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Table 2 Key findings on vitamin D deficiency on ARI incidence

From: Association between micronutrient deficiency and acute respiratory infections in healthy adults: a systematic review of observational studies

Outcome

Author, Year

Population Health Status

Outcome ascertainment

Reported summary risk estimate: Odds Ratio (OR), Risk Ratio(RR) (95% Confidence Interval); % Population infected (infected/population size)

Deficient

Inadequate

Sufficient

Optimal

Per ↑ 10 nmol/L

Incidence of ARI/pneumonia

Laaksi, 2007 [19]

Healthy

Clinically diagnosed episodes of sinusitis, tonsillitis, otitis, bronchitis, pneumonia, pharyngitis, and laryngitis

1.03 (0.90, 1.18)a,c; 88.9% (24/27)

–

1.00 (reference); 86.1% (628/729)

–

–

He, 2013 [17]

Healthy

Symptom diary; URTI was deemed present when (i) total symptom score was ≥15 on any two consecutive days and (ii) when a subject positively indicated suffering from a common cold on ≥3 days

NR; 66.7% (12/18)

NR; 39.7% (27/68)

NR; 43.8% (56/128)

NR; 27.3% (3/11)

–

Jovanonich, 2014 [18]

Mixedb

Laboratory confirmed CAP with chest radiograph

2.57 (1.08, 6.08)d; NR

–

0.96 (0.35, 2.61)d; NR

1.03 (0.51, .09)d; NR

–

Rafiq, 2018 [20]

Mixedb

Self-reported episodes of cold in the month prior to questionnaire

–

–

–

–

1.00 (0.96, 1.05)e; N/A

Sabetta, 2010 [24]

Healthy

Self-reported, followed by clinical diagnosis of acute viral RTI, which may or may not be laboratory confirmed

1.00 (reference); 45.0% (81/180, 32 laboratory-confirmed cases)

–

–

0.52 (0.25, 0.84)a; 16.7% (3/18; 1 laboratory-confirmed case)

–

Berry, 2011 [21]

Supposedly healthy

Self-reported episodes of respiratory infections (influenza, pneumonia, bronchitis, severe cold) in past 3 weeks prior to questionnaire

1.00 (reference)

0.94 (0.7, 1.27)f

0.74 (0.54, 1.02)f

75–99.9 nmol/L: 0.66 (0.46, 0.96)f; NR

≥100 nmol/L: 0.57 (0.34, 0.94)e; NR

0.93, (0.89, 0.97)f; N/A

Nanri, 2017 [23]

Supposedly healthy

Self-reported to be clinically diagnosed with influenza, which may or may not be laboratory confirmed

1.00 (reference)g; 32.8% (59/180)

1.11 (0.74, 1.68)g; '28.6% (106/303)

0.77 (0.37,1.59)g; 28.6% (14/49)

–

–

Lee, 2018 [22]

Healthy

Clinical diagnosis of ILI (retrospective retrieval from system)

1.43 (0.77, 2.67)h; NR

1.55 (0.84, 2.86)h; NR

1.00 (reference); NR

–

–

  1. RTI Respiratory tract infections, NR Not Reported, N/A Not Applicable, ILI Influenza-like illness
  2. aRelative risk reported, otherwise odds ratio was reported
  3. bMixed health status refers to populations that with healthy and diseased subjects with chronic diseases, but statistically adjusted for these diseases in analyses.
  4. cAdjusted for smoking
  5. dAdjusted for diabetes, renal disease and peripheral vascular disease; Odds are compared against the cut-offs for the following serum 25(OH)D levels in the respective categories, i.e. Deficient (<37 nmol/L vs ≥37 nmol/L), Sufficient (<50 nmol/L vs ≥50 nmol/L), optimal (<75 nmol/L vs ≥75 nmol/L)
  6. eAdjusted for age, sex, ethnicity, number of packyears, self-reported obstructive pulmonary disease, use of pulmonary and anti-inflammatory medication, educational level, season, physical activity, BMI, total body fat and waist circumference
  7. fAdjusted for gender, lifestyle factor, BMI and waist circumference
  8. gAdjusted for influenza vaccination status, BMI, exercise and smoking statuses, living with schoolchildren, green tea intake and use of public bus or train for commuting
  9. hAdjusted for age, gender, time from vaccination to serum collection