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Vitamin D supplementation for severe pneumonia--a randomized controlled trial
Nidhi Choudhary1, Piyush Gupta
1Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India.
Insights
Short-term oral vitamin D supplementation did not improve severe pneumonia recovery in children under five. Further research with higher doses or longer durations is needed to confirm these findings.
Area of Science:
- Pediatric infectious diseases
- Nutritional immunology
- Respiratory medicine
Background:
- Severe pneumonia is a leading cause of mortality in children under five.
- Vitamin D plays a crucial role in immune function and may influence respiratory infections.
- Evidence on vitamin D supplementation for severe pneumonia treatment is limited.
Purpose of the Study:
- To evaluate the efficacy of oral vitamin D supplementation in resolving severe pneumonia in young children.
- To assess the impact of vitamin D on key clinical outcomes, including hospitalization duration and symptom resolution.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted with 200 children aged 2 months to 5 years diagnosed with severe pneumonia.
- Participants received either oral vitamin D (1000-2000 IU daily) or a placebo for 5 days, alongside standard antibiotic treatment and supportive care.
- Primary outcome was time to resolution of severe pneumonia; secondary outcomes included duration of hospitalization and time to resolution of specific symptoms.
Main Results:
- No significant difference was observed in the median time to resolution of severe pneumonia between the vitamin D and placebo groups (72 vs. 64 hours).
- Duration of hospitalization and time to resolution of tachypnea, chest retractions, and inability to feed were comparable in both groups.
- Short-term vitamin D supplementation showed no beneficial effect on the studied outcomes.
Conclusions:
- Current evidence suggests that short-term oral vitamin D supplementation (1000-2000 IU daily for 5 days) is not effective in treating severe pneumonia in children under five.
- Further investigation with higher vitamin D doses or extended supplementation periods may be warranted to fully elucidate its potential role.
- The findings highlight the need for robust clinical trials to guide therapeutic strategies for severe pneumonia in pediatric populations.
Objective:
To determine the role of oral vitamin D supplementation for resolution of severe pneumonia in under-five children.
Design:
Randomized, double blind, placebo-controlled trial.
Setting:
Inpatients from a tertiary care hospital.
Participants:
Two hundred children [mean (SD) age: 13.9 (11.7) months; boys: 120] between 2 months to 5 years with severe pneumonia. Pneumonia was diagnosed in the presence of fever, cough, tachypnea (as per WHO cut-offs) and crepitations. Children with pneumonia and chest indrawing or at least one of the danger sign (inability to feed, lethargy, cyanosis) were diagnosed as having severe pneumonia. The two groups were comparable for baseline characteristics including age, anthropometry, socio-demographic profile, and clinical and laboratory parameters.
Intervention:
Oral vitamin D (1000 IU for <1 year and 2000 IU for >1 year) (n=100) or placebo (lactose) (n=100) once a day for 5 days, from enrolment. Both the groups received antibiotics as per the Indian Academy of Pediatrics guidelines, and supportive care (oxygen, intravenous fluids and monitoring).
Outcome Variables:
Primary: time to resolution of severe pneumonia. Secondary: duration of hospitalization and time to resolution of tachypnea, chest retractions and inability to feed.
Results:
Median duration (SE, 95% CI) of resolution of severe pneumonia was similar in the two groups [vitamin D: 72 (3.7, 64.7-79.3) hours; placebo: 64 (4.5, 55.2-72.8) hours]. Duration of hospitalization and time to resolution of tachypnea, chest retractions, and inability to feed were also comparable between the two groups.
Conclusion:
Short-term supplementation with oral vitamin D (1000-2000 IU per day for 5 days) has no beneficial effect on resolution of severe pneumonia in under-five children. Further studies need to be conducted with higher dose of Vitamin D or longer duration of supplementation to corroborate these findings.
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