Clinical prognosis of coronavirus disease 2019 in children and vitamin D levels: a systematic review

Role of Vitamin D and Vitamin D Polymorphisms in COVID-19 Risk and Severity in Children: A Systematic Review

The role of vitamin D in the susceptibility to coronavirus disease 2019 (COVID-19) disease has been investigated since the beginning of the pandemic, but there is still scarce data on children. We investigated the impact of vitamin D status and the related genetic variants on COVID-19 vulnerability and severity of the disease in children. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to identify reports on vitamin D status and genetic polymorphisms, their association with the susceptibility of children to COVID-19 and multisystem inflammatory syndrome in children (MIS-C), and the effect of supplementation on the clinical course. Of an initial total of 279 articles, 26 studies, published between September 2020 and May 2023, were finally included in this review according to inclusion criteria. Quantitative data provided by 11 studies revealed that 43.05% of pediatric COVID-19 patients had low vitamin D levels. Mean serum 25(OH)D levels were observed to be significantly low in COVID-19 cases, with an estimated pooled mean value of 17 ng/mL, as provided by 16 studies. Vitamin D deficiency and the vitamin D receptor (VDR) FokI polymorphism may suggest independent risk factors for susceptibility to COVID-19 in the pediatric population. The 25(OH)D level may constitute a significant biomarker associated with the COVID-19 severity and MIS-C. While supplementation of COVID-19 cases with vitamin D showed favorable results, the effect on the outcome of the disease remains uncertain.

Micronutrient perspective on COVID-19: Umbrella review and reanalysis of meta-analyses

INTRODUCTION

Micronutrients are clinically important in managing COVID-19, and numerous studies have been conducted, but inconsistent findings exist.

OBJECTIVE

To explore the association between micronutrients and COVID-19.

METHODS

PubMed, Web of Science, Embase, Cochrane Library and Scopus for study search on July 30, 2022 and October 15, 2022. Literature selection, data extraction and quality assessment were performed in a double-blinded, group discussion format. Meta-analysis with overlapping associations were reconsolidated using random effects models, and narrative evidence was performed in tabular presentations.

RESULTS

57 reviews and 57 latest original studies were included. 21 reviews and 53 original studies were of moderate to high quality. Vitamin D, vitamin B, zinc, selenium, and ferritin levels differed between patients and healthy people. Vitamin D and zinc deficiencies increased COVID-19 infection by 0.97-fold/0.39-fold and 1.53-fold. Vitamin D deficiency increased severity 0.86-fold, while low vitamin B and selenium levels reduced severity. Vitamin D and calcium deficiencies increased ICU admission by 1.09 and 4.09-fold. Vitamin D deficiency increased mechanical ventilation by 0.4-fold. Vitamin D, zinc, and calcium deficiencies increased COVID-19 mortality by 0.53-fold, 0.46-fold, and 5.99-fold, respectively.

CONCLUSION

The associations between vitamin D, zinc, and calcium deficiencies and adverse evolution of COVID-19 were positive, while the association between vitamin C and COVID-19 was insignificant.REGISTRATION: PROSPERO CRD42022353953.

The Clinical Significance of Vitamin D and Zinc Levels with Respect to Immune Response in COVID-19 Positive Children

AIM

In this study, we aimed to evaluate serum vitamin D and zinc levels in children diagnosed with coronavirus disease 2019 (COVID-19).

MATERIALS AND METHODS

In this study, 88 children with COVID-19 disease and 88 healthy children aged 1-18 years were enrolled between 01 July 2021 and 30 October 2021 in the Pediatrics Clinic of Tekirdağ Çorlu State Hospital. Serum vitamin D and zinc levels have been measured and NCSS (Number Cruncher Statistical System) program has been utilized for statistical analysis.

RESULTS

We included 88 COVID-19 positive pediatric patients [50% (n = 44) female] and 88 healthy children [48.86% (n = 43) female] in this study. The mean serum vitamin D levels of COVID-19 positive patients were statistically significantly lower than the control group (p = 0.0001). The zinc mean values of the study group were found to be statistically significantly lower than the control group (p = 0.0001). There was a statistically significant correlation between serum vitamin D and zinc values in all patient groups (r = 0.245, p = 0.001).

CONCLUSION

As a result, zinc and vitamin D levels were observed lower in COVID-19 patients than in healthy individuals. Since there is no defined treatment protocol for COVID-19 infection on children yet, zinc and vitamin D supplementation can be used as a supportive treatment in COVID-19 infection.