WHO covid-19 database, a comprehensive multilingual source global literature, up to 3 December 2021 six additional Chinese databases 20 February 2021. Studies identified as 1 were included in analysis. Randomised clinical trials which people with suspected, probable, or confirmed randomised drug treatment standard care placebo. Pairs reviewers independently screened potentially eligible articles. After duplicate data abstraction, bayesian meta-analysis was conducted. Risk bias studies assessed using modification Cochrane risk 2.0 tool, certainty evidence grading recommendations assessment, development, evaluation (GRADE) approach. For each outcome, interventions classified groups from most least beneficial harmful following GRADE guidance. 463 enrolling 166 581 patients included; 267 (57.7%) 89 814 (53.9%) are new previous iteration; 265 (57.2%) evaluating at 100 events met threshold inclusion analyses. Compared care, three drugs reduced mortality mostly severe moderate certainty: systemic corticosteroids (risk difference 23 fewer per 1000 patients, 95% credible interval 40 7 fewer, certainty), interleukin-6 receptor antagonists when given (23 1000, 36 Janus kinase inhibitors (44 64 high certainty). two probably reduce hospital admission non-severe disease: nirmatrelvir/ritonavir (36 41 26 certainty) molnupiravir (19 29 5 Remdesivir may (29 6 low Only had quality reduction time symptom resolution (3.3 days 4.8 1.6 certainty); several others showed possible benefit. Several increase adverse leading discontinuation; hydroxychloroquine increases mechanical ventilation (moderate Corticosteroids, antagonists, confer other important benefits covid-19. Molnupiravir This not registered. The protocol is publicly available supplementary material. article living that will be updated reflect emerging evidence. Updates occur years date original publication. fifth version published on 30 July 2020 (BMJ 2020;370:m2980), versions can found supplements. When citing this paper please consider adding number access clarity.

Language: Английский

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The health effects of vitamin D supplementation: evidence from human studies

Nature Reviews Endocrinology, Journal Year: 2021, Volume and Issue: 18(2), P. 96 - 110

Published: Nov. 23, 2021

Language: Английский

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Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study)

Postgraduate Medical Journal, Journal Year: 2020, Volume and Issue: 98(1156), P. 87 - 90

Published: Nov. 12, 2020

Abstract Background Vitamin D has an immunomodulatory role but the effect of therapeutic vitamin supplementation in SARS-CoV-2 infection is not known. Aim Effect high dose, oral cholecalciferol on viral clearance. Design Randomised, placebo-controlled. Participants Asymptomatic or mildly symptomatic RNA positive deficient (25(OH)D<20 ng/ml) individuals. Intervention were randomised to receive daily 60 000 IU (oral nano-liquid droplets) for 7 days with target 25(OH)D>50 ng/ml (intervention group) placebo (control group). Patients requiring invasive ventilation significant comorbidities excluded. 25(OH)D levels assessed at day 7, and was continued those <50 intervention arm. inflammatory markers fibrinogen, D-dimer, procalcitonin (CRP), ferritin measured periodically. Outcome measure Proportion patients negative before day-21 change markers. Results Forty individuals (n=16) control (n=24) group. Baseline serum 8.6 (7.1 13.1) 9.54 (8.1 12.5) (p=0.730), group, respectively. 10 out 16 could achieve by day-7 another two day-14 [day-14 51.7 (48.9 59.5) 15.2 (12.7 19.5) (p<0.001) respectively]. (62.5%) participants group 5 (20.8%) arm (p<0.018) became negative. Fibrinogen significantly decreased (intergroup difference 0.70 ng/ml; P=0.007) unlike other biomarkers. Conclusion Greater proportion D-deficient turned a decrease fibrinogen high-dose supplementation. Trial register number NCT04459247.

Language: Английский

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Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity

Nutrients, Journal Year: 2020, Volume and Issue: 12(11), P. 3361 - 3361

Published: Oct. 31, 2020

Vitamin D deficiency co-exists in patients with COVID-19. At this time, dark skin color, increased age, the presence of pre-existing illnesses and vitamin are features severe COVID disease. Of these, only is modifiable. Through its interactions a multitude cells, may have several ways to reduce risk acute respiratory tract infections COVID-19: reducing survival replication viruses, inflammatory cytokine production, increasing angiotensin-converting enzyme 2 concentrations, maintaining endothelial integrity. Fourteen observational studies offer evidence that serum 25-hydroxyvitamin concentrations inversely correlated incidence or severity The date generally satisfies Hill’s criteria for causality biological system, namely, strength association, consistency, temporality, gradient, plausibility (e.g., mechanisms), coherence, although experimental verification lacking. Thus, seems strong enough people physicians can use recommend supplements prevent treat COVID-19 light their safety wide therapeutic window. In view public health policy, however, results large-scale randomized controlled trials required currently progress.

Language: Английский

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Vitamin D Supplementation Associated to Better Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Quasi-Experimental Study

Nutrients, Journal Year: 2020, Volume and Issue: 12(11), P. 3377 - 3377

Published: Nov. 2, 2020

Background. The objective of this quasi-experimental study was to determine whether bolus vitamin D supplementation taken either regularly over the preceding year or after diagnosis COVID-19 effective in improving survival among hospitalized frail elderly patients. Methods. Seventy-seven patients consecutively for a geriatric unit were included. Intervention groups participants supplemented with (Group 1), and those 2). comparator group involved having received no supplements 3). Outcomes 14-day mortality highest (worst) score on ordinal scale clinical improvement (OSCI) measured during acute phase. Potential confounders age, gender, functional abilities, undernutrition, cancer, hypertension, cardiomyopathy, glycated hemoglobin, number health issues at admission, hospital use antibiotics, corticosteroids, pharmacological treatments respiratory disorders. Results. three (n = 77; mean ± SD, 88 5 years; 49% women) similar baseline (except woman proportion, p 0.02), as used COVID-19. In Group 1 29), 93.1% survived day 14, compared 81.2% survivors 2 16) (p 0.33) 68.7% 3 32) 0.02). While considering reference (hazard ratio (HR) fully-adjusted HR 0.07 0.017) 0.37 0.28) 2. had longer time than (log-rank 0.015), although there difference between Groups 0.32). 1, but not 0.40), associated lower risk OSCI ≥5 (odds 0.08, 0.03). Conclusions. Regular less severe better elderly.

Language: Английский

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Dietary Supplements during COVID-19 Outbreak. Results of Google Trends Analysis Supported by PLifeCOVID-19 Online Studies

Nutrients, Journal Year: 2020, Volume and Issue: 13(1), P. 54 - 54

Published: Dec. 27, 2020

The use of dietary supplements (DSs) has been steadily increasing all over the world and additionally, sales DSs have dynamical increased in wake coronavirus disease 2019 (COVID-19) most countries. We investigated phenomenon 2020 through (1) exploration Google searches worldwide Poland (with Trends (GT) tool), (2) analyses results PLifeCOVID-19 Online Studies conducted during first second wave pandemic. GT analysis cross-sectional studies revealed that COVID-19 outbreak March 2020, interest immune-related compounds foods like vitamins C D, zinc, omega-3, garlic, ginger, or turmeric, as well their consumption increased. Improving immunity was main reason behind supplementation changes pro-healthy foods. shown these interests were positively correlated with COVID-19, but adversely cumulative cases deaths. Respondents tended to start rather than one. Except for role D C, selenium patients deficiencies those nutrients, there are no clear convincing support prevention treatment healthy, well-nourished individuals. Moreover, risk elevated intake some nutrients due popularity exists, effective education consumers rationale health-protecting behaviors against should be developed.

Language: Английский

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Vitamin D, infections and immunity

Reviews in Endocrine and Metabolic Disorders, Journal Year: 2021, Volume and Issue: 23(2), P. 265 - 277

Published: July 29, 2021

Abstract Vitamin D, best known for its role in skeletal health, has emerged as a key regulator of innate immune responses to microbial threat. In cells such macrophages, expression CYP27B1, the 25-hydroxyvitamin D 1α-hydroxylase, is induced by immune-specific inputs, leading local production hormonal 1,25-dihydroxyvitamin (1,25D) at sites infection, which turn directly induces genes encoding antimicrobial peptides. signaling active upstream and downstream pattern recognition receptors, promote front-line responses. Moreover, 1,25D stimulates autophagy, mechanism critical control intracellular pathogens M. tuberculosis . Strong laboratory epidemiological evidence links vitamin deficiency increased rates conditions dental caries, well inflammatory bowel diseases arising from dysregulation handling intestinal flora. also cascades that antiviral immunity; 1,25D-induced peptide CAMP/LL37, originally characterized antibacterial properties, component Poor status associated with greater susceptibility viral infections, including those respiratory tract. Although severity COVID-19 pandemic been alleviated some areas arrival vaccines, it remains important identify therapeutic interventions reduce disease mortality, accelerate recovery. This review outlines our current knowledge mechanisms action system. It provides an assessment potential supplementation infectious diseases, up-to-date analysis putative benefits ongoing crisis.

Language: Английский

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The link between COVID-19 and VItamin D (VIVID): A systematic review and meta-analysis

Metabolism, Journal Year: 2021, Volume and Issue: 119, P. 154753 - 154753

Published: March 24, 2021

Disease severity and mortality rates due to COVID-19 infection are greater in the elderly chronically ill patients, populations at high risk for vitamin D deficiency. Vitamin plays an important role immune function inflammation. This systematic review meta-analysis assesses impact of status supplementation on related health outcomes.

Language: Английский

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Low vitamin D status is associated with coronavirus disease 2019 outcomes: a systematic review and meta-analysis

International Journal of Infectious Diseases, Journal Year: 2021, Volume and Issue: 104, P. 58 - 64

Published: Jan. 2, 2021

BackgroundObservational studies suggest that the risk and clinical prognosis of coronavirus disease 2019 (COVID-19) are related to low vitamin D status; however, data inconsistent.ObjectivesWe conducted a systematic review meta-analysis assess association between status COVID-19.MethodsA search was with PubMed, Embase, Cochrane Library from database inception September 25, 2020. The standardized mean difference (SMD) or odds ratio (OR) corresponding 95% confidence interval (CI) applied estimate pooled results. Random - fixed-effect models based on heterogeneity were used for meta-analysis. Funnel plots Egger regression tests publication bias.ResultsA total ten articles 361,934 participants selected Overall, OR in model showed deficiency insufficiency associated an increased COVID-19 (OR = 1.43, CI 1.00–2.05). In addition, COVID-19-positive individuals had lower levels than COVID-19-negative (SMD -0.37, -0.52 -0.21). Significant existed both endpoints. revealed significant bias.ConclusionsThis indicated might be infection. Further needed evaluate impact supplementation severity patients COVID-19.Systematic Review RegistrationPROSPERO registration no: CRD42020216740.

Language: Английский

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The Role of Micronutrients in Support of the Immune Response against Viral Infections

Nutrients, Journal Year: 2020, Volume and Issue: 12(10), P. 3198 - 3198

Published: Oct. 20, 2020

Viral infections are a leading cause of morbidity and mortality worldwide, the importance public health practices including handwashing vaccinations in reducing their spread is well established. Furthermore, it known that proper nutrition can help support optimal immune function, impact infections. Several vitamins trace elements play an important role supporting cells system, thus increasing resistance to Other nutrients, such as omega-3 fatty acids, sustain function system. The main aim this manuscript discuss potential micronutrients supplementation immunity, particularly against respiratory virus Literature analysis showed vitro observational studies, clinical trials, highlight A, C, D, zinc modulating response. Supplementation with vitamins, omega 3 acids appears be safe low-cost way reduce risk consequences infection, viral should addition healthy diet fall within recommended upper safety limits set by scientific expert bodies. Therefore, implementing nutrition, supplementation, might cost-effective, underestimated strategy burden infectious diseases coronavirus disease 2019 (COVID-19).

Language: Английский

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