25-Hydroxy-Vitamin D Concentration Is Not Affected by Severe or Non-Severe Pneumonia, or Inflammation, in Young Children

Abstract

Poor vitamin D status has been associated with increased risk and severity of respiratory tract infections. Whether or not inflammation and infection affects 25-hydroxy vitamin D (25(OH)D) concentration is controversial and is important in the interpretation of observational studies using plasma-25(OH)D as a biomarker for status. Our objectives were to measure whether 25(OH)D concentration was altered by an episode of acute lower respiratory tract infection and whether markers of inflammation predicted the 25(OH)D concentration. Children aged 2–35 months with severe (n = 43) and non-severe (n = 387) community-acquired, WHO-defined pneumonia were included. 25(OH)D concentration and inflammatory markers (cytokines, chemokines, and growth factors) were measured in plasma during the acute phase and 14, 45, and 90 days later. Predictors for 25(OH)D concentrations were identified in multiple linear regression models. Mean 25(OH)D concentration during the acute phase and after recovery (14, 45, and 90 days) was 84.4 nmol/L ± 33.6, and 80.6 ± 35.4, respectively. None of the inflammatory markers predicted 25(OH)D concentration in the multiple regression models. Age was the most important predictor for 25(OH)D concentration, and there were no differences in 25(OH)D concentrations during illness and after 14, 45, and 90 days when adjusting for age. Infection and inflammation did not alter the 25(OH)D concentration in young children with acute lower respiratory tract infections.

Vitamin D status is associated with treatment failure and duration of illness in Nepalese children with severe pneumonia

“…We did not include a healthy control group in this study, but we have data on vitamin D status in young children in the same area, both in children with less-severe pneumonia (28) and in healthy infants (31). In the study of children with lesssevere pneumonia the percentage of children with vitamin D insufficiency and deficiency was comparable to the findings in this study.…”

“…In a recent publication in children with bacterial illness, no difference was found between 25(OH)D concentration during bacterial infection and 4 weeks later, and the authors concluded that an acute alteration in vitamin D status seemed unlikely, but they also acknowledged the problem that no pre-infectious samples were taken. Further, in a sample of young Nepalese children, we demonstrated that 25(OH)D concentration was not affected by clinical infection or inflammation (28).…”

High incidence of rhinovirus infection in children with community‐acquired pneumonia from a city in the Brazilian pre‐Amazon region

“…This study found an interesting gender association, with males exhibiting a higher incidence of severe CAP. However, Haugen et al studied 420 children with nonsevere and severe CAP but did not observe this gender association. This disagreement suggests that new studies with higher numbers of subjects are necessary to resolve the relevance of gender as a risk factor.…”

Does Serum Vitamin D Level Affect COVID-19 Infection and Its Severity?-A Case-Control Study

“…Lastly, serum 25(OH)D levels among the cases was determined only during hospital admission, after the onset of COVID-19 symptoms. However, prior research shows that blood vitamin D level is stable, and not affected by acute respiratory infection (37), so the 25(OH)D level at admission most probably reflects the level before infection.…”