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Effect of COVID-19 Disease on Serum Vitamin D Status in Children with Asthma-A Retrospective Study
Jaqueline Abdul-Razzak1,2, Mihaela Ionescu3, Radu Diaconu2
1Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Insights
Children with asthma experiencing respiratory infections, including COVID-19, have lower vitamin D levels. This is linked to worse asthma control and increased airway inflammation, highlighting vitamin D's role in infection response.
Area of Science:
- Pediatric Pulmonology
- Nutritional Immunology
- Infectious Diseases
Background:
- Vitamin D deficiency is associated with increased risk of respiratory infections and asthma exacerbations in children.
- The impact of SARS-CoV-2 and other acute respiratory infections (ARIs) on vitamin D levels and lung function in pediatric asthma is not fully understood.
Purpose of the Study:
- To evaluate changes in serum vitamin D concentrations in children with asthma following SARS-CoV-2 or other ARIs.
- To examine the relationship between vitamin D levels, clinical symptoms, and paraclinical results indicative of lung function in pediatric asthma patients post-infection.
Main Methods:
- Retrospective study of 145 children with asthma.
- Data collected included demographics, serum vitamin D, GINA asthma control, FeNO, pulmonary function tests, allergies, and exacerbations.
- Children were grouped based on the presence or absence of SARS-CoV-2/ARIs; statistical analysis performed using SPSS.
Main Results:
- Children with SARS-CoV-2/ARIs (n=93) had significantly lower median serum vitamin D levels compared to those without (n=52).
- Lower vitamin D levels correlated with variable airflow limitation and partially controlled asthma.
- Decreased vitamin D was significantly associated with increased FeNO (airway inflammation) in children with asthma and COVID-19, and in the overall study group.
Conclusions:
- Pediatric asthma patients with SARS-CoV-2/ARIs exhibit significantly reduced serum vitamin D.
- Lower vitamin D levels are linked to increased airflow limitation, poorer asthma control, and heightened airway inflammation.
- Vitamin D may play a crucial role in modulating asthma severity and the immune response to respiratory infections in children.
Abstract:
Background/Objectives: Vitamin D is known to decrease the risk of contracting respiratory infections and developing exacerbations for children with asthma. This research evaluates the alterations in serum vitamin D concentrations and examines lung function in children with asthma, as indicated by clinical symptoms and paraclinical results, after experiencing SARS-CoV-2 infection or other acute respiratory infections. Material and Method: This retrospective study included 145 children with asthma. For each patient, the following variables were acquired: demographic data, serum vitamin D levels, GINA asthma control levels, the fraction of exhaled nitric oxide (FeNO), pulmonary function tests parameters, data related to allergies, and the presence of exacerbations. Children were divided into two groups, according to the presence or absence of SARS-CoV-2 infection or other acute respiratory infections. Variables were statistically processed in SPSS. Results: In total, 93 children with asthma with SARS-CoV-2 infection or other acute respiratory infections and 52 children with asthma without SARS-CoV-2 infection or other acute respiratory infections were included in the study. Median serum vitamin D values were statistically significantly lower in children with a variable airflow limitation, compared to children with normal values (p = 0.004), as well as for children with partially controlled asthma, relative to children with well controlled asthma (p < 0.0005). Similarly, children with acute respiratory infections/COVID-19 disease had lower median values of serum vitamin D, compared to children without acute respiratory infections/COVID-19 disease (p < 0.0005). A decrease in serum vitamin D value was statistically significantly associated with an increase in FeNO value for children with asthma with COVID-19 disease (p = 0.027), as well as for the entire study group (p < 0.0005). Conclusions: Children with asthma who had acute respiratory infections, including COVID-19 disease, showed considerably reduced serum vitamin D levels and were linked to more significant airflow limitation, reduced asthma control and elevated airway inflammation, suggesting its potential role in influencing asthma severity and infection response.
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