Effect of Vitamin D3 Supplementation on Severe COVID-19: A Meta-Analysis of Randomized Clinical Trials.

Since the beginning of the COVID-19 pandemic, vitamin D has attracted interest due to its immunomodulatory properties. Numerous studies show a correlation between vitamin D levels and COVID-19 cases and mortality. Therefore, we conducted a meta-analysis in order to assess the relationship between vitamin D3 supplementation and COVID-19 severity. We included 13 randomized clinical trials that contained the analyzed endpoints: length of COVID-19 hospitalization, number of intensive care unit (ICU) admissions, length of stay in the ICU, number of cases requiring any supplemental oxygenation, duration of any supplemental oxygenation, number of overall mortality and number of deaths associated with COVID-19. The relative risk with 95% confidence interval (CI) and the mean difference with 95% CI were calculated to compare the effect. A random effects model was used to calculate effect sizes. Our meta-analysis showed a positive effect of vitamin D3 supplementation on ICU admission (RR = 0.73; 95% CI [0.57; 0.95], p = 0.02, I2 = 19.6%) and mortality associated with COVID-19 among patients (RR = 0.56; 95% CI [0.34; 0.91]; p = 0.02; I2 = 0%). Vitamin D3 supplementation may potentially reduce the risk of ICU admission and death associated with COVID-19.

Was China's zero-COVID policy the right choice? The multiple factor analysis of variables that affected the course of COVID-19 pandemic in China.

Background: After 3 years of the COVID-19 pandemic and zero-COVID policy, a rapid increase in the number of daily COVID-19 infections was observed in China from November to December 2022. Therefore, we decided to analyze the factors that have been related to the COVID-19 pandemic in China. Methods: The multiple factor analysis was conducted, using the data from publicly available databases from the beginning of the COVID-19 pandemic to 30 January 2023. Results: Our study showed that each year of the pandemic in China had different profiles and can be described by different variables: year 2020 was characterized by restrictions, such as international travel controls, stay at home requirements, and health system policies including contact tracing and protection of older adults; year 2021 was characterized by Alpha, Beta, Gamma, and Delta variants; 2022 was characterized by new cases per million, Omicron lineages, and a few restrictions-related variables; and year 2023 was mainly described by the number of new deaths per million and Omicron variant 22B (BA.5) but also by testing and vaccination policies, as well as the number of people fully vaccinated per 100 and total boosters per 100. Conclusion: The COVID-19 pandemic has changed over time. Therefore, the anti-pandemic policies implemented must be dynamic and adapted to the current situation.

Which Factors Were Related to the Number of COVID-19 Cases in the 2022/2023 Season Compared to the 2021/2022 Season in Europe?

The number of COVID-19 cases was greater in early autumn 2022 in contrast to in autumn 2021. Therefore, we decided to examine the factors that may have affected differences in the number of COVID-19 cases between the time periods 2021/2022 and 2022/2023 with consideration of the occurrence of influenza. In this cross-sectional study, we conducted a multiple factor analysis using data from publicly available databases for weeks 35-14 in 2022/2023 and 2021/2022 for Austria, Germany, Greece, Italy, and Slovenia. In the 2021/2022 season, the analyzed countries had similar profiles and were characterized by restrictions, health system policies, and SARS-CoV-2 variants, such as Alpha, Beta, Delta, Kappa, Eta, as well as Omicron sublineages (BA.1, BA.2), which were positively correlated with the number of new cases of COVID-19 per million people. However, in the 2022/2023 season, the analyzed countries were described by groups of variables corresponding to vaccination, influenza, the number of flights, and the Omicron SARS-CoV-2 subvariant. In summary, crucial factors correlated with the increasing of number of COVID-19 cases in the 2021/2022 season were the presence of dominant SARS-CoV-2 variants as well as the lifting of restrictions and strict health system policies.

Relationship between vitamin D and asthma from gestational to adulthood period: a meta-analysis of randomized clinical trials.

BACKGROUND: Despite numerous studies investigating vitamin D, its impact on asthma is still unknown. The aim of our meta-analysis is to analyze the vitamin D supplementation influence on asthma prevention and treatment ranging from gestational to adulthood period. METHODS: Fifteen randomized clinical trials were included after database search. Studies contained the analyzed endpoints: the number of asthma and wheezing occurrence in gestational and infantile periods, the change of childhood/adult asthma control test score and forced expiratory volume in one second (FEV1) in childhood and adulthood periods. Random effects model was used to calculate effect sizes. RESULTS: Supplementation by women during pregnancy period decreased the wheezing occurrence in their children by 23% (RR = 0.77; 95% CI [0.64; 0.92]; p < 0.0049, I2 = 0%); whereas had no effect on given asthma parameters during the infantile period. Moreover, vitamin D administration had negative effect on the FEV1 change in children (MD = -3.84; 95% CI [-7.68; -0.01]; p = 0.0497; I2 = 95%), but had positive effect on the change of ACT score in adults (MD = 1.80; 95% CI [0.12; 3.49]; p = 0.0359; I2 = 99%). CONCLUSIONS: Our meta-analysis showed the varying results depending on patient's life period. It is important to further investigate the role of vitamin D supplementation in asthma management.

Does Vitamin D Work Synergistically with Anti-Asthmatic Drugs in Airway Remodeling?

Vitamin D is commonly known for its properties of airway remodeling inhibition. Due to this, we decided to analyze the action of calcitriol with anti-asthmatic drugs in airway remodeling. The HFL1 cell line was treated with calcitriol, beclomethasone 17-propionate, montelukast sodium, LTD4 and TGF-ß in different combinations. Real-time PCR was used to analyzed the expression of ACTA2, CDH-1, Vimentin, ADAM33, MMP-9 and CysLTR1 on the mRNA level, whereas Western blot was used to analyze gene expression on the protein level. One-way analysis variants, the Kruskal-Wallis test, Student's t-test or Welch's t-test were used for statistical analysis. Concerning the results, pre-treatment with calcitriol increased the inhibitory effect of beclomethasone 17-propionate and montelukast sodium on the expression of ACTA2 (p = 0.0072), Vimentin (p = 0.0002) and CysLTR1 (p = 0.0204), and 1,25(OH)2D3 had an influence on the effects of beclomethasone 17-propionate and montelukast sodium and of CDH1 expression (p = 0.0076). On the protein level, pre-treatment with calcitriol with beclomethasone 17-propionate and montelukast sodium treatment decreased ACTA2 expression in comparison to the LT (LTD4 and TGF-ß) control group (p = 0.0191). Hence, our study not only confirms that vitamin D may inhibit airway remodeling, but also shows that vitamin D has a synergistic effect with anti-asthmatic drugs.

COVID-19 mortality rate determinants in selected Eastern European countries.

BACKGROUND: The COVID-19 pandemic has caused increased mortality worldwide. We noticed a tendency for higher number of deaths in Eastern European countries. Therefore, we decided to investigate whether any common factor that might be responsible for the increased COVID-19 mortality exists. METHODS: In our cross-sectional study, we conducted the correlation and multiple regression analysis using R basing on the data gathered in publicly available databases. In the analysis, we included variables such as: number of deaths, number of new cases, number of hospitalizations, number of ICU (intensive care units) patients, number of vaccinations, number of boosters, number of fully vaccinated individuals, stringency index, number of reported COVID-19 variant cases, and number of flights. Additionally, we analyzed the influence of population density and median age in particular European countries on total number of COVID-19 deaths. Analyzed data represents periods from start of the COVID-19 pandemic in particular Eastern European Countries: Bulgaria, Croatia, Czech Republic, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia and Slovenia, while as the end of the study the day of January 31, 2022 is considered. Results were considered statistically significant at p < 0.05. RESULTS: Our study showed that mortality rate reflects the number of COVID-19 cases (e.g. for Poland was 0.0058, p < 0.001), number of hospitalized patients (e.g. for Poland 0.0116, p < 0.001), and patients in intensive care (e.g. for Slovakia 0.2326, p < 0.001). Stringency index corresponding to level of introduced restrictions and vaccination can affect the mortality rate of COVID-19 in a country-dependent manner: e.g. for Romania 0.0006, p < 0.001; whereas in Lithuania - 0.0002, p < 0.001. Moreover, occurrence of B.1.1.7 and B.1.617.2 variants increased COVID-19 mortality rates. CONCLUSION: Our analysis showed that crucial factor for decreasing mortality is proper healthcare joined by accurate restriction policy. Additionally, our study shows that COVID-19 vaccination proven successful in COVID-19 mortality prevention.

Factors That Affect the COVID-19 Pandemic in Summer 2022 Compared to Summer 2021.

The COVID-19 pandemic still goes on. The increasing number of COVID-19 cases has been observed since the start of summer 2022, although this was not in summer 2021. Therefore, we would like to compare factors that were responsible for this trend in five selected countries in the European Union (Greece, Italy, Slovenia, Austria and Germany) using the data from publicly available databases for the analyzed period of weeks 22-30 in 2021 and 2022. The multiple factor analysis was conducted in R, using mean or median score. Our cross-sectional study showed that analyzed countries had similar profiles in 2021 characterized by restrictions and health system policies, as well as B.1.351, B.1.1.7, B.1.617.2 and P.1 variants. Similarly, these countries had similar profiles in 2022, but described by other variables: number of new COVID-19 cases per million, number people fully vaccinated per hundred, number of total boosters administered per hundred and also occurrence of Omicron variant and its sub-lineages. Although the COVID-19 vaccination rate is relatively high in the European Union, during the summer of 2022, the number of COVID-19 cases sharply increased daily, which seems to be connected with the presence of the Omicron variant and its sub-lineages.

COVID-19 vaccination efficacy in numbers including SARS-CoV-2 variants and age comparison: a meta-analysis of randomized clinical trials.

BACKGROUND: New vaccines are being developed to fight the ongoing COVID-19 pandemic. In our study we compared the efficacy of COVID-19 vaccines to prevent COVID-19-related infections and mortality. METHODS: 17 randomized clinical trials of COVID-19 vaccines were included after search in databases. We compared COVID-19 vaccines based on symptomatic and severe infections, number of deaths and hospitalizations related to COVID-19. Also, we analyzed the efficacy of COVID-19 against different variants of SARS-CoV-2 as well as according to different age groups. Random effects model using Mantel-Haenzeal method was used to pool relative risk (RR). RESULTS: Our meta-analysis shows that full vaccination could decrease not only the risk of symptomatic or severe COVID-19, the risk of hospitalization and death caused by COVID-19. COVID-19 vaccines were also effective against variants of SARS-CoV-2 (RR = 0.36; 95% CI [0.25; 0.53], p < 0.0001). However, efficacy of vaccination varied in COVID-19 variant-dependent manner. Moreover, the analysis in different age groups showed that COVID-19 vaccines had the similar results: the risk was slightly lower in adults compared to elderly cohort [Formula: see text] 65 years): (RR = 0.16, 95% CI [0.11; 0.23]) and (RR = 0.19, 95% CI [0.12; 0.30]), respectively. CONCLUSIONS: Data obtained from clinical trials of COVID-19 vaccines looks promising, in order to fully investigate efficacy of the vaccines further clinical examination is required especially considering new SARS-CoV-2 variants.

The risk of anaphylaxis behind authorized COVID-19 vaccines: a meta-analysis.

BACKGROUND: A serious allergic reaction that may occur in response to medical products is anaphylaxis, which potentially can lead to anaphylactic shock. In the light of recent COVID-19 pandemic, much public attention had been paid to the severe allergic reactions occurring after COVID-19 vaccination. Therefore, in our study we would like to investigate the risk of authorized COVID-19 vaccines to induce anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock. METHODS: We searched databases, such as PubMed, Web of Science and Embase and found eight articles about the incidence of anaphylactic and anaphylactoid reactions. Also, we used data from four databases from Canada, the U.S., the European Union and the United Kingdom. To calculate effect sizes, we used random effects model with inverse variance method. The risk ratio with 95% confidence interval were used for dichotomous outcomes. Statistical analysis was prepared in R. Results were considered statistically significant at p < 0.05. RESULTS: The most cases of anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock were reported in female aged 18-85 years after BNT162b2 vaccine according to data from the EU. Analyzed COVID-19 vaccines can cause the anaphylaxis/anaphylactic reaction with risk of 106.99 (95% CI [39.95; 286.57], p < 0.0001, I2 = 59%), whereas the anaphylactoid reaction, anaphylactic and anaphylactoid shocks with risk of 113.3 (95% CI [28.11; 456.53], p < 0.0001), 344.2 (95% CI [85.77; 1381.39], p < 0.0001), 14.9, 95% CI [1.96; 112.79], p = 0.009), respectively. CONCLUSIONS: Our meta-analysis shows that the risk of anaphylactic reaction, anaphylactoid reaction, anaphylactic shock and anaphylactoid shock do not occur only after mRNA COVID-19 vaccines. Therefore, vaccination centers should be prepared to render assistance in the event of a reaction in all cases.