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Association of vitamin D status with COVID-19 disease severity in pediatric patients: A retrospective observational
Solmaz Heidari1, Shooka Mohammadi1, Mohammadreza Fathi1
1Department of Pediatrics, Faculty of Medicine Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran.
Insights
Pediatric COVID-19 patients with vitamin D deficiency showed increased inflammatory markers and disease severity. Lower vitamin D levels were linked to higher C-reactive protein, fibrinogen, and d-dimer, indicating poorer outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Immunology
- Nutritional Biochemistry
Background:
- Vitamin D deficiency is a known risk factor for respiratory infections.
- Emerging evidence suggests a link between vitamin D status and coronavirus disease 2019 (COVID-19) severity.
- Understanding these associations in pediatric populations is crucial for effective management.
Purpose of the Study:
- To investigate the relationship between COVID-19 severity and serum vitamin D levels in Iranian children.
- To examine the association between vitamin D concentrations and key inflammatory markers in pediatric COVID-19 patients.
Main Methods:
- Retrospective study of 144 hospitalized pediatric COVID-19 patients in Ahvaz, Iran.
- Patients categorized into two groups based on serum vitamin D levels (<20 ng/ml vs. ≥20 ng/ml).
- Analysis of demographic, clinical data, serum vitamin D, calcium, lymphocyte, C-reactive protein (CRP), fibrinogen, and d-dimer levels.
Main Results:
- Patients with lower vitamin D levels (Group 1) exhibited significantly lower calcium and lymphocyte counts, and higher fibrinogen, d-dimer, and CRP levels compared to Group 2.
- Group 1 also presented with more severe symptoms including dry cough, fever, chest radiographic findings, higher respiratory rate, and longer hospital stays.
- Vitamin D levels positively correlated with calcium, lymphocytes, and neutrophils, but negatively with CRP, fibrinogen, and d-dimer. Fibrinogen was an independent predictor of severe COVID-19.
Conclusions:
- This study highlights significant associations between reduced serum vitamin D concentrations, elevated inflammatory markers, and increased severity of COVID-19 in pediatric patients.
- Findings suggest that vitamin D status may play a role in modulating the inflammatory response and clinical outcomes of COVID-19 in children.
- Further research is warranted to explore potential therapeutic implications of vitamin D supplementation in pediatric COVID-19 management.
Background And Aims:
Vitamin D deficiency is associated with increased vulnerability to respiratory infections. This study aimed to determine the potential relationships between coronavirus disease 2019 (COVID-19) severity, serum vitamin D concentrations, and some inflammatory markers among pediatric COVID-19 patients in Iran.
Methods:
A retrospective study was conducted among hospitalized pediatric COVID-19 cases in Abuzar Hospital (Ahvaz, Iran) for 6 months. The COVID-19 diagnosis was based on the real-time reverse transcription-polymerase chain reaction technique. Demographic and clinical data of patients were recorded. Patients with serum vitamin D levels lower than 20 ng/ml were assigned as Group 1 and those with serum vitamin D concentrations equal to or more than 20 ng/ml were considered as Group 2.
Results:
A total of 144 patients were enrolled. Their mean age was 80 ± 49 months (range: 1-16 years). Patients in Group 1 had significantly lower levels of serum vitamin D, calcium, and lymphocytes, as well as higher fibrinogen, d-dimer, and C-reactive protein (CRP) levels compared with those in Group 2 (p < 0.001). In addition, they had a significantly higher dry cough, fever, chest radiographic findings, respiratory rate, and longer hospital length of stay than patients in Group 2. Serum concentrations of vitamin D were positively correlated with levels of serum calcium, lymphocytes, and neutrophils but negatively correlated with CRP, fibrinogen, and d-dimer values. Furthermore, patients with moderate or severe courses of COVID-19 had significantly higher inflammatory markers (CRP, d-dimer, and fibrinogen), as well as lower levels of serum calcium, vitamin D, lymphocytes, and neutrophils than those with mild COVID-19 (p < 0.001). In the multivariate analysis, fibrinogen level on admission was detected as the independent predictor of severe COVD-19 (odds ratio = 1.06, 95% confidence interval: 1.03-1.09; p < 0.001).
Conclusion:
This study indicated associations between the severity of COVID-19, serum vitamin D concentrations, and some inflammatory markers in pediatric COVID-19 patients.
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