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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

OutcomeAuthor, YearPopulation Health StatusOutcome ascertainmentReported summary risk estimate: Odds Ratio (OR), Risk Ratio(RR) (95% Confidence Interval); % Population infected (infected/population size)
DeficientInadequateSufficientOptimalPer ↑ 10 nmol/L
Incidence of ARI/pneumoniaLaaksi, 2007 [19]HealthyClinically diagnosed episodes of sinusitis, tonsillitis, otitis, bronchitis, pneumonia, pharyngitis, and laryngitis1.03 (0.90, 1.18)a,c; 88.9% (24/27)1.00 (reference); 86.1% (628/729)
He, 2013 [17]HealthySymptom 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 daysNR; 66.7% (12/18)NR; 39.7% (27/68)NR; 43.8% (56/128)NR; 27.3% (3/11)
Jovanonich, 2014 [18]MixedbLaboratory confirmed CAP with chest radiograph2.57 (1.08, 6.08)d; NR0.96 (0.35, 2.61)d; NR1.03 (0.51, .09)d; NR
Rafiq, 2018 [20]MixedbSelf-reported episodes of cold in the month prior to questionnaire1.00 (0.96, 1.05)e; N/A
Sabetta, 2010 [24]HealthySelf-reported, followed by clinical diagnosis of acute viral RTI, which may or may not be laboratory confirmed1.00 (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 healthySelf-reported episodes of respiratory infections (influenza, pneumonia, bronchitis, severe cold) in past 3 weeks prior to questionnaire1.00 (reference)0.94 (0.7, 1.27)f0.74 (0.54, 1.02)f75–99.9 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 healthySelf-reported to be clinically diagnosed with influenza, which may or may not be laboratory confirmed1.00 (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]HealthyClinical diagnosis of ILI (retrospective retrieval from system)1.43 (0.77, 2.67)h; NR1.55 (0.84, 2.86)h; NR1.00 (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