Role of Vitamin D Deficiency in Increased Susceptibility to Respiratory Infections Among Children: A Systematic Review

Raju, Anjumol; Luthra, Gaurav; Shahbaz, Mahrukh; Almatooq, Halah; Foucambert, Paul; Esbrand, Faith D; Zafar, Sana; Panthangi, Venkatesh; Kurupp, Adrienne R Cyril; Khan, Safeera

doi:10.7759/cureus.29205

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…The final stage of the study selection involved a meticulous evaluation of these 73 full-text articles to determine their applicability to the research objectives and their adherence to the predefined methodological criteria. As a result of this rigorous scrutiny, eight studies emerged as meeting all requisite criteria for inclusion in the systematic review, which are referenced in the literature as [ 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. This process of study selection and the associated reduction in the number of studies considered for inclusion are illustrated in Figure 1 , which provides a clear visual representation of the systematic review’s methodological progression.…”

Section: Resultsmentioning

confidence: 99%

“…A comprehensive understanding of the relationship between vitamin D status and RTI may inform clinical practice and public health policies aimed at reducing the burden of these infections in pediatric populations. Although previous trials and systematic reviews have addressed this topic, with inconclusive results [ 22 , 23 ], there was no focus on a particular type of infection or age range during childhood, when the immune system is developing and is significantly different from adults’ immunity [ 24 , 25 ]. Moreover, respiratory infections are the most common diseases in children, while the preschool age sets a boundary on community exposure to respiratory infections.…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review

Marusca,

Reddy,

Blaj

et al. 2023

Diseases

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Childhood respiratory tract infections (RTIs) pose a significant health burden, especially in children under six years old. The main objective of this systematic review was to assess the effectiveness of vitamin D supplementation in the prevention of RTI in this population while also exploring potential effect modifiers such as age, baseline vitamin D status, and type of respiratory infection. A systematic review of the literature published up to February 2023 was conducted according to PRISMA guidelines, searching PubMed, Web of Science, Cochrane, and Scopus databases. Eight studies met the inclusion criteria, which investigated the association between vitamin D supplementation and respiratory infections in children between zero and five years old. The included studies were conducted between 2012 and 2021, encompassing a total of 2189 children from five randomized trials, two case-control studies, and one prospective cohort study. The relationship between vitamin D supplementation and the prevention of childhood RTI was not consistently observed across all included studies. Pooled results demonstrated varied effects of vitamin D supplementation on respiratory infection incidence, severity, and symptoms. Three studies reported statistically significant associations between low vitamin D levels and respiratory infections (OR = 4.90, OR = 6.97), while one study found that children who received vitamin D supplementation of 800 UI/day for 3 months during the cold season had fewer episodes of respiratory symptoms (RR = 0.55) and recovered more quickly from acute RTI. Lastly, according to one study, vitamin D intake < 80 IU/kg/day was significantly associated with the risk of acquiring pneumonia (OR 7.9) but not bronchiolitis. The remaining five studies found no statistically significant differences in infection rates or severity (p-value > 0.050). The available evidence on the effectiveness of vitamin D supplementation for preventing and treating respiratory infections in children under six years old is limited, with only a few favorable effects being reported. In some cases, a dose of 80 UI/kg/day was found to provide significant protection for acute respiratory infections, although in the major trials the only benefit was a quicker recovery and fewer respiratory symptoms, with no impact on incidence and severity of respiratory infections. Nevertheless, the study protocol, the supplementation dose, and duration of supplementation had significant variations between studies, leading to inconclusive findings.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review

Marusca,

Reddy,

Blaj

et al. 2023

Diseases

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“…Vitamin D deficiency has been suggested to be associated with an increased risk of respiratory viral infections in children [ 33 ]. In the current review, we systematically appraised the available literature to determine the effect of vitamin D deficiency on the severity and mortality of COVID-19 infection and the reported genetic variants known to modulate susceptibility to severe COVID-19 disease.…”

Section: Reviewmentioning

confidence: 99%

Role of Vitamin D and Vitamin D Polymorphisms in COVID-19 Risk and Severity in Children: A Systematic Review

Giatraki,

Galanakis,

Perdikogianni

2024

Cureus

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The role of vitamin D in the susceptibility to coronavirus disease 2019 (COVID-19) disease has been investigated since the beginning of the pandemic, but there is still scarce data on children. We investigated the impact of vitamin D status and the related genetic variants on COVID-19 vulnerability and severity of the disease in children. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to identify reports on vitamin D status and genetic polymorphisms, their association with the susceptibility of children to COVID-19 and multisystem inflammatory syndrome in children (MIS-C), and the effect of supplementation on the clinical course. Of an initial total of 279 articles, 26 studies, published between September 2020 and May 2023, were finally included in this review according to inclusion criteria. Quantitative data provided by 11 studies revealed that 43.05% of pediatric COVID-19 patients had low vitamin D levels. Mean serum 25(OH)D levels were observed to be significantly low in COVID-19 cases, with an estimated pooled mean value of 17 ng/mL, as provided by 16 studies. Vitamin D deficiency and the vitamin D receptor (VDR) FokI polymorphism may suggest independent risk factors for susceptibility to COVID-19 in the pediatric population. The 25(OH)D level may constitute a significant biomarker associated with the COVID-19 severity and MIS-C. While supplementation of COVID-19 cases with vitamin D showed favorable results, the effect on the outcome of the disease remains uncertain.

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“…Beyond these traditional roles, emerging evidence suggests a significant impact of vitamin D on the immune system, particularly in the prevention of infections [ 3 , 4 , 5 ]. Epidemiological studies have consistently shown a link between vitamin D deficiency and increased susceptibility to infectious diseases, including respiratory infections [ 6 , 7 , 8 ]. This association is of particular interest in preschool children who are at a higher risk of developing respiratory infections due to their still-developing immune systems and high exposure rates in communal settings, such as daycare and preschool [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Preventive Potential of Vitamin D against Respiratory Infections in Preschool-Age Children: A Cross-Sectional Study

Sarau,

Rachabattuni,

Gadde

et al. 2024

Nutrients

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Recent studies hypothesized that vitamin D supplementation and subsequent higher 25(OH)D serum levels could protect against respiratory infections in children. This cross-sectional study, conducted from May 2022 to December 2023 in Timisoara, Romania, aimed to evaluate the potential influence of vitamin D supplementation on the incidence of respiratory infections among preschool-age children. This study examined 215 children over 18 months who were split into a group of patients with recurrent respiratory infections (n = 141) and another group of patients with only one respiratory tract infection in the past 12 months (n = 74). Patients were evaluated based on their serum vitamin D levels 25(OH)D, demographic characteristics, and health outcomes. The study identified that preschool-age children with recurrent infections had significantly lower mean vitamin D concentrations (24.5 ng/mL) compared to the control group (29.7 ng/mL, p < 0.001). Additionally, a higher proportion of vitamin D deficiency was observed among children with recurrent infections in the past 12 months. Notably, vitamin D supplementation above 600 IU/week significantly reduced the likelihood of respiratory infections, evidenced by an odds ratio of 0.523 (p < 0.001), indicating that preschool-age children receiving a dose of vitamin D higher than 600 IU/week were about half as likely to experience respiratory infections compared to those who did not. Furthermore, no significant associations were found between sun exposure, daily sunscreen use, and the incidence of respiratory infections. Conclusively, this study underscores the potential role of vitamin D in helping the immune system against respiratory infections in preschool-age children. The observed protective effect of vitamin D supplementation suggests a potential public health strategy to mitigate the incidence of respiratory infections in preschool children on top of the already known benefits.

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Role of Vitamin D Deficiency in Increased Susceptibility to Respiratory Infections Among Children: A Systematic Review

Cited by 8 publications

References 25 publications

The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review

The Effects of Vitamin D Supplementation on Respiratory Infections in Children under 6 Years Old: A Systematic Review

Role of Vitamin D and Vitamin D Polymorphisms in COVID-19 Risk and Severity in Children: A Systematic Review

Exploring the Preventive Potential of Vitamin D against Respiratory Infections in Preschool-Age Children: A Cross-Sectional Study

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