Vitamin D deficiency and severity of pneumonia in Indonesian children

Abstract

Objective To determine the prevalence of vitamin D deficiency in Indonesian children hospitalized with pneumonia and evaluate the association between vitamin D status and severity of pneumonia. Methods A hospital-based cross-sectional study was conducted from February 2016 to July 2017 in two district hospitals in Yogyakarta province, Indonesia. Infants and young children aged 2–59 months hospitalized with pneumonia were recruited. Serum blood samples were collected on admission and analyzed for total serum 25-hydroxyvitamin D3 and 25-hydroxyvitamin D2 concentrations using liquid chromatography-tandem mass spectrometry. Vitamin D deficiency was defined as a level of serum vitamin D <50 nmol/L. The association between vitamin D deficiency and severity of hospitalized pneumonia according to WHO criteria, including the presence of danger signs, hypoxemia (SpO2 in air below 90%), duration of hospitalization, and admission to Intensive Care Unit (ICU), was analyzed using logistic regression. Results 133 children with WHO-defined pneumonia were enrolled in the study and 127 (96%) had their vitamin D status determined. The mean vitamin D concentration was 67 (± 24 SD) nmol/L and 19% of participants were vitamin D deficient. Age younger than 6 months was associated with prolonged hospitalization (> 5 days) and low birth weight and poor nutritional status on admission were risk factors for hypoxemia. However, vitamin D status was not associated with the presence of danger signs, duration of hospitalization, or hypoxemia. Conclusions One in every five children hospitalized with pneumonia was vitamin D deficient. Vitamin D status was not associated with the severity of pneumonia.

Vitamin D deficiency is a public health emergency among Indonesian children and adolescents: a systematic review and meta-analysis of prevalence

“…We also found 14 articles from citations and hand searching, which resulted in an additional manuscript (15) . Notable exclusions include one study which did not specify the vitamin D cut-off value (34) , one study that included Dutch residents of Indonesian ethnicity (35) , two studies (36,37) that were generated from the same dataset (38) , one poster presentation (39) that were ultimately published as a full A c c e p t e d A r t i c l e paper (40) , and five studies (41)(42)(43)(44)(45) were also excluded as they were part of Southeast Asian Nutrition Surveys (SEANUTS) study (15) . Therefore, seven studies (15,38,40,(46)(47)(48)(49) are available for systematic review and meta-analysis (Supplementary Figure 1).…”

Malnutrition and Pneumonia among Under-five Children in Sadewa Maternal and Child Hospital, Yogyakarta, Indonesia

“…19 In this study, 16,2 % of pneumonia patients in children under five years old treated at Sadewa Maternal and Child Hospital, Yogyakarta, were malnutrition, and 17,3 % of severe pneumonia were malnutrition, consistent with findings from other studies. 20 Based on previous studies showed that undernutrition is a significant risk factor for severe pneumonia and is related to mortality. It can increase the incidence, severity, and mortality of pneumonia due to weaker host defense mechanisms and impaired respiratory muscle performance.…”

The Role of Vitamin D in Supporting Health in the COVID-19 Era

“…Vitamin D deficiency is related to several lung pathologies, including respiratory distress syndrome, alveolar inflammation, and epithelial damage. A link between vitamin D status and respiratory morbidity was revealed by several studies on children [ 65 , 66 , 67 ], adults, and the elderly [ 68 , 69 ]. It was clearly demonstrated that low vitamin D status was associated with inflammation in patients with chronic obstructive pulmonary disease (COPD) [ 70 ].…”