Tesis

Pengaruh Suplementasi Vitamin D Terhadap Derajat Keparahan dan Risiko Mortalitas COVID-19: Sebuah Telaah Sistematis = The Effect of Vitamin D Supplementation on Severity and Mortality Risk of COVID-19 Patient: A Systematic Review.

Kadar vitamin D darah diketahui berhubungan dengan perbaikan disregulasi imunitas dengan menekan badai sitokin, sehingga mencegah perburukan klinis pasien COVID-19. Namun, uji klinis terkait efek suplementasi vitamin D terhadap pasien COVID-19 masih belum konsisten. Tujuan penelitian ini adalah menggabungkan secara sistematis temuan terkait suplementasi vitamin D terhadap derajat keparahan dan mortalitas pasien COVID-19. Penelusuran literatur dilakukan di pangkalan data Pubmed, Cochrane, Science Direct, ProQuest, MedXriv, WileyOnline Library, dan Scopus pada 27 September 2020. Studi yang menilai efek suplementasi vitamin D terhadap derajat keparahan dan mortalitas pasien COVID-19, tanpa adanya restriksi desain studi, diinklusi dalam penelitian ini. Penilaian kualitas studi dilakukan oleh tiga panelis. Empat studi dengan kualitas rendah hingga sedang, diikutsertakan dalam penelitian. Seluruh studi melaporkan risiko mortalitas, dan tiga di antaranya yang melaporkan derajat keparahan. Dua dari tiga studi ini sepakat bahwa pasien dengan suplementasi vitamin D mengalami risiko keparahan penyakit yang signifikan lebih rendah dibandingkan dengan tanpa suplementasi. Satu studi lainnya menemukan tidak adanya perbedaan bermakna, meskipun proporsi terjadinya COVID-19 derajat berat lebih tinggi ditemukan pada kelompok tanpa suplementasi. Berkaitan dengan mortalitas, tiga dari empat studi melaporkan suplementasi vitamin D merupakan faktor protektif dari risiko mortalitas pasien COVID-19. Satu studi lainnya, dengan validitas yang rendah dan risiko bias yang tinggi, melaporkan bahwa pasien dengan suplementasi vitamin D lebih banyak mengalami kematian dibandingkan dengan pasien tanpa suplementasi. Peneliti menyimpulkan bahwa terdapat perbedaan derajat keparahan dan risiko mortalitas antara pasien COVID-19 yang mendapatkan suplementasi vitamin D dengan tanpa suplementasi vitamin D. Suplementasi vitamin D menjadi faktor protektif terjadinya keparahan kondisi dan mortalitas pasien COVID-19.
Kata kunci: COVID-19, derajat keparahan, mortalitas, vitamin D


Vitamin D levels are known to be associated with improved immunity dysregulation by suppressing cytokine storms to prevent clinical worsening of COVID-19 patients. However, clinical trials regarding the effects of vitamin D supplementation on COVID-19 patients are still inconsistent. This study aimed to systematically analyze the vitamin D supplementation’s effect on the severity and mortality risk of COVID-19 patients. A literature search was conducted in Pubmed, Cochrane, Science Direct, ProQuest, MedXriv, WileyOnline Library, and Scopus on 27 September 2020. Studies assessing the effect of vitamin D supplementation on the severity and mortality of COVID-19 patients were included without any study design restrictions. Three authors carried out the study quality assessment. Four studies of low to moderate quality were included in the study. All studies reported a risk of mortality, and three of them reported the degree of severity. Two of the three studies agreed that patients with vitamin D supplementation had a significantly lower risk of disease severity than those without supplementation. One other study found no significant difference, although a higher proportion of severe COVID-19 was recorded in the group without supplementation. Three of the four studies reported vitamin D supplementation as a protective factor for mortality in COVID-19 patients. With low validity and a high risk of bias, one of the studies reported that a group of vitamin D supplements had a higher death rate than the group without supplementation. Researchers concluded that there were differences in the degree of severity and risk of mortality between COVID-19 patients given vitamin D supplementation and COVID-19 patients without vitamin D supplementation. Vitamin D supplementation was a protective factor in the severity and mortality risk of COVID-19 patients.
Keywords: COVID-19, mortality, vitamin D, severity