PDF(Pubmed)
Abstract：
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.
摘要：
自大流行开始以来，已经研究了维生素D在2019年冠状病毒病(COVID-19)易感性中的作用，但是关于儿童的数据仍然很少。我们调查了维生素D状态和相关遗传变异对儿童COVID-19易损性和疾病严重程度的影响。根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价。为了确定维生素D状态和遗传多态性的报告，它们与儿童对COVID-19和儿童多系统炎症综合征（MIS-C）的易感性有关，以及补充对临床过程的影响。在最初总共279篇文章中，26项研究，在2020年9月至2023年5月之间发表的文章，最终根据纳入标准纳入本综述。11项研究提供的定量数据显示，43.05%的儿童COVID-19患者维生素D水平较低。在COVID-19病例中，平均血清25（OH）D水平明显较低，估计合并平均值为17ng/mL，由16项研究提供。维生素D缺乏和维生素D受体（VDR）FokI多态性可能提示儿科人群对COVID-19易感性的独立危险因素。25（OH）D水平可能构成与COVID-19严重程度和MIS-C相关的重要生物标志物。虽然COVID-19病例补充维生素D显示出良好的效果，对疾病结局的影响仍不确定。
