Prevalence of Vitamin D Deficiency and its Association with Disease Severity in Children Hospitalized with Acute Respiratory Infections.

BACKGROUND

Vitamin D deficiency (VDD) is highly prevalent in pediatric patients, and it has been implicated in the pathogenesis and clinical severity of acute respiratory infections (ARI).

OBJECTIVES

To evaluate the prevalence of VDD and its association with ARI disease severity and clinical outcomes in hospitalized pediatric patients.

METHODS

A 4-year prospective case-control study, conducted between 2021 and 2024, in two Romanian pediatric hospitals, included 400 inpatients, aged 0-18 years, admitted for ARI. Patients were stratified into cases with a low level of vitamin D (n=200) and controls with a normal vitamin D (n=200). Clinical severity of ARI, inflammatory biomarkers, presence of fever, need for supplemental oxygen, and length of hospital stay were recorded and analyzed in both cases and controls.

RESULTS

Low serum vitamin D levels were significantly associated with severe ARI (26.5% vs. 5.5%), fever at admission (61.0% vs. 32.0%), and increased requirement for oxygen therapy (69.5% vs. 21.0%). Cases also exhibited higher C-reactive protein levels (3.50 vs. 1.64mg/L), higher clinical severity scores (3.77 vs. 1.62), and longer hospital length of stay (4.68 vs. 2.89 days).

CONCLUSIONS

Vitamin D deficiency was strongly associated with increased disease severity and adverse clinical outcomes in pediatric inpatients with ARI.