Role of Vitamin D in Hospitalized Children With Lower Tract Acute Respiratory Infections

J Pediatr Gastroenterol Nutr. 2016 Mar;62(3):479-85. doi: 10.1097/MPG.0000000000001003.


Background: Vitamin D is known to have modulatory actions in the immune system. Its influence on the severity of lower tract acute respiratory infections (LT-ARIs) is unclear.

Objectives: The aim of the present study was to evaluate the role of vitamin D on LT-ARI in paediatric patients.

Methods: Children admitted to hospital with LT-ARI were prospectively recruited through the GENDRES network (March 2009-May 2013). The 25-hydroxyvitamin D (25-OHD) levels were measured by immunoassay. The severity of the illness was evaluated according to clinical scales, length of hospital stay, ventilatory requirements, and pediatric intensive care unit admission.

Results: A total of 347 patients with a median (interquartile range) age of 8.4 (2.6-21.1) months were included. The mean (SD) 25-OHD levels in our series were 27.1 (11.3) ng/mL. In this study, a cutoff value of ≥30 ng/mL was considered optimal vitamin status. Patients with 25-OHD levels <20 ng/mL were at a higher risk of showing severe signs of respiratory difficulties (OR 5.065, 95% confidence interval 1.998-12.842; P = 0.001) than patients with normal values, and had a 117% higher risk of oxygen necessity and 217% higher risk of ventilatory requirement than those patients with normal values. An inverse correlation was found between 25-OHD levels and the severity in the evaluated scales. 25-OHD levels did not influence PICU admission rate or length of hospital stay.

Conclusions: 25-OHD levels of children admitted because of a LT-ARI are <30 ng/mL. Lower levels of 25-OHD were found to be correlated with severity of the disease. The possible role of abnormal 25-OHD levels as a facilitator or consequence of the infection needs further evaluation.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Child
  • Child, Hospitalized
  • Female
  • Humans
  • Infant
  • Intensive Care Units, Pediatric
  • Length of Stay / statistics & numerical data*
  • Male
  • Patient Admission / statistics & numerical data*
  • Prospective Studies
  • Respiration, Artificial / statistics & numerical data
  • Respiratory Tract Infections / blood*
  • Severity of Illness Index
  • Spain
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / epidemiology*


  • Vitamin D
  • 25-hydroxyvitamin D