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Updated: Nov 20, 2025
A Data-Driven Approach to Quantifying Immune States in Sepsis
Published on: February 7, 2025
Vitamin D status was associated with sepsis in critically ill children: A PRISMA compliant systematic review and
Weijie Yu1, Qinlai Ying1, Wen Zhu1
1Department of Pediatrics, The Second Affiliated Hospital of Jiaxing University, Zhejiang Province.
Insights
Critically ill children with sepsis often have lower vitamin D levels. Severe vitamin D deficiency was significantly more common in children with sepsis, highlighting a potential link.
Area of Science:
- Pediatric Critical Care Medicine
- Nutritional Immunology
- Epidemiology
Background:
- Sepsis is a leading cause of mortality in critically ill infants and children.
- The association between vitamin D deficiency and sepsis incidence remains controversial.
- This study addresses the need for clarity on vitamin D's role in pediatric sepsis.
Purpose of the Study:
- To systematically review and meta-analyze the association between vitamin D deficiency and sepsis in critically ill children.
- To evaluate the impact of vitamin D levels on sepsis incidence.
- To explore the relationship between vitamin D status and clinical outcomes in pediatric sepsis.
Main Methods:
- Systematic search of Ovid Medline, Embase, PubMed, and Cochrane Library until April 2020.
- Inclusion of 27 studies (17 case-control, 10 cohort).
- Analysis of 25-hydroxyvitamin D (25-OHD) levels, with 20 ng/mL as a cutoff for vitamin D deficiency.
Main Results:
- Case-control studies showed significantly lower maternal and neonatal 25-OHD levels in sepsis cases.
- Severe vitamin D deficiency was significantly more prevalent in children with sepsis (OR=2.66).
- Cohort studies indicated a higher sepsis incidence in the lower 25-OHD group (30.4% vs. 18.2%), but no significant differences in ventilation rates or mortality.
Conclusions:
- Critically ill children with sepsis exhibit lower 25-OHD levels and higher rates of severe vitamin D deficiency.
- Further research is warranted to investigate the potential benefits of vitamin D supplementation in preventing sepsis in critically ill children.
Background:
Sepsis leads to the high mortality in critically ill infants and children. It is still controversial whether vitamin D deficiency was associated with the incidence of sepsis. Thus we designed the systematic review and meta-analysis.
Methods:
The Ovid Medline, Embase, PubMed, and Cochrane library were systematically searched until April 5, 2020. The 25 hydroxyvitamin D (25-OHD) level was recorded and set 20 ng/mL as cut-off in cohort study to divide the lower and higher 25-OHD group. The odds ratio (OR) and 95% confidence intervals (CIs) were calculated for comparing the impact of vitamin D deficiency on the incidence of sepsis in critically ill children.
Results:
A total of 27 studies were included with 17 case-control studies and 10 cohort studies. In those case-control studies, the maternal 25-OHD level and neonatal 25-OHD level in sepsis group was significant lower than non-sepsis group (P < .001). The percentage of severe vitamin D deficiency was significant higher in sepsis group comparing to non-sepsis group (odds ratio [OR] = 2.66, 95% CI = 1.13-6.25, P < .001). In those cohort studies, the incidence of sepsis in lower 25-OHD group was 30.4% comparing with 18.2% in higher 25-OHD level group. However, no statistical significant difference in terms of mechanical ventilation rate and 30-day mortality.
Conclusion:
We demonstrated that critically ill infants and children with sepsis could have a lower 25-OHD level and severe vitamin D deficiency comparing to those without sepsis. Future studies should focus on the association of vitamin D supplement and the occurrence of sepsis in critically ill children.
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