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NICE Evidence Review of Vitamin D for COVID-19

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NICE Evidence Review of Vitamin D for COVID-19 National Institute for Health and Care Excellence NG187 Vitamin D for COVID-19 [A] Evidence reviews for the use of vitamin D supplementation as prevention and treatment of COVID-19 NICE guideline NG187 Evidence reviews underpinning recommendations 1.1 to 1.3 and research recommendations in the NICE guideline December 2020 Final These evidence reviews were developed by Centre for Guidelines Methods and Economics Team Error! No text of specified style in document. Disclaimer The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian. Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties. NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn. Copyright © NICE 2020. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3942-8 Contents 1 Vitamin D for COVID-19 prevention and treatment ........................................................ 7 1.1 Review question ....................................................................................................... 7 What is the clinical effectiveness and safety of vitamin D supplementation for the treatment of COVID-19 in adults, young people and children? ............. 7 1.1.1 Introduction ................................................................................................... 7 1.1.2 Summary of the protocol ............................................................................... 7 1.1.3 Methods and process ................................................................................... 8 1.1.4 Effectiveness evidence ................................................................................. 9 1.1.5 Summary of studies included in the effectiveness and prognostic evidence .................................................................................................... 9 1.1.6 Summary of the effectiveness evidence ....................................................... 9 1.1.7 Economic evidence .................................................................................... 10 1.2 Review question ..................................................................................................... 10 What is the clinical effectiveness and safety of vitamin D supplementation for the prevention of SARS CoV2 infection (and subsequent COVID-19) in adults, young people and children? .......................................................... 10 1.2.1 Introduction ................................................................................................. 10 1.2.2 Summary of the protocol ............................................................................. 10 1.2.3 Methods and process ................................................................................. 11 1.2.4 Effectiveness evidence ............................................................................... 12 1.2.5 Summary of the effectiveness evidence ..................................................... 12 1.2.6 Economic evidence .................................................................................... 12 1.3 Review question ..................................................................................................... 12 Is vitamin D status independently associated with susceptibility to developing COVID-19, severity of COVID-19, and poorer outcomes from COVID- 19 in adults, young people and children? ................................................. 12 1.3.1 Introduction ................................................................................................. 12 1.3.2 Summary of the protocol ............................................................................. 13 1.3.3 Methods and process ................................................................................. 13 1.3.4 Association evidence .................................................................................. 15 1.3.5 Summary of studies included in the effectiveness and prognostic evidence .................................................................................................. 16 1.3.6 Summary of the association evidence ........................................................ 26 1.3.7 Economic evidence .................................................................................... 34 1.3.9 References – included studies .................................................................... 34 Appendices ........................................................................................................................ 37 Appendix A – Review protocols ................................................................................ 37 A.1.1 Review question 1 ............................................................................................. 37 A.1.2 Review question 2 ............................................................................................. 44 4 A.1.3 Review question 3 ............................................................................................. 51 Appendix B – Literature search strategies ............................................................... 58 Medline ALL ................................................................................................................. 58 Embase ........................................................................................................................ 60 Cochrane Database of Systematic Reviews (CDSR) & CENTRAL ............................... 62 MedRxiv & BioRxiv preprints ........................................................................................ 64 World Health Organization Global research on coronavirus disease (COVID-19) ......... 65 Clinicaltrials.gov ........................................................................................................... 66 Appendix C – Effectiveness & association evidence study selection .................... 67 C.1.1 Review question 1 ............................................................................................. 67 C.1.2 Review question 2 ............................................................................................. 68 C.1.3 Review question 3 ............................................................................................. 69 Appendix D – Effectiveness & association evidence ............................................... 70 D.1 Effectiveness evidence .............................................................................................. 70 D.1.1 Vitamin D as treatment ...................................................................................... 70 D.1.1.1 Entrenas Castillo 2020 ...................................................................................... 70 D.2 Association evidence ................................................................................................. 80 D.2.1.1 Annweiler 2020 .................................................................................................. 80 D.2.1.2 Annweiler 2020a ................................................................................................ 92 D.2.1.3 Hastie 2020 ...................................................................................................... 101 D.2.1.4 Hernandez 2020 ............................................................................................... 110 D.2.1.5 Karahan 2020 ................................................................................................... 121 D.2.1.6 Kaufman 2020 .................................................................................................. 128 D.2.1.7 Macaya 2020 .................................................................................................... 134 D.2.1.8 Meltzer 2020 ..................................................................................................... 141 D.2.1.9 Merzon 2020 ..................................................................................................... 154 D.2.1.10 Radujkovic 2020 .............................................................................................. 160 D.2.1.11 Raisi-Estabragh 2020 ...................................................................................... 168 D.2.1.12 Ye 2020 ............................................................................................................
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