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

Haugen, Johanne; Basnet, Sudha; Hardang, Ingrid Marie M.; Sharma, Arun Kumar; Mathisen, Maria; Shrestha, Prakash; Valentiner‐Branth, Palle; Strand, Tor A.

doi:10.1038/pr.2017.71

Cited by 22 publications

(34 citation statements)

References 37 publications

(43 reference statements)

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“…Low vitamin D status is an independent risk factor for treatment failure and delayed recovery from severe lower respiratory infections. 52 The level of serum vitamin D in patients with pneumonia was significantly low, 53 maybe because of a systemic inflammatory response in the host. 54,55 In total, there remains little evidence to suggest that vitamin D supplementation has an effect on most outcomes, including time to resolution of pneumonia, duration of hospitalization, recovery rate of pneumonia, and the main secondary outcomes (including mortality of pneumonia, rate of ICU/hospital admission, complications rate, time to resolution of fever, and change in serum levels of serum PCT and hs-CRP), strengthening the hypothesis that low vitamin D status is a consequence of ill health rather than its cause.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies

et al. 2020

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The purpose of this meta-analysis was to summarize randomized controlled trial (RCT) evidence and evaluate the efficacy and safety of vitamin D (VD) supplementation as an adjunct to antibiotics for the treatment of pneumonia. Data sources published from the inception dates up to January 2020 were searched. RCTs of VD supplementation of any duration, age, and dosing regimen type were eligible for inclusion if data on pneumonia were collected. Thirteen studies (4786 randomized participants) fulfilled eligibility criteria. VD supplementation significantly increased levels of serum 25(OH)D (mean difference = 15.97; 95% CI, 7.49-24.44; P = .002) and reduced incidence of repeat episodes of pneumonia (risk ratio [RR] = 0.68; 95% CI, 0.50-0.93; P = .02). Subgroup analysis revealed VD supplementation had more reducing effects on repeat episodes of pneumonia among participants in trials in which the population were children (RR = 0.66; 95% CI, 0.48-0.90), duration <3 months (RR = 0.55; 95% CI, 0.33-0.91), or dose of VD <300,000 IU (RR = 0.51; 95% CI, 0.29-0.89). Although our results suggested that VD supplementation had a positive effect on recovery rate of pneumonia (RR = 1.28; 95% CI, 0.94-1.74; I 2 = 13%), there was no statistical difference (P = .12). High-dose VD intervention may have an effect on reducing the incidence rate of repeat episodes of pneumonia by enhancing immune efficacy, although more population studies are needed to support that VD supplementation has therapeutic effects on pneumonia itself.

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Section: Discussionmentioning

confidence: 99%

Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies

et al. 2020

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“…Haugen J et al, and Oduwole OA et al, studies found that vitamin D deficiency is associated with treatment failure in severe pneumonia, present study also had similar predictor which was indirectly measured by clinical signs of rickets. 14,15 Studies have also shown low Vitamin D levels is an independent risk factor for the development of pneumonia and increases the disease severity. [16][17][18][19] Authors found that anemia and its increase in severity is risk factor for treatment failure, this result is comparable with study done by Moschovis PP et at, in which anemia at high altitude increases the risk of poor outcome with severe pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Predictors of treatment failure in severe pneumonia treated with Ampicillin in tertiary care center

Lakshmi

Manu

Kalpana

et al. 2019

Int J Contemp Pediatr

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Background: Pneumonia affects 156 million children under five years every year and is the leading cause of mortality in this age group. It emphasizes the need to identify high risk factors for Treatment Failure so as to treat them aggressively. The objective of this study was to assess factors influencing treatment failure in severe pneumonia treated with Ampicillin.Methods: Prospective observational study, in which 235 children with severe pneumonia between 2 months to 60 months were enrolled and started with intravenous Ampicillin as per WHO protocol. If no clinical improvement was seen after 48 hours, it was taken as treatment failure and managed accordingly.Results: Among 235 children, 43(18.2%) did not respond to Ampicillin. Among treatment failure cases males were 20 (46.5%) and females were 23 (53.6%). All the following parameters were statistically significant(p<0.05). Majority of 23(53.4%) were between 2 to 12 months. 13(30.2%) were incompletely immunized. MAM were 23(53.4%) and 22(51.1%) cases had signs of Rickets. 34(79.1%) had Anemia out of which 22(64%) had moderate anemia. 39(90.6%) children had fever and hypoxia at admission.Conclusions: Infancy, malnutrition, severity of anemia, rickets, lack of immunization, hypoxia at baseline were significant predictors of treatment failure in severe pneumonia. Strengthening immunization and improving nutritional status may improve the outcome. Children with above risk factors require vigilant monitoring.

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“…A recent review seems to support the protective role of VD against tuberculosis, otitis media, pharyngotonsillitis, bronchiolitis, and viral wheezing . Low VD status (25(OH)D < 50 nmol/L) is an independent risk factor for treatment failure and delayed recovery from severe lower respiratory infections in children . Shen‐Hao Lai et al observed that infants with low cord serum 25(OH)D levels have poorer lung function at 6 months of age compared with those with high levels.…”

Section: Role Of Vd In Infectionsmentioning

confidence: 99%

Vitamin D in pediatric health and disease

Peroni

Trambusti

Cicco

et al. 2020

Pediatric Allergy Immunology

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Vitamin D (VD) is an essential hormone for humans. Despite the classical functions of VD in the regulation of calcium-phosphorus homeostasis and bone metabolism, in the last few years, evidence has been accumulated on the pleiotropic effect of VD, as many cells throughout the body express the VD receptor and the enzyme 1α-hydroxylase. 1 This article discusses the actions of VD and the relationship between VD status and the risk to develop various diseases. | VITAMIN D ME TABOLIS MVitamin D is the general term encompassing both vitamin D 2 (ergocalciferol) and vitamin D 3 (cholecalciferol). In humans, VD is mainly synthesized in the skin, whereas only a minor part is derived from dietary sources. Few natural, non-fortified products such as fatty fish or some types of mushrooms contain relevant amounts of VD. The endogenous synthesis pathway starts in the skin, when cutaneous-derived 7-dehydroxycholesterol undergoes photolytic conversion by UVB sunlight to form pre-vitamin D3, rapidly converted to biologically inactive vitamin D3. It then undergoes hydroxylation in the liver by 25-hydroxylase to become 25-(OH) D, the major circulating form of VD in humans. In the kidney, 25(OH) D is further converted to the fully active metabolite 1,25-(OH)2 D by the enzyme 1-α-hydroxylase. This process is finely regulated by parathormone, fibroblast growth factor 23, calcium, and phosphorus and depends on some factors such as ethnicity, latitude, culture, and sunscreen. 2 VD plays a fundamental role in the processes of acquisition and achievement of peak bone mass. 3,4 | E X TR A S K ELE TAL AC TI ON S OF VDIn recent decades, several studies have suggested that VD contributes to diverse processes extending far beyond mineral homeostasis, defined as extraskeletal actions. These observations suggest a critical role for VD in the modulation of immune function, above all during pediatric age, exerted by modulating both innate immunity AbstractSeveral scientific societies established that vitamin D (VD), in its metabolized form 25(OH)D, levels higher than 20 ng/mL are sufficient to ensure optimal bone health, while 25(OH)D levels higher than 30 ng/mL are needed to favor VD extraskeletal actions. However, it has been estimated that approximately 30% of children and 60% of adults worldwide are VD deficient and insufficient, respectively. This is the reason why it is important to provide a practical approach to VD supplementation for infants, children, and adolescents. It is the pediatrician's role to evaluate the modifiable lifestyle risk factors for deficiency, particularly a reduced sun exposure, following an evidence-based approach, and to suggest VD supplementation only when there is a rational reason to support its use. K E Y W O R D S childhood disorders, health, vitamin D3 How to cite this article: Peroni DG, Trambusti I, Di Cicco ME, Nuzzi G. Vitamin D in pediatric health and disease. Pediatr Allergy Immunol. 2020;31(Suppl 24):54-57. https ://doi.

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

Cited by 22 publications

References 37 publications

Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies

Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies

Predictors of treatment failure in severe pneumonia treated with Ampicillin in tertiary care center

Vitamin D in pediatric health and disease

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