| Outcome |
Relative effect
(95% CI) |
Absolute effect
(95% CI)1 |
Certainty of the Evidence
(GRADE) |
Clinical improvement
D28 |
RR: 1.12
(0.01 - 1.24) |
106 more per 1000
(from 874 fewer to 212 more)
|
Low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviation from intended intervention and outcome measurement Inconsistency: Not serious Indirectness: Not serious Imprecision: Serious
due to low number of participants/events
|
| 2 trials
Entrenas Castillo M, 2020; Elamnir YM, 2021
126 participants
|
|
Vitamin D
988 per 1,000
(9 - 1000) |
Standard care/Placebo
882
per 1,000 |
|
Clinical improvement
D60 |
Outcome not yet measured or reported
|
|
WHO progression score (level 7 or above)
D28 |
RR: 0.04
(0.01 - 0.29) |
480 fewer per 1000
(from 495 fewer to 355 fewer)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization and deviations from intended interventions. Inconsistency: Not serious Indirectness: Serious
Indirectness downgraded by 1 level: single study from a single institution therefore results in this population might not be generalizable to other settings Imprecision: Serious
due to low number participants
|
| 1 trials
Entrenas Castillo M, 2020
76 participants
|
|
Vitamin D
20 per 1,000
(5 - 145) |
Standard care/Placebo
500
per 1,000 |
|
WHO progression score (level 7 or above)
D60 |
Outcome not yet measured or reported
|
|
All-cause mortality
D28 |
RR: 0.44
(0.07 - 2.97) |
36 fewer per 1000
(from 60 fewer to 127 more)
|
Very low certainty
Reasons to downgrade
Risk of bias: Serious
Risk of bias downgraded by 1 level: some concerns regarding adequate randomization, deviations from intended interventions and selection of reported results. Inconsistency: Serious
Inconsistency downgraded by 1 level: I²=54.7% Indirectness: Not serious
Imprecision: Very serious
Imprecision downgraded by 2 levels: due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm and low number of participants
|
| 3 trials
Entrenas Castillo M, 2020; Murai IH 2020; Elamir YM, 2021
366 participants
|
|
Vitamin D
28 per 1,000
(5 - 191) |
Standard care/Placebo
64
per 1,000 |
|
All-cause mortality
D60 |
Outcome not yet measured or reported
|
|
Viral negative conversion
D7 |
Outcome not yet measured or reported
|
|
Adverse events
|
RR: 3.00
(0.12 - 72.91) |
Absolute effects were not calculated due to zero events in the control group
|
Low certainty
Reasons to downgrade
Risk of bias: Not serious
Inconsistency: Not serious
Indirectness: Not serious
We presume that the adverse event rates and the corresponding relative risks, are similar across diverse settings; therefore not downgraded for indirectness.
Imprecision: Very serious
Imprecision downgraded by 2 levels: due to very wide confidence interval consistent with the possibility for benefit and the possibility for harm and low number of participants
|
| 1 trials
Murai I, 2020
240 participants
|
|
Vitamin D
0 per 1,000
(1 - 608) |
Standard care/Placebo
0
per 1,000 |
1 additional study was identified that assessed this outcome, but no results were reported. |
Serious adverse events
|
Outcome not yet measured or reported
|
|
1The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: Confidence interval; RR: Risk ratio
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
